Why IS my party leader scared to tell you the truth about the crisis-hit NHS?
EACH winter, the NHS crisis takes the same form: A&E departments across the country overwhelmed, the target for patients to be seen within four hours broken, operations cancelled.
Add to that reports of ambulances being unable to deliver their charges on arrival into casualty departments, and you have the usual sad winter litany of a health service at bay.
Each time, doctors and nurses struggle through. But each time, it takes us one step closer to a nightmare scenario – the collapse of perhaps the nation’s most cherished institution.
I may be accused of scaremongering, of exaggerating the threat to our universal, freeat-the-point-of-use health service. But in my view, nothing short of a revolution is required – a radical rescue plan to save the NHS from financial meltdown and to take it out of day-today party political control.
Sadly, I see no such plan from either the Tories under David Cameron or, I regret to say, my own party under Ed Miliband.
Instead, where we should see far-sighted vision, we are getting sticking plasters and shortterm palliatives to hide the problem until post-Election.
It’s as if our political leaders are too scared to tell the truth or, to put it another way, the doctor is too timid to tell the patient how bad their condition really is. So let me.
The health service is facing potentially its worst financial crisis in its 66-year history.
By 2020, on current plans, there will be a £30billion shortfall in its budget. The figure is already known. It has been flagged up now for months.
The causes are also well known. We’re an ageing population. While longer lifespans are one of the blessings of the age, they come at huge cost as older people use the health service more.
Also, the advances in medicine now being realised come at a huge cost. What was untreatable 40 years ago is now curable – but at a price. Less exciting, but just as important in budget terms, inflationary pressures always hit the NHS harder than much of the rest of the public sector. So while the Coalition has in principle protected health service spending and ring-fenced it from wider cutbacks, in real terms, its budget has been cut.
If all that wasn’t bad enough, we know that even after five years of austerity, further massive public spending cutbacks await whoever holds the keys to No 10 Downing Street after the General Election in May.
Therefore, without radical treatment, the prospects for the NHS are not just bleak, they are catastrophic. If nothing is done, within a few short years, the health service as we know it will have ceased to exist.
A&E departments will not just be overstretched, they will be unrecognisable. Instead of queues reaching to the waiting room doors, they will be stretching into the streets. Waiting lists will grow like Topsy and slashing the number of operations will be standard.
GP services will have to be drastically reduced as their budgets are slashed. A growing number of hospitals will go bankrupt and staff, dedicated and highly trained, laid off.
In other hospitals, regimes reminiscent of the disgraceful events in Mid Staffordshire will be in place, with patients left unnursed and unfed for long periods of time.
Such a scenario, one would have thought, would now be igniting the most intense debate between the Tory and Labour parties on how this catastrophe can be averted. But that thought would be wrong. Both major parties hope to get past May 7 without any serious debate with you, the electorate, on the existential crisis facing our NHS. If they are planning to avert this national calamity, it is being kept well under wraps.
In my own party’s case, time is running out as far as our traditional polling advantage on the NHS is concerned. One poll shows that David Cameron is more trusted than Ed Miliband on safeguarding the NHS.
Labour is now promising to publish radical plans to put the NHS on a financially sustainable footing. But so far, the party shows no signs of facing up to the scale of the challenge.
They intend to use money from a mansion tax, a crackdown on hedge funds and a levy on tobacco firms but this will simply not cover the £30billion deficit.
QUITE simply, the way we fund the NHS needs to be revolutionised – starting with a serious increase in National Insurance contributions that will raise a huge proportion of the necessary cash. I suspect both parties know such a genuinely radical move is necessary; they are just scared of being the first to say so.
But why? Poll after poll says the electorate is up for contributing more money, not only to stave off a health catastrophe, but to help to reshape the NHS to match their needs in the 21st Century. In fact, one survey showed that 60 per cent of voters were happy to pay more. That is why I propose that the extra cash the NHS desperately needs should be levied through a reformed NI system.
A rise of one per cent in NI contributions will raise £15billion over the next five years – half the impending health service deficit. But to save the NHS, we have to go further.
We should do nothing short of split off the health service from day-to-day political control to create an NHS Mk II – one truly owned and run by the people through a new national mutual, of which we will all be members.
We would elect our own trustees and they would be responsible for spending the NHS budget, pushing through reforms and settling with us what future contributions should be.
Pushing through reforms would be a key part of that new NHS mutual’s responsibilities and would deliver the productivity increases needed to meet the other half of the NHS deficit.
And those reforms are crucial as the new NHS must realise more quickly than the old version that it cannot always expect taxpayers to stump up any money for any bill presented.
It must also recognise that it can no longer deliver a worldclass service through institutions devised by the Victorians for an age when there were few treatments and even fewer drugs. This age of the dominance of hospitals has to end.
Many health staff are better located in easy-to-access health centres where treatments can take place at most within days.
Likewise, any NHS true to its first principles of treatment free at the point of use will follow the lead of the last Labour Government and use the private sector to gain a better deal for us as patients and taxpayers.
So, a revolutionised NHS outside day-to-day control of politicians and free to deliver the best treatment in the world for decades to come. Unthinkable? Too radical even to contemplate?
Tell that to the people who did the unthinkable and set up the NHS in 1948.