Saturday, 18 February 2017

The NHS debate

If you have not already heard the NHS debate mounted by BBC Radio 4 in the Inside Health series, it is downloadable here:

Granted that more of the audience, let alone the panel, clearly had vested interests than was good for balance, and that a couple of the concerns raised did not apply to Wales (even fewer to Scotland), this was well worth listening to. Government in particular should have paid heed.

The underlying message it seems to me is that the electoral timetable militates against sensible management of the NHS, in all the home nations. Most of the cures for the services' ills advanced in the debate are front-loaded - resources, especially in terms of taxpayers' money, need to be applied now for improvements which will be seen typically five or more years in the future. That is beyond the horizon of most party politicians, whose eyes are fixed on the next general election, likely to lead to a change of party in government*.

On the other hand, there were few present who disagreed that some democratic oversight of health provision was necessary. Putting the NHS in England under the control of a Parliamentary (i.e., cross-party) body rather than a Department of state, as suggested by Margaret McCartney (a GP practising in Glasgow!) would go some way to squaring the circle. However, it would be impractical in Wales until we have an increase in the number of AMs, who are stretched as it is.

* I would argue that Blair and Brown missed a trick in 1997. With a huge majority and the Conservatives in disarray, it was clear that Labour would be in power for two electoral cycles at least, and the opportunity could have been taken to reverse the first steps towards privatisation taken by the Thatcher/Major governments, and to ramp up the training of doctors and nurses, the shortage of whom was to be felt a decade later.

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