The latest policy disaster currently affecting the NHS has put it into sharp focus - not only as institution but as saver of life and national treasure. It has also made me consider more deeply the unique position it occupies in our collective consciousness.
I can tell you a tale of its life saving accomplishments, of selfless nurses and committed doctors. Tales of compassion and hope, of the role it plays in the start of life and the dignity it provides at the end.
But, I can also tell you of the nurses with no time or emotion to spare, of dirty sheets and terrible food. Tales of despair and horror, of mistakes made and the loss of dignity at the end.
This is not unique, and I would imagine most of us have seen the NHS at something approaching its best and its worst. But if your anything like me that doesn’t stop you loving it, for all it can be and all it is, limitations and all. Don’t get me wrong I’m not a fundamentalist, I would like to see reform in some areas but I’m becoming increasingly convinced that politicians are not the correct people to drive that change.
As someone who has worked within the NHS I was always impressed that it worked at all, that it didn’t just all collapse under its own weight, like a patient on the gastric band waiting list.
So whilst the criticism of the NHS by the coalition and the plans to reform it didn’t come as a total shock, it certainly took me by surprise given that they didn’t give any warning like, I don’t know, actually putting it in a manifesto maybe? No, that would be too easy they must have said, people might not like that, you know what let’s just get elected then just change it all anyway.
Not long ago Andrew Lansley was lauded as a leader, someone who could drive change and modernise the NHS. The NHS was failing, unsustainable and stifled competition. It was too beauracratic, wasteful and led by the wrong people. GP’s are the people to lead the NHS given that they work on the frontline, let’s give them the money and let them spend it. Get rid of the PCT’s and save the nation a fortune.
What a difference a day makes (or several months) fast forward to the present and Lansley is political death and his reforms lie in tatters. Why? Because it doesn’t appear he did the thing that people usually do when they want to change something.
Ask the people who know about it, will be affected by it and care about it.
On that basis that’s everyone.
The NHS for me is not like other elements of government, its not transport or highways or overseas aid, it’s not trade and industry or even the military it occupies a different space altogether and one which people are far less likely to go quietly into the night when changes are proposed. We are all heavily invested in its past, present and future and we cannot allow it to be destroyed by those who believe it to be just another public service which can be 'modernised', reformed and used for political capital.
When politicians can prove they have its best interests at heart then I will agree they are the correct people to be custodians of it. What their latest proposed reforms have shown is their inability to understand it, both as service and institution and a lack of respect for those who care about its future direction.
The real irony is that the coalition believe front-line medical practitioners are the correct people to decide how the resources of the NHS are distributed but they can’t help decide or be consulted on the future direction of it as an organisation.
Let’s just hope the coalition listening exercise moves beyond just that and they actually hear what the people of this country are saying.
Mark Bowles
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