Thursday 4 January 2018

NHS, Crisis(?) and Lord Kerslake

This week "crisis" measures have been announced to enable the National Health Service to cope with its  now annual near collapse..  The British Red Cross declared last year's situation a "humanitarian crisis" and this year's is said to be even worse.

The measures imposed to cope with the increasing number of "black alerts"  (hospitals admitting officially that they cannot cope with the demands on them) include:
  •  outpatient appointments cancelled
  • day surgery cancelled
  • non-urgent surgery planned for this month postponed to February (or later)
  • penalties for having mixed wards suspended.
The minister responsible, Health Secretary Jeremy Hunt, explained on BBC 2's Newsnight last night that there was no crisis because he had planned for the situation. He then went on to repeat his mantras of  how much more each year the government is spending on the NHS and how this is much more than Labour used to spend.

Yes, of course the government is spending more, but it doesn't need  a degree in statistics or economics to understand that, with a growing population, more effective but more expensive drugs and procedures, and most of us (including me) living longer than expected,  there needs to be even more expenditure.

I'm surprised that the resignation of Lord Kerslake as Chair of the King's College Hospital NHS Foundation Trust (part of London's NHS provision) last month has not received more, and more prolonged, publicity.  Kerslake resigned becasue, he said,  " hospitals are being asked to agree to meet unrealistically demanding savings targets."

This is not just any old resignation by the chair of a large organisation who is out of his depth.  In his former manifestation as Sir Bob, Lord Kerslake was head of the Home Civil Service and as such the UK's top Mandarin, most experienced and skilled bureaucrat, the Sir Humphrey of all Sir Humphreys.  If he says that the tasks to be performed cannot be achieved with the resources available then they can't.

For years we have been deluged with tales of bureaucratic waste, possible efficiency savings, and organisational reforms which will enable  enable our public services to do "more with less."  Kerslake's resignation reveals the falsity of these claims.

As usual the price to be paid for this mendacity is borne by the poorest in society.  Those who can afford it (including me, though I haven't done so yet) can evade the shortage by "going private."  It's those without spare resources who have no option but to suffer.

And in this case much of the  suffering will  be literal rather than figurative.  Elective surgery involves such things as hip and knee replacements.  I've not so far  had or needed either, but understand that those who do are in constant pain.

OK says our government, you can endure for another month so we can implement our ideological policies of cutting back the state.

There is absolutely no need for the sufferers to endure this.  For most of my working life the standard rate of income-tax was around 33%.  It is presently only  20%.  A relatively minor tax increase, intelligently implemented, will enable us to afford all the resources the NHS needs to maintain an acceptable standard.

Actually finding the money is probably the least of the problems.  Brexit has so unsettled many skilled  practitioners from other EU countries  presently working in the NHS that they are leaving in droves, and recruitment  from the EU is becoming increasingly difficult.  And it will take time to educate and train suitable replacements form within the UK.

 But that's two other stories.

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