Fox (n): carnivore of genus vulpes; crafty person; scavenger; (vb) to confuse; -ed (adj): to be drunk.

Wednesday, 16 January 2013

Save us.


No, not the airbrushing. The promise - that the greatest social benefit and political achievement of any British government for centuries would, at all costs, be protected.

We had no money, the banks had taken the lot, things were going to be tough, belts needed to be tightened, cloth would be cut to suit and so on. A lot of gruel would be dished up for the masses in times of austerity, but the beloved, vital, life-saving and unbiased National Health Service would be sacrosanct.

The Government said it would "stop the top-down reorganisations of the NHS that have got in the way of patient care", and did this by way of launching a top-down reorganisation of the NHS abolishing health authorities, primary care trusts and the NHS executive and making GPs, whether they like it or not, engage in 'increased competition' and buy in services from private providers.

A document detailing the ways in which patients might suffer was produced, withheld, debated, vetoed and only finally published after being heavily edited as to what, exactly, the suffering might involve.

In September the King's Fund revealed 'trolley waits' as they are known are 'an emerging upward trend' since the time of the 2010 General Election.

Last month the Care Quality Commission revealed a third of patients it polled had spent more than four hours waiting to be treated in Accident & Emergency - the worst figure since 2004.

Yesterday the medical director of the NHS admitted sight-saving cataract operations were being rationed across half the country.

In the House of Commons less than 24 hours ago, health minister Dan Poulter - himself a part-time NHS doctor - was forced to apologise to his Labour oppo after he accused him of lies.

Six thousand nurses have 'disappeared'. Waiting times for treatment have risen. There are 18,000 fewer administrative staff most of whom are not the reviled 'NHS managers' but consist of low-paid receptionists, record-keepers, porters and clerks. Seventeen hospitals are said to have unsafe staff levels and, entirely coincidentally, the whole organisation has been told to save £20billion by 2015.

My local hospital is bankrupt, and another is facing the closure of good A&E and maternity units to pay the debt of its neighbour.

So what are they doing about it? Today in the House of Commons the Prime Minister was told the NHS was "being taken back to the 1980s". He responded: "The NHS is improving every day under this government."

At the same time the Health Secretary, a startled meerkat who goes by the name of Jeremy Hunt, has leaked details of a speech in which he says the NHS should be entirely paperless by 2018 to save £4.4billion.

So that's every doctor and nurse filling in forms on an iPad rather than a bit of paper, in order to save money.

That's every medical record of 66million people stored on a giant database which someone would have to invent, in order to save money.

That's repeating, pretty much, the last failed attempt to digitise the NHS which took 10 years, cost £11.4bn, and ended up being scrapped because it didn't work and was a waste of cash, in order to save money.

It doesn't matter what your politics are, or who you blame for the country's economic woes - we will all need the NHS at some point. Even the fabulously wealthy need it when they have car accidents or their helicopters crash, when their children crack their heads open or the nanny breaks a finger.

Most of us need it now and again, when we're ill, or scared, or just a little bit worried. We need it when our parents need looking after, we need it to help us have our children, patch up our mistakes, and to hold our hands when the whole world comes tumbling down around us.

My local, broken, indebted hospital has for me, in the past four years, dealt with two cancer scares, a skiing injury and an emergency admission.

The National Health Service is not a luxury. It is not an indulgent bit of bubble bath, or organic beef burgers you spend more on in order to be sure they don't contain horse. It's like your backbone - a damn useful thing you'd be pretty stuck without.

Backbones occasionally need surgery, but of a very delicate and careful kind because the slightest slip paralyses the patient for life. One moment of thoughtlessness and suddenly someone perfectly healthy is looking at sixty years of colostomy bags and widened doorways.

Backbones are not something you tinker with. You especially don't tinker with them if you're an idiot, or even worse a large group of idiots.

It's true of course that belts can be tightened a lot more if there is no backbone at all. But what you are left with is a strange, floppy thing which inevitably someone is going to suggest would be better off put out of its misery. And it's not as though we have too much good health and are using hospitals for frivolous things we can do without - cataracts might not kill, but losing your sight can.

Which is a strange place to end up from having promised to protect the NHS at all costs only two years ago, and from people who probably, in all honesty, thought they were doing something helpful and had no intention of breaking the thing they were twiddling with.

But twiddle they have. And break it, one day, they will, for the simple reason that the people concerned look upon the NHS as something which needs to be fixed rather than the thing which can fix them.

They think 'saving' is the same as 'cutting', and it's not.

You promised.


Anonymous said...

One of the best NHS pieces I've read in recent weeks (and that's a lot). Your strength over the rest of them (including my own)? You write in a language we can all understand.

Thank you for getting to the heart of it.

random ideas said...

It's really very simple. Anything you don't personally use or benefit from has no value to you and so by definition is valueless and can be eliminated.

