Tuesday, 22 September 2015

The NHS: as safe as ever in Tory hands

Labour lost the UK general election on 7 May, in part at least because it kept harping on about issues that were beginning to bore the electorate.

It constantly denounced zero-hour contracts, for instance, which tie up employees but not their employers: the former can’t take other work, but the latter aren’t obliged to offer them any work, or any pay, on any particular day. Many voters, including some on zero-hour contracts who found them attractive, but mostly those who have never experienced such arrangements, started to find it tedious that Labour kept denouncing them.

Even worse, though, was the NHS. The Labour message was clear. Let the Tories back and you may lose the National Health Service. This may astonish some in the United States, where the NHS has a bleak reputation, but on this side of the pond, a great many people value that institution highly and would like to be able to rely on its being there, in the event they ever need it.

On the other hand, Labour kept repeating the dire warnings and it began to turn voters off. “Yes, yes,” they seemed to be responding, “you’ve said all that before. How about changing the record?”

The previous government, which was a coalition between the Conservatives and the Liberal Democrats, claimed to be protecting the NHS. Its funding, it claimed, would be protected. When other budgets were cut, NHS finance would remain sacrosanct, and even grow.

The Labour Party questioned this claim. First of all, while it was true that funding was increasing, it was not increasing in line with the specific inflation of the healthcare sector, where the availability of increasingly effective but increasingly expensive treatments puts budgets under pressure. Nor, and this was a much more significant problem, was it increasing in line with increasing demand for healthcare: an ageing population, which is additionally beset by growing numbers of chronic conditions such as diabetes, heart disease and obesity, is generating constantly growing demand for care, for diseases that start earlier and last longer than before.

Worst of all though, and above all dangerously hidden, is the consequence of what on the surface seems to be a positive idea. There is increasing pressure for treatment to take place outside the hospital environment. Care in hospitals tends to be far more expensive, and it’s an environment which is often demoralising to patients and even unsafe – they’re surrounded by other sick people, after all – and it makes sense to treat in the community as far as is possible.

Unfortunately, a great deal of community care takes the form of social care, for which the NHS is not responsible. It’s handled by local government – and that sector has absolutely not had its budgets protected. So to maintain the kinds of levels of social care the new initiatives require often means calling on the NHS to fund an increasing proportion of it. Those outflows from the NHS are certainly not covered by the allegedly protected funding arrangements.

This week, Norman Lamb, Liberal Democrat Member of Parliament, came out with a dramatic statement that the NHS would crash within two years without a massive injection of funds from the government. Interestingly, Lamb is well-placed to make that judgement. He served as a minister of health in the last government. So he was part of the team that set the NHS on its downward spiral.

It’s great to have his warning now, though it might have been more helpful if he and his colleagues had pulled out of the government and brought it down while there was still time to do so. But, I guess, there was no other way they were likely to get ministerial portfolios, and that matters too. Not as much, to me, as saving the NHS, but perhaps as much to them.

Addenbrooke's (Cambridge University Hospital)
Now we learn that Addenbrooke’s hospital in Cambridge, a world class centre for medical research as well as acute treatment, is being put into what are known as special measures. It’s failing to maintain proper standards of safety. It’s the 26th NHS Trust in special measures, out of 160 in England. One in six.

One of the reasons care at Addenbrooke’s isn’t safe is that it can’t afford to maintain adequate staffing levels on wards. Which is perhaps not surprising, since it’s losing £1.2m a week. But let’s remember the Tories are maintaining funding to the NHS, which is safe in their hands.

It might be time for the people who were so switched off by talk of the NHS during the election campaign to see if they can drum a little interest in the subject again. If Norman Lamb is even partly right, they may not have much time to wait.

And – who knows? – perhaps after that they might find it in themselves not to regard zero-hour contracts as quite as monotonous as they thought either.

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