Nick Timothy:
The word “crisis” is all too readily attached to the NHS, especially at this time of year. With hospitals flooded by elderly flu victims and managers forced to cancel thousands of planned non-urgent operations, the service is once again said to be in crisis. The Labour Party and the health unions claim it is the worst ever, but their memories are wilfully short. Almost from its inception in July 1948, the NHS has been in financial difficulties. Within a few years, prescription charges and eye test fees were introduced to help relieve the pressure. Ever since, there have been sporadic emergencies to which successive governments have responded with structural reforms or more money or both.
Massive sums are spent on the NHS, yet the service continues to struggle; and as a growing population ages, medical technology advances and public expectations carry on rising, matters can only get worse without fundamental reform which politicians refuse to countenance.
The NHS’S untouchable nature is never more pronounced than at times like this. Jeremy Hunt, the Health Secretary, felt compelled to apologise to patients who have had operations cancelled and to the people working in the service. But neither he nor any other politician is prepared to question the way the NHS is run and funded. They all know that to do so is to invite political death. Even so radical a reformer as Margaret Thatcher dared only to tinker with the structure, introducing an internal market and management reforms but retaining the overriding principle that public healthcare should be “free to all at the point of use”.
Good ideas like the polyclinics proposed to the Blair government never saw the light of day, killed off by other sectional health interests. Often, the principal barriers to reform are the practitioners themselves – and especially the BMA, which was opposed to setting up the NHS in the first place.
Better systems might improve matters in hospitals; yet best practice is too rarely passed around. Hospitals are being used as care homes for the elderly and A&E departments are overwhelmed by patients who have given up on GP surgeries because they are not open when they need them. This perpetual crisis will not go away until the nettle of reform is grasped. As Nick Timothy suggests on this page, a Royal Commission may be the only way to address this issue and take it out of the political arena.