Are all discussions about the NHS doomed? Nick Hayes writes that “the popular history of healthcare is commonly built around misconceptions, fashioned by contemporary concerns and agendas”.
The most obvious sign of the grip that a misconceived version of the past has on contemporary debate, may be the repeated mentions of the sainted Nye Bevan which one commentator referred to as “a cottage industry amongst [New Labour] health ministers”.
Roy Lilley is chairing the “People’s Inquiry into London’s NHS” to hear what is going on and find the facts about the current London health scene. Are the members of the panel going to be able to resist the siren calls and avoid ship wreck on the rocks and long grass of the island of Ignore where so many other inquiries have washed up and disappeared from human ken?
They have finished taking 30 hours of evidence and a report will emerge in February. No doubt they will want reforms – fat chance according to Sir John Oldham writing in the BMJ (£ wall) – ‘Reform Reform’ is his rallying cry. He argues that with new Secretaries of State for Health coming along on average every 26 weeks – each with their prescription for change – the NHS is now inoculated against change or, to change medical metaphors in mid-stream, the scar tissue thickens making future success even less likely. Indeed each attempt at reform ends up by strengthening the status quo based as it is on a ‘body parts’ view of health – not the whole person.
I attended one People’s Inquiry session and was struck by two submissions – one from NHS England London Region’s Director, Dr Anne Rainsbury, and the other from the chief executive of University College London NHS Foundation Trust, Sir Robert Naylor. Listening to the latter was like attending a briefing from the Admiral of Star Fleet Command describing a parallel health universe compared to the stories (myths?) of a dilapidated ruin of a health service trying to serve Londoners.
UCLH is the latest space cruiser – a bright and shiny product reaching standards of excellence that lead the world, the universe, everywhere, leaving us earthlings who are not UCLH patients feeling rather left out . The other interesting point from the Rainsbury address was that things were not that bad in London – cut down on the number of one or two person GP surgeries and concentrate scarce resource in fewer hospitals were the solutions that I heard. London (with fewer CCGs) would be fine. Her plea was for people actually to pay some heed to the data and where there was no or little data then create it. In the meantime go easy on the doom and gloom and to the politicos – do not run for cover at the first sign of resistance.
How can we break what Nick Hayes calls our” intuitive resistance to all NHS reform”? As the data he has collected shows, the past was not as bad as we think and in any case should not be invoked as a barrier against change in the future.