The Tories "running" the country don't use the NHS (BUPA), don't use the state education scheme (Eton), don't use public transport (or if they do don't pay for it so don't care how much it costs), don't have low wage jobs so don't care about the minimum wage, tax credits etc etc.

If you don't use a service yet are paying for it (from the income tax on the bit of your income you haven't managed to off-shore yet) then cutting it seems fine and dandy.

If politicians had to use the NHS and State education and pay for their own season tickets then half the stupid things they do would stop instantly.

Anonymous said...

Spot on. Nothing to add.

RandomFuture said...

Good piece - trolley waits aside you could have used ambulance waits of up to two hours and people being treated in hospital car parks - not really something you want in any circumstance, but particularly not in the cold weather we're having now.

Ron Graves said...

He responded: "The NHS is improving every day under this government."
So, once again, Cameron blatantly lies to Parliament - and there is no redress, as ever.

Andrew S Loveland said...

Superb piece of writing. Thankfully, I wrote my own take on the destruction of the NHS before I read this. I might not have written anything had I came here first. Articulate. Concise. Passionate.
A more rambling and incoherent read, including some interesting facts about poppies(!) can be found at

Ian Cox said...

A scalpel has never been so sharp!

Lee said...

Absolutely brilliant piece. I shall forever be grateful to the NHS (there's no way I could have afforded the emergency surgery and six months of Chemo if I'd had to pay privately so I should be dead!) and get so angry when people try to mess with it. For me, the line that sums up this bunch of overpaid idiots so-say in charge of the country and coming up with stupid ideas like "a paperless NHS" was, "They think 'saving' is the same as 'cutting', and it's not." Straight to the heart of what is wrong with this Government.

Anonymous said...

Incisive and accurate. Its all a bloody mess and the starteled meercat is flushing it all down the pan.

John said...

Just how much taxpayers money do you want to spend before you realise that: (a) if will never be enough as expectations are allowed to run wild (b) productivity in the NHS will continue to fall and (c) hospitals will continue to not even give old ppl water...yet despite all this you think it is great and bleat on about it all being about money. Absolute tosh, the NHS is mediocre at best, bankrupt and in need of scrapping and replacing with a new system.

Celia Stanley said...

Brilliant and terrifying piece.

Anonymous said...

Hard to agree when as a software buck you read the guy gawk at a paperless NHS with a "giant database" of 66million people. Facebook with over 20 times that user base as ACTIVE users (rather than just the 66 million dormant data files) was created for a fraction of the price that Labour wasted on their failed software with their frankly embarrassingly naive licensing.

Interestingly, I've had the best experiences of the NHS ever this year, the longest wait I've had? For my paper based records to be shipped from previous GPs Indiana-Jones-like-vault to new GPs vault by a team of highly skilled paper handlers and postmen, under secure guard and no doubt at great expense.

To top it off, data is then retrieved or entered on what looks to be computers from the 1990s. Where was the investment over the past decade there?

And don't make me laugh, iPads. For the handful of Drs and Nurses that don't own their own iPhone (which are always turned on and in their pockets from experience) to fill notes on any decent system - a cheap android tablet is around £50 at retail and a desktop computer up to the mark of using Facebook would not be greatly more.

Mr writer, go back and write your bit for the daily hacker. And write something that I can fully believe which doesn't read like "Reasons why David Beckham should never have played for England" or the like.

Anonymous said...

Great article. The only thing I will add is this: Sharing this article on your Facebook page will not save the NHS.

The next march to save Lewisham Hospital's A&E and maternity units (as mentioned in the article "My local hospital is bankrupt, and another is facing the closure of good A&E and maternity units to pay the debt of its neighbour.") is on January the 26th ( - it would be good if some of you who feel so strongly about saving the NHS would attend.

If pushed through it would be a disaster for the whole of South East London, and will leave an area containing 750,000 residents with one A&E to serve them.

So please, skip the football, walk your dog early, cancel the visit to the in laws and help us stop this. Show the people in charge that they need to stick to their promises. This may be a local issue but it could be you next.

Anonymous said...

Succinct and to the point. The only element missing is the handovers that are happening across the country to private sector providers and what the results look like. It's not good news. It's happening stealthily and piecemeal, so it's difficult to keep track of. And then there's other structural stuff like the Foundation Trust Regulator, Monitor, and the new regulatory frameworks they're consulting on - one of which quite nicely buried the notion that new private sector providers of NHS services wouldn't need to pay corporation tax. Until 38 degrees picked it up and turned it into a campaign. Which Monitor backed down over. I don't disagree that the NHS needs to change, but not into something that leaves only massively pressurised A&Es in NHS hands with everything else cherry picked off for profit. It's ALL about shareholders and shows a total disregard for the need to have connectivity (and the same values) to deliver integrated care. That's what any political party should be aiming for - integration. Not total fragmentation.

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