I RECALL many years ago the government of the day brought in “sweeping reforms” of the health service.
The upheaval was trumpeted as a means of bringing enterprising new people in to reinvigorate the moribund system, a bit like a blood transfusion for a patient in decline.
Being young and naïve I took all this at face value; so imagine my surprise when I rang up my local hospital, tentatively inquiring who would now be dealing with a particular function. I was put through to someone in a new office with a completely new job title – and found it was exactly the same person I had been dealing with before. Meet the new NHS manager, same as the old NHS manager, as The Who might almost have said.
But I wouldn’t want you to imagine these “NHS reforms” had no impact whatsoever. Far from it; they took up lots of time and effort, and I seem to think they cost many millions of our taxpayers’ pounds.
Did they do anything for patient care? Given that many people think things were better in the pre-reform days, when matrons apparently ran hospitals with a rod of iron, and the fact there have been numerous subsequent NHS “transformations”, I think it’s fair to say there may be an element of doubt.
So when the latest upheaval was announced I couldn’t help thinking: “Oh no, not again.” There’s nothing party-political about my view; if any of you are getting a sense a déjà vu here, I must confess I called on politicians to stop attempting major surgery on the health service during the time of the previous Labour administration. While I knew that plea would be in vain, I really had thought there was a chance the coalition might have so much more to worry about it wouldn’t embark on any more health adventures. Some hope.
I don’t actually believe the NHS should be left in a time warp; indeed, from what I hear some alterations being quietly made in such areas as hospital discharge procedures are really rather sensible.
But changes like that could be made with relatively little fuss, and without root-and-branch changes to NHS administration. Such low-key improvement would, however, create little in the way of either soundbites or boosts for the egos of politicians who think they have a miracle cure for the health service’s ills. So we have yet another massive set of reforms, which I believe will consume vast amounts of energy and cash that could have been put to more useful purposes.
In addition, the changes will create all sorts of upheaval for those working within the service, diverting them from carrying out their actual jobs of providing health care for the nation.
I’m not suggesting the existing system is perfect, but I do wonder how much difference it will make if, to take one strand of the proposed changes, we abolish primary care trusts and hand many of their powers to GP practices. Whoever makes the decisions will face the same desperate quandaries entailed in matching a finite budget to ever-increasing demands for treatments, and the same people, or people with the same skills, will be needed to administer the system whether they are employed by GP practices or primary care trusts – a bit like my hospital manager with the new title of so many years ago.
So I will make my plea again to the politicians; if you really want the NHS to be fit and healthy, forget the universal panaceas.
Deal with the worst problems, of course, but you can do that without shaking up the whole system. Give the patient a bit of TLC, but, most important of all, let those who work within it get on with their jobs for a while without massive interference. That’s my diagnosis, but I doubt my recovery regime will ever be put into practice.
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