Yet again a new government in the UK sets its eyes on the NHS.
Why is it that change in the NHS has to be dramatic and so, so, expensive both in financial and human terms?
Is it really the case that having had to concentrate on the cold war for all those years politicians have to justify their existence on what they perceive to be the “biggest challenge” facing the country?
If the NHS is such a sacred cow why do successive health ministers insist on trying to apply such radical surgery with no scientific base?
In their dealings with health care why do politicians seem to have to let dogma dominate their policy far more than they do in any other sector?
Why do they listen so little to the individuals at the sharp end?
Why do they introduce changes that are untried and untested?
Why is there no science in their actions?
I would suggest that in Health (and the country’s involvement in Afghanistan, but that’s way beyond my area of expertise) they take note of George Santayana’s words: “Those who cannot remember the past are condemned to repeat it.”
The BMJ recently asked a range of commentators from clinicians to academics to comment on the white paper on health Equity and excellence: liberating the NHS. Has the NHS become “a huge laboratory for some dodgy experiments,” in the words of one commentator; will the white paper divide the medical profession, as another claims; or will it simply empower doctors?
I’m grateful to my brother who is far more involved in both health & education than I for sending me this article and for pointing out what I agree is the best comment on the white paper. It’s by Jonathan Waxman, professor of oncology, Imperial College London who says:
The white paper is a finely written piece of prose redolent with allegory and metaphor that comes straight from a copywriter’s posterior. It proposes joined up, radical change to the way the NHS is managed and will empower the professionals . . . well some of them, the GPs. The trouble is that the white paper doesn’t seem to be written by an empowered joined up professional, and so lacks insight into the way the NHS works. It shows little understanding that health care is complex and doesn’t just involve one group of doctors, but many professional groups working together.
It seems that the notional cost of introducing these proposed changes is £1.7bn (2bn; $2.6bn). We know that government costing estimates are born in ya ya land, and usually out by a factor of 10 or 100, or whatever. We have seen the £15bn disaster of the NHS computer costs. The primary care trusts were introduced without trialling, and they have been a mess that costs £5bn a year to administer. The NHS is a £100bn business. What type of business introduces change of the order that the government is proposing without trialling? Don’t you think we should think about things before we leap off the white cliffs into the savage sea and on to the razor rocks?
The current white paper sets one group of health providers against another. It claims to be joined up, but it is divisive and potentially destructive. Please minister, think again.
Those words again:
The white paper is a finely written piece of prose redolent with allegory and metaphor that comes straight from a copywriter’s posterior.
……lacks insight into the way the NHS works. It shows little understanding that health care is complex and doesn’t just involve one group of doctors, but many professional groups working together.
Please minister, think again.
I couldn’t agree more.