Well, probably not. All the parties involved have expressed the intention to 'ringfence' front line services, without explaining in any detail what they propose to do. All state their aim of efficiency, as a means to reduce the cost of the NHS, now in excess of £100bn a year. As virtually no-one argues against the demise of hordes of managers, which seems to be the route to escape from perdition, the actual solution has assumed the role of an 'elephant in the room'. But will it be so; I think not.
If we are to use the example of history, as a guide for either of the 'mainstream' political parties efficiencies in health care, we would be sadly deluded, because it has been a pawn in the game of one-upmanship for successive Governments since 1948. The 'Thatcher' years spawned a whole new breed of bureaucracy dedicated to billing various sections of the care chain for its services to each other. And of course the invention of PFI and the concept of Private Healthcare to contract to the NHS. Most of this vast 'iceberg' of beancounters remains still, busily engaged in dubious duties, invented to avoid the loss of empires built by powerful managers whose tenure became enshrined almost in statute.
The New Labour agenda was to improve from this low point, to give us all healthcare, unfettered by cost, but as it incorporated the worst of the Tories errors, so much continued as before. But, now the Trust and worse, the Foundation Trust came into being. New Labour believed it could bring about a new tomorrow by codifying responsibilities in the form of protocols, contracts, and regulations to govern care and charter compassion. All it achieved was the stifling of freedoms, the loss of integrity and worst the inability of patients to be seen as people, only a group of symptoms to be treated. It fed into the ego of the Consultants and later the GP's, to construct lucrative arrangements whereby they could get more for doing less. We have ended up with the largest employer in Europe, possibly the World to achieve a system that is incapable of providing out of hours care at Primary or Hospital level, with Nurses who no longer provide front line care to patients, Junior Doctors being given responsibilities far above their pay scale or abilities and Managers salaries exceeding that of senior doctors.
Along the way they have meddled with the Complaints System on serial occasions, with no obvious improvement, failed to support the 'Whistleblowers' of the consummate failings in the system, stopped short in curtailing the appalling conduct of some doctors and denied justice and candour to the legion of aggrieved patients and their loved ones who have been harmed. Hospital beds have diminished in number, as have Nurses. ISTC's have been paid for work they have not done. Hospitals have been forced to build new facilities on contracts that tie up budgets for thirty years or more with nothing in assets at the end of the term. Mortgaging their futures for the political dogma of a despotic DofH
Society is now so cowed by the dogma of 'rights balanced by responsibilities' forged by the Blairites that it expects to be treated with disdain, even condescension as a matter of course. Our paucity of freedom is now so ingrained in the physche that we rarely rail against our regimentation to seek a personal role outwith that allowed to us by our job description or the petty rules of society in the 'brave new world' of New Labour. A hung Parliament will do little to foster any spirit of freedom, just even more consensus politics. The role of Politics itself hangs in the balance as those of us who seek to exercise integrity in our lives and in our Health care system stand and watch in horror, as two freshfaced young men and one old, one eyed fat bloke attempt to galvanise us into placing a cross on a piece of paper in their favour.
If one of them can offer me liberty and the chance to conduct my life without referring to a code of conduct and give credence to the claim of Doctors to 'do no harm' he will have my vote. I suspect however, as always, that I will have to choose the lesser of a number of evils
Hi Ernie
ReplyDeleteVery well said and far more eloquent than my words. Such a shame to look at our country and see what it has become. Also, scary to think what is to come in the future.Thanks for coming to my blog, always lovely to hear from you.
Keep up the good blogging and take care.
Nikki