It’s election time – and that means that (only once in every
five years) the politicians are making us promises.
Once upon a time they used to make ludicrous promises that
were never kept. Nowadays they don’t promise very much at all.
I suppose it’s time to compare what’s on offer.
The first problem is that both Labour and the Tories have
already promised that they are going to cut public debt while at the same time
they have guaranteed that taxes aren’t going to go up.
Obviously that isn’t going to work out; services will have to
be cut.
Basically, someone is going to have to bite the bullet and
increase taxes for those who are best able to afford to pay. Until then we aren’t
going to get anywhere.
So here are the promises.
The Labour Party is committed to;
“An NHS with the time to care”
Certainly, there has been a problem with staff being alienated
and undervalued at the lower end of the pay scales.
The promises?
“We will build an NHS with the time to care: 20,000 more
nurses and 8000 more G.P’s. We will join up services from home to hospital, and
guarantee GP appointments within 48 hours and cancer tests within one week.”
Well, these limited promises are easily affordable: they just
don’t go far enough.
There is a national shortage of GP’s already, we need a
national programme to train new Doctors and we need to ensure that they stay
within the NHS when they qualify.
The ‘walk-in centre’s’ created by the last Labour government
were a runaway success – hated by the profession and (unfortunately) based on
private, profit making suppliers. We need a new tier of large NHS owned polyclinic
walk in centres; local and staffed by Doctors and Nurses, offering a full range
of preventative treatments including chiropody etc.
The increase in Nurses is welcome – most of the Accident and
Emergency problems in Hospitals are caused by a lack of beds on the wards which
means a queue for treatment.
More Nurses = more beds = better outcomes.
The problem is that with shift patterns, training and
sickness; 20,000 more Nurses is only equivalent to about 4000 Nurses working at
any one time.
At 8 beds to one nurse that means about 32000 beds nationally.
Unfortunately, the real cost of beds is much higher – the dirty
work is done by a small army of care assistants and they also cost money too.
We also have a shortage of trained Nurses to deal with.
Cancer tests? We need more screening to bring us up to
European and American survival rates.
My verdict?
It’s OK but it’s not enough – we need a lot more resources
and more ambitious plans; to start with lower level staff have been on a pay
freeze for far too long.
The Conservatives.
So far, the only pledge has been 24 hour hospital treatment
by 2020.
It’s a very clear pledge and an important one – mortality rates
and outcomes get much worse at the weekends when consultants are at home or
treating private patients leaving trainee Doctors are left to fend for
themselves.
Problem?
The Tories aren’t telling us what it would cost, where the
Doctors are coming from and how they are going to pay for it.
The BMA has calculated a cost of £8 Billion – other commentators
believe it will be much more.
We currently have 5 day week working except for Accident and
Emergency; at a simplistic level you can add two sevenths to the wages bill.
Actually, with diagnostics and consumables it would be a lot
more.
And it probably isn’t what we need.
Right now, no one needs their planned operation done at the
weekend. No one needs a routine appointment then either.
This is all about Emergency medicine.
What’s needed is a properly staffed A and E (including
consultants) 7 days a week. We need to take Major Trauma, Stroke and Cardiac
units away from local hospitals and centralise them in regional units large
enough to support 7 day week working at all levels and able to provide all
staff with a proper work life balance.
The London experience has shown that closing stroke units and
centralising them has saved lives and improved outcomes. More skilled,
specialised staff in centralised units creates a collegiate atmosphere with cover
for time off.
Everyone benefits.
A and E’s don’t work if they can’t get the scans or the blood
test done; we need round the clock diagnostics too.
This is a right wing agenda – a simplistic campaign from The
Daily Mail and The Telegraph over the last few years. Broadly it’s unachievable
without massive privatisation and a further damaging NHS reorganisation which
no one needs.
The past record of the parties.
The Conservatives
Over the last 5 years, the Tories increased health spending
but did not keep up with developments in new medicines and treatments, they
froze wages and allowed a general deterioration in services.
The NHS is now running up a deficit of at least £800 million
a year which is unsustainable.
Morale, premises and patient outcomes are all deteriorating.
The NHS is in a worse place than it has been for 20 years.
On the positive side, Jeremy Hunt reacted to health scandals
by improving the investigation and regulation of the medical profession to try
and reduce the problems in future; it looks like it may be working.
Labour.
The 1997/2010 governments inherited an NHS which had been
underfunded and neglected by the previous Tory governments. It was in a dangerous
condition.
It’s fair to say that they threw money at it – they increased
the pay of Doctors dramatically without getting anything in return. The
notorious contracts are still being paid for.
Beds continued to be scrapped, privatisation was brought in
and they left all control and regulation up to the medical profession.
Serious health scandals and patient deaths and mistreatment resulted.
What do I want?
An end to the pay freeze.
An end to privatisation for profit.
A guaranteed, above inflation annual increase in NHS
spending.
Walk in polyclinics within easy reach of all, open 14 hours a
day.
Local A and E’s with 24 hour cover.
Centralised emergency units for Major Trauma, Stroke and
Cardiac treatment.
Early screening for cancers.
Am I going to get any of that?
Eh no.
My backing goes to Labour but we need to pressure them into
some real commitments during the campaign.
Neil Harris
(a don’t stop till you drop production)
