Will the NHS survive another five years of the Tories?
Dr Andrew Hardie says the Conservatives are making the NHS more effective but Dr Jackie Applebee argues that a Tory majority means the fight is on to save the NHS
Prime Minister David Cameron has often described his tremendous gratitude to the NHS for how it looked after his son during his short life. Ten NHS doctors and nurses have just been elected to Parliament as Conservative MPs. These are just two examples of the deep and personal connections the NHS has with the Conservative party.
It was a pleasure to see so many positive messages about our NHS in the Conservative election campaign; they stand in stark contrast to the carping - and often untrue - stories from the Labour party.
I’ve spent the entirety of my professional life working for the NHS. But I know that if it fails to adapt to change, it will wither and die. I was driven to become a Conservative candidate in 2010 by the frustration of seeing how the last Labour Government, with its top-down bureaucracy, was failing to modernise the service. With so many deserving causes, it simply isn’t justifiable that a huge increase in expenditure resulted in a 3% decrease in productivity under the Labour administration.
The Conservatives are moving the NHS forward. For instance, putting public health back into local authorities’ hands is bound to help further the integration of health and social care. I have already seen this produce a cross-fertilisation between the two and it is another example of how new structures are beginning to break down the ‘silo’ culture that has so damaged service integration.
Additionally, the Conservatives’ plan to create CCGs gave responsibility to GPs, who know their patients and know the structures of the NHS. GPs’ dynamism and creativity has become a driving force in commissioning.
CCGs have led to more effective healthcare, making full use of modern devices and techniques, and drawing on GPs’ expertise to carry out more work in primary care and reduce unnecessary hospital referrals. This has maximised resources and resulted in less time being wasted for patients.
Labour’s bureaucratic approach to the NHS demonstrably failed to produce real, effective change for the people whom the service is meant to serve. Despite some small, headline-grabbing successes, the party failed to address the more important task of adapting the fabulous creation of 1948 to today’s needs.
The Conservatives know how to introduce modern advances effectively to make the patient journey to care easier.
Dr Andrew Hardie is a retired GP and a Conservative councillor in Sutton Coldfield
Now that we have a majority Conservative Government, the Health and Social Care Act will not be repealed, which may finally kill off the NHS.
Privatisation, which accelerated under the Coalition, will continue apace and there is likely to be a transatlantic trade agreement that makes a return of the NHS to public ownership almost impossible. Billions will be wasted as the market promotes competition and fragmentation over collaboration and integration.
A two-tier NHS will now be enshrined. Cash-strapped trusts, many tied into usurious PFI contracts, may have little choice but to exploit the Act’s provision that allows up to 49% of their work to be in the private sector - pushing NHS patients to the back of the queue.
Figures show private firms won 37% of contracts awarded in England last year. This trend will continue, with Jeremy Hunt remaining as health secretary. Former minister for government policy Oliver Letwin, who allegedly said in 2004 the NHS ‘will not exist’ within five years of the election of a Conservative Government, is now a full member of the Cabinet, perfectly placed to ensure his prediction comes true.
NHS funding is falling as a percentage of GDP, while demand rises. Even if the promised £8bn a year by 2020 materialises, it will be nowhere near enough. And former NHS chief executive Sir David Nicholson said the extra £22bn savings called for by his successor Simon Stevens will be hard to implement.
Experienced staff are leaving the NHS, while pay freezes, cuts and unmanageable workloads have brought morale to breaking point - a problem that will only worsen with the Tory majority.
But history shows GPs and other health workers can join with patients, fight back and win. The Save Our Surgeries campaign in east London won a reprieve for the practices worst hit by the MPIG withdrawal, and the people of nearby Lewisham successfully campaigned to save their hospital.
Midwives, nurses and radiographers have shown they are ready to stand up for the NHS by taking industrial action. GPs could follow their lead by, say, collectively refusing to undertake activities not directly related to patient care. Founder Aneurin Bevan said the NHS ‘would only last as long as there are folk with the faith to fight for it’.
The time for that fight is now.
Dr Jackie Applebee is a GP in east London and chair of Tower Hamlets LMC