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Devolution of the NHS could be next Devolution of the NHS could be next
(about 1 hour later)
What of the play, Mrs Lincoln? While the United Kingdom faces disintegration or devo max, its National Health Service may soon face a similar fate. Figures forecast this week will show England’s NHS lurching £1bn into deficit. An unprecedented majority of hospitals are reportedly trading in the red – even the semi-autonomous foundation trusts, for the first time in their 10-year history.What of the play, Mrs Lincoln? While the United Kingdom faces disintegration or devo max, its National Health Service may soon face a similar fate. Figures forecast this week will show England’s NHS lurching £1bn into deficit. An unprecedented majority of hospitals are reportedly trading in the red – even the semi-autonomous foundation trusts, for the first time in their 10-year history.
Britain’s NHS is already devolved into England, Scotland and Wales. While Wales has met its crunch and is not protecting health under its austerity regime, England is in the grip of political shroud-waving, as last year when the health secretary, Jeremy Hunt, bailed it out with a previous £1bn. This was variously to prevent another Mid Staffs hospital scandal, cope with soaring A&E demand and “get through the winter”. Billions come and go in the NHS. It knows it is a poor version of a bank, too big to fail.Britain’s NHS is already devolved into England, Scotland and Wales. While Wales has met its crunch and is not protecting health under its austerity regime, England is in the grip of political shroud-waving, as last year when the health secretary, Jeremy Hunt, bailed it out with a previous £1bn. This was variously to prevent another Mid Staffs hospital scandal, cope with soaring A&E demand and “get through the winter”. Billions come and go in the NHS. It knows it is a poor version of a bank, too big to fail.
The day is clearly approaching when reckless promises and thrown money are just not available. Labour may pledge “same-day GP consultations” somehow paid for by “cutting bureaucracy”. But the outgoing NHS boss, Sir David Nicholson, warned in March that the service needed “up to £5bn a year for several years” to rescue it “from oblivion”.The day is clearly approaching when reckless promises and thrown money are just not available. Labour may pledge “same-day GP consultations” somehow paid for by “cutting bureaucracy”. But the outgoing NHS boss, Sir David Nicholson, warned in March that the service needed “up to £5bn a year for several years” to rescue it “from oblivion”.
A growing lobby of doctors is already suggesting means-tested payments for GP consultations, to relieve pressure on surgeries, a proposal narrowly voted down at the last BMA conference. The same pressure may come to A&E. Charges are already applied to foreign visitors. The drift to privatising routine tests and operations can only continue if hospital costs are so much higher.A growing lobby of doctors is already suggesting means-tested payments for GP consultations, to relieve pressure on surgeries, a proposal narrowly voted down at the last BMA conference. The same pressure may come to A&E. Charges are already applied to foreign visitors. The drift to privatising routine tests and operations can only continue if hospital costs are so much higher.
If devolution to Scotland and Wales is seen to have “worked”, how soon is it before it is applied to England? The foundation hospitals, despite recent troubles, have mostly worked as self-governed units. New GP purchasing teams are cohering locally, and may yet revert to some community or regional format. The agonies of a personal service run as a politicised national bureaucracy are all too evident. Across Europe, hospitals and doctors operate under various forms of devolution, mostly far from the political spotlight. The idea of different regions with differing GP charges, waiting times, drugs regimes and in-patient services remains anathema to Britons, especially to the post-war generation born under the NHS and now its most intensive client. But what of the next generation, bred on the expectation of choice? It is not just a very different UK that beckons, but a very different NHS. If devolution to Scotland and Wales is seen to have “worked”, how soon is it before it is applied to England? The foundation hospitals, despite recent troubles, have mostly worked as self-governed units. New GP purchasing teams are cohering locally, and may yet revert to some community or regional format. The agonies of a personal service run as a politicised national bureaucracy are all too evident. Across Europe, hospitals and doctors operate under various forms of devolution, mostly far from the political spotlight. The idea of different regions with differing GP charges, waiting times, drugs regimes and inpatient services remains anathema to Britons, especially to the postwar generation born under the NHS and now its most intensive client. But what of the next generation, bred on the expectation of choice? It is not just a very different UK that beckons, but a very different NHS.