Bernard Ingham: NHS desperately needs a dose of political honesty
We brothers, now in our ‘80s, are testimony to NHS care. My wife and I, now needing community as well as medical attention, are among the vast majority who think the NHS is doing a good job.
The man from Mars would not get that impression reading the public prints, even if he allowed for the British propensity for running itself down – bad news continues to outscore the good, aided by the activities of shameless ambulance-chasing lawyers.
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Hide AdDay after day, we have the steady drip of criticism – often from people seeking to get their hands deeper into the public purse – about, for example, poor diagnosis, notably of cancer and dementia, abuse of elderly and vulnerable patients, the midwifery service and ambulance queues at hospital A&E units.
Now, on top of several hospital scandals, comes a severe condemnation of the Labour-run Welsh NHS, with patients reported to be fleeing to England for treatment or paying for it to avoid queuing.
The only conclusion we can draw from all this is that, while the NHS continues after 66 years to give general satisfaction, all is not well with it. It would be surprising if it were.
For too long it has been treated as a sacred cow – all of which eventually die – instead of a precious piece of machinery built to last but in constant need of testing, repair and renewal.
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Hide AdThis leads to another conclusion: all the usually politically-inspired “overhauls” and tinkering over the years have not been notably successful.
Meanwhile, the politicians, with six months to go to a general election, are holding a public auction for votes by chucking money at the NHS. This is frankly irresponsible on several counts.
First, there is no spare cash. No political party will have freedom of manoeuvre until the outstanding £100bn deficit has been eliminated. Chancellor George Osborne is having the devil of a job cutting public borrowing this year.
Second, everyone knows that demand for a service that is free at the point of delivery is never going to shrink – and certainly not with an ageing population, the almost exponential growth of medical technology and the pressures of uncontrolled immigration and health tourism. Why, within a few years of the NHS’s launch, Bevan was moaning about “the cascade of pills down the public throat”.
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Hide AdThird, a public auction is irresponsible when we have been debating these issues for years, know that provision for health care could eventually bankrupt the nation and that sooner or later we shall have to get many more bangs for our health bucks whichever party is in office.
In an rational world, the next election would go to the party with a convincing plan for performing NHS wonders with a fixed budget, especially as such a party would almost by definition be financially responsible. I have not seen even the hint of that.
This being so, I offer my layman’s view of what needs to be done.
If GPs and A&E units are the front line of the NHS, they are crucial to securing greater efficiency.
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Hide AdWe can’t have A&Es run off their feet while GPs, courtesy of Gordon Brown, put them up in the evenings and weekends.
We cannot continue to ignore the cost of lifestyle diseases caused, for example, by smoking, drinking and obesity any more than we can afford cosmetic operations to order on the NHS or its exploitation by foreigners and Friday night drunks. We need clear limits on what is “free”.
Then, since the NHS is in the business of caring, its management (not politicians) must look at attitudes, what is a manageable entity and what stands in the way of necessary change.
The private health sector is there to be exploited, not excluded because the unions might lose members.
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Hide AdI would add that NHS management, like that in the private sector, must realise that lavishing riches on themselves while front line pay is held down is destroying morale.
Only managers can restore the pride we feel in the NHS. With clever use of high technology and public and private resources, they can deliver more healing at less cost.
That inevitably is their task for the foreseeable future. Maybe it’s all in the mind.