David Cameron’s seven-day NHS is shameless political game-playing
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Version 0 of 1. Speaking at the Conservative spring conference in Manchester on Saturday, David Cameron said: “Conservatives would substantially extend weekend working of NHS services if they formed a new government.” He made a similar promise at the last election in 2010. Without a detailed, fully costed plan to provide the staff and resources needed to deliver more seven-day services, this is at best an empty pledge and at worst shameless political game-playing. According to a report published by The King’s Fund this week, the last three years of Cameron’s NHS “reforms” have put the NHS on life support. Waiting lists have swollen to almost three million, waiting times are lengthening and A&E targets are missed in most of the hospitals. It’s about time Cameron faced the fact that not only is it impossible to deliver with the current workforce but it takes five years minimum to “grow” a GP from first qualification and nine years to become a consultant. Related: Cameron pledges seven-day NHS services under future Tory government People forget about the majority of consultants who provide on-call urgent and emergency care, or the 40% of GPs who do work out-of-hours. It is disgraceful that the prime minster is perpetuating an impression that at 5pm all doctors pack up and go home. The government has spent four years pushing changes to the NHS on reluctant doctors and patients who weren’t expecting them, yet these changes have done nothing to meet the real challenges we face. The launch of NHS 111 was meant to be a miracle cure to the building pressures of out-of-hours care, and yet its botched introduction has only made the situation worse. The question remains: how do politicians who call for a fully functioning 24/7 NHS expect to resource it when the government can hardly afford its current model, and when demands are being made to take a further £30bn from the NHS budget by 2021 as efficiency savings? These measures will only increase demand culture and fail to take into account the available resources, investment and flexibility that will be needed to achieve this. Nobody disagrees with Cameron that a continuous evolution of the NHS is needed to resolve its massive problems but so far there have been no tangible gains. From Tony Blair’s time as prime minster to Cameron’s current stint, the usual response to problems has not been to try to solve them, but to apportion blame while projecting the impression of safeguarding the NHS. We have witnessed a drive to cut down the number of nurses, district general hospitals and A&Es, and a simultaneous push for an expansion of community services, as well as secondary care from within the existing resources. Pouring more money in may not be the solution, but prime ministers’ duty of candour must surely require them to engage with professionals, be transparent with the public and, above all, stop politicising the NHS. The NHS faces huge challenges. The elephant in the room, as recently reported by the Academy of Medical Royal Colleges, is that billions is being wasted on care that not only brings no benefit to patients but causes harm through inappropriate investigations, operations and treatment. As a past president and current chair of the GMC, Professor Terence Stephenson, said: “One doctor’s waste is another patient’s delay.” And he’s absolutely right. The government would be doing a great service to the British public by regulating against the obscene manipulations and excesses of the device and pharmaceutical industries. Furthermore, failure to regulate the food industry is the root cause of increasing demand, much of which is being driven by diet-related disease. We all want a patient-focused NHS, but this comes at a cost. Unlike supermarkets and banks, which can increase their income streams by making their service more attractive, the NHS cannot attract more revenue by changing its availability to the public, as it has a fixed budget. Longer routine work will mean more costs – there is only so much that can be achieved by efficiency savings and these are already squeezed out to unprecedented levels. All political parties need to work with doctors, and likewise we want to work with them. But an injection of realism is necessary to stop the destruction of the NHS. Forcing reform after reform, or chasing spurious projects, can only undermine the objectives of this publicly funded body and the morale of its workforce. |