Gerry Robinson was interesting last night on his Panorama programme about NHS reforms. Maybe it was because I was mending my son’s school trousers (after 2 days back) while I watched but I seem to have missed the moment where the factual analysis was dismissed and he turned from being a pragmatic businessman to an emotional supplicant. I fear, he whispered, that this could be the end of the NHS… without telling us why, on what basis. It was a real shame as his interviews with GPs were good and got the opportunities and worries of the Health Bill across well.
This Bill remains a huge challenge for the government, especially if the whiff of ‘the end of the NHS’ really takes off. The genuine tragedy would be that this is a false scent. Yes the process has been chaotic, the complexity unnecessary, the alienation astonishing, the distraction (from the essential task of more efficient spending) disabling, but the NHS has ALWAYS been an institution of partnership between the public and private sectors. There is no conflict, there is no threat. Consultants will go on working in NHS and their private practices. Industry will continue to supply the kit, the medicines, the beds and bed-pans that enable NHS employed nurses and self-employed GPs to do their work. Care will still be mostly free at the point of delivery in the way it is now.
What it will be the end of is treating the NHS budget as a bottomless pit. Doctors and nurses may want to work as if there was no end of supply, a daily supermarket sweep where they can ignore the checkout, but with government allocating nearly 25% of it’s Totally Managed Expenditure on health and social care already, this cannot go on. It is unfortunate that instead of having a national debate on healthcare spending and priorities, we have had the messy process of this Bill. But we are where we are. We need to get this Bill passed now, so that we can get on with the far more crucial tasks of improving efficiency, ensuring value for money, strategic planning, encouraging self-care, rooting out fraud, educating patients, incentivising healthy choices.
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