This letter is sent to
you with good intent, with no political bias. Although I have been a Tory voter
for most of my adult life, when I was working in the NHS during the 2010
election, I felt that a labour victory would have been poor for the economy but
preferable for the NHS. I believe that the two previous Labour Health
Secretaries, Alan Johnson and Andy Burnham understood our state funded health
system while their two Tory successors, Andrew Lansley and Jeremy Hunt, have
done more harm than good.
I fear that during your short tenure as Prime
Minister so far, you are getting it terribly wrong when it comes to a service genuinely
under severe pressure and I have some very simple advice for you – so please
take note:
Avoid mixed messages: In your first speech outside No.10 just
after accepting the Queen’s direction to form a new government you channelled a
mix of Mother Teresa and the three musketeers with your commitment to make
Britain a ‘country that works for
everyone…. Do everything we can to help anybody, whatever your background..’
Maybe you were trying to emulate Margaret Thatcher as she quoted St Francis of
Assisi’s prayer when she came to power, but like Maggie, you appear to have
quickly turned from school welfare officer to Headmistress. This is not always
a bad thing – as long as you still have the welfare of our community well in hand
but this doesn’t seem to be the case.
There is no quick fix for the NHS: But something does
need to be done as a matter of urgency. You need a short, medium and long term
plan. It is vital that primary, secondary, tertiary care and social services
are all linked but we know this is a highly complex process that will take
time. Resources need to be increased at every stage of the patient pathway (including
prevention to stop them becoming a patient in the first place) as each area is
of equal importance. In the short term you must..
Admit there is a crisis: If you don’t believe
doctors, nurses, NHS managers or even patients and their relatives – look at
the statistics. The targets for Accident
and Emergency departments and hospital waiting lists are reasonable and achievable
in an appropriately resourced facility
but if a hospital is short of staff (clinical and administrative), beds,
equipment or places to safely transfer patients within the community, they will
start to miss targets as a matter of routine and this is happening. Now.
Austerity and a state funded health system don’t
mix: Service improvement and efficiency
measures
can help but they are not enough. Choose your metaphor – the dead horse has
been
flogged, the blood has been squeezed out of the
stone, the NHS has streamlined its services and
yes there is room for further improvement, but
additional resource (funding) must be made
available. We are already lagging behind many
of our neighbours on % GDP spent on health and
last year in his article on health spending
the Kings Fund’s Chief Economist, John Appleby placed
the UK at 13th out of the original
15 EU members. Like it or not – we may have to accept an
increase in tax to allocate additional resource
where it is vitally needed.
Don’t ignore private healthcare: Subcontracting
to local private facilities is already assisting
some
NHS Trusts with capacity issues and are a realistic option to be considered by
clinical
commissioning
groups. As I am sure you are aware, for example, hip replacements undertaken in
a nearby
private hospital with spare capacity can be a cost effective way of freeing up local
NHS
beds
for trauma cases and ease pressure on
A&E. This is not privatising the NHS and is not a long
term
fix but it can certainly help in the short term. And how about reducing
insurance premium
tax
on health insurance subscriptions – do you really want some of the 10.6 million
people with
private
health insurance to relinquish their cover and put even more pressure on the NHS?
It is
their
right after all.
If you don’t trust your Health Secretary, choose a new
one: It
seemed strange that when forming your cabinet last year you missed an
opportunity to remove an unpopular Health Minister and introduce a new era of
cooperation with a carefully selected individual who could build bridges and work
with key decision makers within the NHS.
Instead you seem to have taken on the role of health spokesperson yourself, unhelpfully
berating GPs and making sweeping statements that suggest that you don’t really
understand the key elements of the service. I would assume that you will be
pretty busy with ‘Brexit means Brexit’ and would respectfully suggest that you
either give Jeremy Hunt back his mandate or pick a new Minister. If you are
going to continue to make statements about the NHS then please…
Listen: …To those that are in the know, even if you don’t
like what you hear. Organisations like the independent think tank, Kings Fund, people
like Simon Stevens, Head of NHS England, Clare Gerada, and Helen Stokes
Lampard, former and current chairs of the Royal College of General Practitioners,
Janet Davies, Chief Executive of the Royal College of Nursing. The list is
endless – and these people know what they are talking about. Trust them
Watch: Forget Sherlock or Call the Midwife, if you
only watch one series this year I beseech you to tune in to BBC2’s exceptional documentary,
Hospital. The first programme provided a level, calm but absolutely no-holds-barred
view of what it really is like to work in a major Hospital Trust. After I
watched the programme, I wept tears for not the patients – who without doubt
received excellent care, but for the wonderful clinical staff, managers and
administrators who work under almost unbearable pressure every day. On second
thoughts – maybe you should watch Call the Midwife which shows how health and
social care was before the state system was properly funded..
And finally…
Apparently you want
your legacy as PM to be more than overseeing Brexit. Please make sure that your
legacy is not that you were in charge when the NHS finally ceased to be fit for
purpose.
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