|A letter from Dr Mark Porter to BMA members is revealing. He also is in denial, but the illusion to meltdown is correct. This is a virtuous and altruistic letter in every respect except that it avoid the funding and demographic issues. (There is a string of copied text with empty boxes between – so please follow down the pages)
How the NHS is like a snow globe:
Here’s a paradox. How can a national consensus also be a source of constant dispute and contention? You might have guessed that I’m talking about the NHS, and it’s during an election year that we notice this paradox most of all. When the parties start publishing their manifestos, you can guarantee that each will contain a strong statement of support for the NHS. The support will sound convincing. Every day in the NHS, we work hard to maintain the trust that our patients place in us. They in turn want the NHS to thrive, and the parties reflect that. But all too often politicians make promises as if words alone can improve the NHS. Resources and commitment are vital too. They pledge thousands more GPs, for example, but with no apparent recognition of the growing and unsustainable pressures faced by general practices, and when the numbers entering GP training in England have actually dropped by 15 per cent this year alone. And after each election, the new minister has the power to make us feel as if we’re in a giant snow globe.
|A colossal hand reaches for the NHS, and we’re being shaken up again with some new laws and organisations|
|After the turmoil the snow settles; everything’s in a different place, but little has been made better than it was. The time and endeavour would have been better spent in protecting what we are in danger of losing through starved resources and an obsession with competition and markets. The NHS is, according to the highly respected Commonwealth Fund, the highest-quality and most cost-effective healthcare system of 11 leading economies, including Germany, France and the US. And so our many foreign admirers ask the same question: if the system is that good, why do your governments keep playing around with it? For doctors, it’s doubly frustrating when there has been so much unnecessary reorganisation, while real opportunities to improve services have been repeatedly passed over. There is nothing more demoralising than trying to make failed policies work, but doctors have never been a passive or a reactive voice. It’s down to all of us to articulate and create an NHS that serves our patients best, in whichever nation we work. The BMA has already produced its own manifesto for the UK general election and this year we will be building on our existing policy work to create a detailed vision for the future of the NHS in England – an NHS in which change must be evidence-based, clinically led and right for patients. Reviving our marginalised, fragmented and underfunded public health services will be a major part of this vision. Whoever is in government, we must lobby for every policy to be a health policy. Sir Michael Marmot, a former BMA president, has laid bare the deep and increasing inequalities that shape health outcomes. Health is devolved to national governments, but there will be many policies enacted at UK level that have a profound effect on our patients’ lives. Anything, anywhere, that betters or worsens the health of our patients is our business too.|