Is section 119 wrong…

Having been submerged under Syria, floods and Sochi, Healthcare has emerged again like spring daffodils to be the talk of the news. Dorrell and Burnham slogged it out yesterday on Radio 4’s Today over section 119 and the vote was mentioned again today; genetic testing for Alzheimer’s was kicked back into touch (fabulous England win on Sunday by the way) as we were told not get excited by the latest research, and written press revealed (again) the black market growth in kidney sales.

Back to section 119 – the Commons vote on this section of the Care Bill today. I wonder whether reason and logic will prevail and we’ll have a frank debate about delivering quality and safe services from a NATIONAL Health Service, or whether localism wins (read local votes) and MPs default to protecting their ‘Neighbourhood’ Health Service as symbolised by bricks and mortar.

OK, I don’t wonder, we won’t. Because although section 119 will be rejected by those who say they will defend their local hospital to their dying day (which will probably be in the said hospital) and it must not be cut (and privatised, as if the two went together), the real reason to reject section 119 is because it represents another failure of communication and vision, of putting the stick in place before describing to the public what choices are before the NHS.

Maybe I am being idealistic, naïve, ignorant even, but we all want the same thing: a sustainable, safe NHS fit for the 21st century. It doesn’t take a genius to realise that a National service means that health economies are interconnected, but nor does it defy reason that people object when their local hospital is put in jeopardy by the failure of surrounding organisations, as happened in Lewisham.

We need national, political involvement when it comes to strategic planning of the expensive, specialised services; we need local engagement when it comes to improving the efficiency of neighbourhood services. The thinking behind Foundation Trusts public engagement was good, but unfortunately this cemented the NHS as a National Hospital Service as no one had the vision to describe where care should be best delivered in the future.

The Secretary of State is now looking for the power to make reconfiguration happen, but just like the recent care.data debacle, which crashed because of the total lack of narrative and disregard for public understanding, section 119 is putting the cart before the horse. The public deserve better. They deserve considered debate and consultation on the future of the NHS as a whole. A serious, large scale initiative to communicate the issues needs to be mapped and rolled out. It’s urgent but it mustn’t be rushed. That there is no one-size fits all solution must be clear. That to improve quality and safety, services mustn’t be cut but delivered differently. That there isn’t enough money to deliver everything, let alone everything everywhere must be broached. Anything else will simply result in more ‘save the NHS’ campaigns with no one working from the facts.

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About Julia Manning

Julia Manning is a social entrepreneur, writer, campaigner and commentator. She is based in London and is the founder and Chief Executive of 2020health, an independent, social enterprise Think Tank whose aim is to Make Health Personal. Through networking, technology, research, relationships and campaigning 2020health has influenced opinion and action in fields as diverse as bioethics, alcohol, emerging technologies, fraud, education, consumer technology and vaccination. Julia studied visual science at City University and became a member of the College of Optometrists in 1991. Her career has included being a visiting lecturer at City University, a visiting clinician at the Royal Free Hospital, working with south London Primary Care Trusts and as a Director of the UK Institute of Optometry. She specialised in diabetes (University of Warwick Certificate in Diabetic Care) and founded Julia Manning Eyecare in 2004, a home and prison visiting practice for people with mental and physical disabilities using the latest digital technology, which she sold to Healthcall (now part of Specsavers) in 2009. Experiences of working in the NHS, contributing to policy development, raising two children in the inner-city and standing in the General Election in Bristol in 2005 led to Julia forming 2020health at the end of 2006. Julia is a regular guest on TV and radio shows such as BBC News, ITV’s Daybreak/ GMB, Channel 5 News, BBC 1′s The Big Questions, BBC Radio, LBC and has taken part in debates and contributed to BBC’s Newsnight, Panorama, You and Yours and ITV’s The Week. She is mum to a rugby-mad son, a daughter passionate about Shakespeare, and wife of a comprehensive school assistant head-teacher. She loves gardening, ballet, Zimbabwe, her Westies Skye and Angus, is an honorary research associate at UCL and a Fellow of the RSA.
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