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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