Saving money – or spending it better – it’s your choice. Try playing the “Minister of Health” game…

Where would you choose to spend what little money you have if you were the minister of health in England? Only last week my grand-daughter aged 5 had pneumonia in London. Best practice would have been an antibiotic drip but there were no beds. Fortunately she did well enough on a home treatment regime but it was taking a risk, and bought fear into my heart…. We need a new decision making body, and the principles and ideology need re-thinking after and during an ongoing honest debate.. Dishonesty makes a bad smell ..

Today in the Times news there are several competing demands:

Hospitals unable to cope with acute pressures. – Hospitals struggle to cope before the winter

Children with depression not getting access to assessment, let alone therapy. – Depressed children unable to get help

A perinatal and neonatal mortality shaming us against other countries. – Extra cash to halve stillbirths

Junior Doctors wanting respect – and threatening strike action – Doctors’ strike raises fears for patients

The cancer drugs fund is an example of political psychosis. Whilst England cuts it (Outrage as NHS cuts funding for dozens of cancer drugs ), the same party has an opposite approach in Wales (Owain Clarke for BBC News Wales 12th November 2015: Wales cancer drugs fund pledge by Conservatives)

If I was the minister, and agreed to play this facile game, I would have the following thoughts before making any decision. Health care decision rarely win votes, but they can lose them…

Acute hospital care has to have the capacity needed for universal cover, otherwise we are agreeing to bring back fear… (In Place of Fear A Free Health Service 1952 Chapter 5 In Place of Fear). This is priority one. It will always trump the others….

Children with depression do not vote, but their parents do, and the psychiatric care needed takes many months and years to train enough people to provide. This is beyond the next election, and therefore comes third, and goes into the “pending” tray.

The stillbirths are only 200 per annum. Looking after maternity care is already a problem, as we don’t have enough midwives. It is emotive, and parents and grand-parents are equally distributed across the social classes. This comes as second priority, but lip service will be enough until after the next election….

Junior doctors threatening to strike is interesting. I want to control the most powerful and successful union in the land, and I want this MORE than I want a happy and motivated workforce. This definitely comes last in my priority list… I have made such enemies of them already, and there is no trust between us. A short term battle is far more preferable to a long drawn out campaign.

The Cancer Drugs fund – well even the minister and the conservative party don’t seem to be able to make a rational decision. Mr Drakeford has made a rational choice in Wales, but it won’t win him the votes – “Mr Drakeford has consistently rejected calls to introduce a fund, arguing it would be unfair and unethical because it prioritises disease.” Now will it win him the votes of the families with children needing psychiatric care, or mothers whose babies have or would have died? I doubt it.

The politics of health.. The Lemmings of the left leave a vacuum where Mr Stevens’ debate will not happen… Are we all lemmings as far as our health system is concerned?


This entry was posted in A Personal View, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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