Monday, 30 March 2015

Election review.

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.


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.


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)

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