THE NHS: AN OBITUARY
Long before the concrete of history is dry,
there’s never a shortage of people eager
to stand on it in order to leave their mark.
Such a person is fifty-eight-year-old Patricia
Hewitt, Secretary of State for Health from
May 2005 and former pupil of the Canberra
Grammar School for Girls. Her smile, no doubt
a defence mechanism, is contagious – like
Spanish flu or the bubonic plague, for example.
[M]eet it is I set it down,
That one may smile, and smile,
and be a villain;
At least I’m sure it may be so
in Britain¹ |
Does the reader
detect
traces of venom – say, of paraquat
or strychnine
or even of ratsbane? Yes, I admit that
my
body’s awash with poisons. My local
hospital’s
been obliged to close its toxicology
department,
so I can do nothing about it.
Let’s return to
our Secretary
of State. She emigrated from Australia
to
the United Kingdom in the 60s, studying
English
literature at Newnham College, Cambridge
– surely an ideal preparation for the
root
and branch reformation of a health
service;
from there she went on to Nuffield
College,
Oxford, where she obtained two master’s
degrees.²
After leaving university she worked
for Age Concern and Liberty and was
subsequently
Neil Kinnock’s press and broadcasting
officer
from 1983 to 1989. During the following
eight
years she worked in two think tanks
before
being elected in 1997 to Leicester
West.
Married, Ms Hewitt has two children
and a
burning ambition to leave her imprint
on
the NHS.
Despite our Harold
Shipmans,
our Bristols and our adequate share
of incompetent
or skiving doctors, the NHS has struggled
since its inception in 1948 to provide
us
with a by and large reliable, caring
service
that has endeared it to Britons of
all political
shades. Half a century later this heroic
shambles of a system let out a warning
death
rattle when Alan Milburn, Secretary
of State
at one remove from Patricia Hewitt,
made
a speech in the Commons that’s now
referred
to as Shifting the Balance of Power:
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Today I want to argue this shift can only
happen if the centre of gravity
within the
health service itself moves from
Whitehall
to the NHS frontline.
|
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The NHS today stands at a crossroads. After
decades of neglect the NHS is
finally getting
the investment it needs.
|
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[. . .] the time has come to liberate the
NHS frontline.
To expand staff numbers and to
value staff
more [. . .]
To realise the immense potential of our million,
brilliant staff.
And above all else, now to shift
the balance
of power
from Whitehall to the NHS frontline.
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In 2002, as a direct
consequence of the programme outlined in
Milburn’s speech, the Health Authorities
were abolished and Primary Care Trusts or
PCTs created by the incumbent Secretary of
State; by the end of 2005 all patients were
offered a choice of four to five hospitals
as well as the time for their treatment.
It all seemed as if heaven were descending
on earth and that the NHS would truly be
brought round. Not even the clinicians around
the bedside knew that NOT TO BE RESUSCITATED
had been written in her notes.
First signs of approaching
extinction came when the tariff for orthopaedic
work wasn’t set high enough to reimburse
hospitals, some of which were forced to close
these units: and if you take out one card
the whole A & E pack tumbles to a floor
contaminated with MSE.
As politicians gathered
round the corpse, PCTs were beginning to
direct GPs to cut their hospital referrals
by as much as 25% in order to achieve economies.
Seven thousand job cuts have already been
announced, and the figure’s expected to climb
to thirteen thousand – some say as high as
twenty.
Already four thousand beds short and a further
two thousand five hundred threatened with
closure, ministers are bringing back old
cottage hospitals from the brink of death
to fill the bed need while sixty hospitals
are on the point of closing their doors.
So this is shifting the balance of power?
Milburn’s rallying words echo through the
months:
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[. . .] the time has come to liberate the
NHS frontline.
To expand staff numbers and to
value staff
more [. . .]
To realise the immense potential
of our million,
brilliant staff.
|
Everywhere opinion
hardens
against this Alice in Wonderland expansion.
Listen to Lib Dem John Hemming speaking
in
the debate of 20 March 2006:
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We are caught up in a horrible
administrative
mess. The Prime Minister said
that every
time he reformed something, he
wished later
that he had gone a bit further.
When everything
in the health service settles
down, we will
look back and think, ‘No, we
did that a little
too fast.’ There is far too much
change.
The well organised managers who
can add up
are reeling with the pace of
change, and
we get more and more change.
|
or to Labour MP Paul Farelly in the same
debate:
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Even if eyes have been taken off the ball—amid
all the change in my area, they
certainly
have—what is important now is
that the response
to tackle the deficits must not
veer out
of control.
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And is it out of control?
When
you consider our Prime Minister’s farsightedness
is that of a stag beetle with 12-diopter
myopia it’s difficult to reach any
other
conclusion: the NHS has slipped over
the
edge and is at present hurtling to
certain
annihilation. Nothing triggers Blair’s
enthusiasm
as much as an almost unanimous national
opposition:
you have only to think of Iraq and
its disastrous
consequences. He will destroy Bevan’s
legacy
if it kills him and is adamantly certain
that we’ll thank him for it in the
end.
¹Denmark in Shakespeare’s original Hamlet,
I, v, 107-109
²I cannot yet discover in which
subject(s).
|
Evans Experientialism 
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