Health: an expensive necessity

The NHS is a dream which longevity and bureaucracy are killing.



Years ago my medically orientated family talked of the NHS never being able to meet its obligations, as people lived longer, drugs to cure people were invented and everyone wanted access to them.  What, if anything at all, has changed?

Tinkering by sucessive governments - remember Virginia Bottomley's attempts to reform the Health Service when a minister in the early to mid '90s, or Gordon Brown's massive injection of funds into the NHS during his ten-year tenure as Chancellor until 2007? - have failed to sort the place out.  Waiting lists targets of the past decade resulted in "distorting resource allocation", destroyed morale and wrecked "the pride and independence of ... hospitals" as Peter Oborne so aptly put it in The Telegraph when saying the intention of the government to "deliver high standards" had had the "reverse effect".

David Cameron and Andrew Lansley's latest attempts are no different.  They try to deal with a probably insoluble issue.  The thing costs too much, has become too cumbersome and inefficient and is delivering too poor a service.

We all need health care.  It doesn't seem too difficulty to make the leap of faith to a place where every company (with over say 200 staff) in England gives free health insurance to every employee, thus reducing in one fell sweep a huge burdon on the public health service.  All people who are below employment age, in full-time education, registered unemployed, disabled, imprisoned or pensioned could obtain free state funded care.

The former military top brass could be brought in to install discipline and cleanliness into the hospital network.  Didn't Florence Nightingale develop her skills on the battlefields of the Crimea?  Perhaps then we'd reduce the incidents of life-threatening diseases contracted from inside hospital wards.  And nurses might revert to the efficiency levels of the era of Hattie Jacques and James Robertson-Justice films.  As Judith Woods remarked in another Telegraph article, "an old-fashioned figure of authority, a Hattie Jacques to see off James Robertson Justice, who is firm, fair – and always washes her hands."

GPs are never going to be experts on every development of every disorder or disease.  They are great at reassurance and referral at best, and incompetant or disinterested at worst.  To have them in charge of hospital-screening appears at first sight to be ill-advised.  Surely, Consultants should run hospitals (assisted by a tight, dedicated team of office-workers), for only they can deduce and monitor demand?

Still, it's up to the government as usual, and they've made such a success of it so far, haven't they?

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