Which party would do least damage to the NHS? The Coalition has increased NHS funding by 0.9% a year in the last five years, when the previous average increase has been 4% a year. Unsurprisingly, given the cuts in social care, many services are now hideously overstretched. In England 3 million people are now waiting to see a specialist with 250,000 more patients needing treatment who are not on the official waiting list. But had Labour won in 2011, it seems unlikely they would have been able to fund the NHS any more generously given the economic circumstances.
The Coalition’s biggest error has been the Health and Social Care Act, not just because it destroyed trust in breaking a key pledge not to have a massive structural reorganisation of the NHS, but because it has lead to a rapid expansion of the role of commercial companies in the NHS. Outsourcing is rarely the answer to anything, and the record in the NHS thus far is woeful. Many of Labour’s early PFI schemes for hospital development have been eye-wateringly expensive, with some trusts lumbered with payback fees more than ten times the original build cost. The withdrawal of NHS services provided by Circle, Serco, UnitedHealth and other private companies when they have been unable to make a profit has not stopped vital clinical services being put out to tender. Excellent, well-established NHS sexual health services have lost out to private contractors and Virgin Care has just won a £280 million contract to provide care for the elderly and those with long term conditions in East Staffordshire (Eye last), with £1.2 billion of specialist cancer care also up for grabs.
The danger for patients of outsourcing the NHS is not just that services may disappear if they can’t be made to be profitable, but also that services may not be of a high standard if staff don’t want to work for private providers. Nottingham University Hospitals NHS Trust has had to stop its acute adult dermatology service after senior consultants left when the contract was awarded to the Circle Partnership. The consultants had made it very clear well in advance that they would not work for a private company and with so many consultant dermatology jobs in the NHS remaining unfilled, they will find it easy to secure work elsewhere.
This would be excellent ammunition for Labour, had they not started it all. And the reopening of GMC case into Dame Barbara Hakin is a timely reminder of the idiotic top-down ‘targets uber alles’ enforcement that existed under Labour (as well as the incompetent tardiness of the GMC). MD and Eye journalist Andrew Bousfield referred Dr Hakin to the GMC in in July 2012 to investigate if she put patients at risk in her role as CEO of the former East Midlands Strategic Health Authority by insisting non urgent targets be met when Gary Walker, the then chief executive of United Lincolnshire Healthcare Trust, told her that the hospital was so overcrowded that it would not be safe to adopt such an approach.
In October 2014 – 27 months after the original referral – the GMC decided not to take any action against Dr Hakin. MD and Mr Bousfield were so appalled at the failure of the GMC to grasp the basics of patient safety, particularly in the light of the disastrous effects that the mandatory target culture, over-crowding and under-staffing had on Mid Staffordshire hospital – that we mounted a detailed challenge of the GMC decision on January 6, 2014. On April 1 (sic) 2015 – nearly 3 years after the original referral – we were informed that the GMC will be undertaking a review of the ‘patient safety’ aspects of the original complaint because the original review “may have been materially flawed” and that a “review is necessary for the protection of the public or otherwise necessary in the public interest.” MD is almost certain that the GMC will take no action against Dr Hakin who says she was following the orders of her chief executive (Sir David Nicholson) and the Labour government. But whoever is in charge of the NHS on May 10 needs a far more intelligent, compassionate, honest and collaborative approach to patient safety – and a change in culture that is entirely alien to adversarial party politics. The omens are not good.
The most sensible, sustainable evidence-based NHS policy is from the National Health Action Party
MD’s best-selling book – ‘Staying Alive – How to Get the Best from the NHS’ is available here