Resilient NHS – gutless politicians – the problem that seems to prove the rule – politics is small and cannot discuss philosophical issues

In a letter to The Times, Lord Hunt remarks on the “the resilient NHS” – a problem that seems to prove the rule – politics is small, local, and cannot discuss philosophical issues. No wonder the professions are disengaged. There is an opportunity for an honest party to challenge the status quo, but has anyone got the guts?

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Sir, Your leader (“Small politics”, Dec 28) states that the NHS “keeps demanding more money yet is constantly on the verge of crisis”. In fact the NHS has been remarkably resilient in the face of a population increase of more than 7 per cent since 2003, an ageing population and the sharply rising burden of avoidable illness. Yet the average annual real terms funding increase over the last parliament was less than 1 per cent compared with a historic average of 4 per cent since the birth of the NHS in 1948. The next five years promises a meagre 0.85 per cent real terms increase per annum.

The recent OECD analysis (Health at a Glance 2015) shows that 24 countries spend more on healthcare as a share of GDP than we do. Not surprisingly we have, per capita, fewer doctors, nurses, hospital beds, and access to sophisticated medical equipment than any comparable country. Surely the right conclusion to be drawn is that the NHS is remarkably robust.

Lord Hunt of Kings Heath

Shadow deputy leader of the Lords

Small Politics (Times leader 28th December 2015)

British politics is changing even though the election result seemed conventional. Neither the government nor the opposition appear capable of rising to the challenge

In British politics everything is changing, yet it all remains so familiar, at least for now. This was an election year in which the opinion pollsters got their predictions wrong, in which a hung parliament looked likely as new parties waxed and old parties waned. Yet the year ends with a majority Conservative government locked in an argument about Britain’s place in Europe.

The May general election did reassert one hardy perennial of political knowledge. No party with a commanding lead on both leadership and economic competence has ever lost a general election. The quirks of the electoral system made it seem possible that 2015 would be an exception. Labour never dealt with the accusation of profligacy and, despite the government’s flawed and tardy programme of deficit reduction, the Conservative party remained the trusted custodian of the public finances. Though David Cameron had been a strangely complacent prime minister, he looked a comfortable occupant of the office, and the public never saw Ed Miliband in the same guise.

On the face of it, the Conservative overall majority looked a traditional victory. Yet politics is becoming more volatile. In 1945, Labour and the Conservatives between them took 97 per cent of the popular vote. In 2015 they commanded just 67 per cent. A political system designed to give full executive power to the more popular of two large parties just about coped with the change.

The insurgent force of British politics in 2015 was and is nationalism. The Scottish National Party shattered the granite Labour vote and took 56 of the available 59 seats. The prospect of a coalition led by Labour but upheld by a party that did not believe in the state it was helping to govern was an important incentive for people to stick with the Conservatives. In England, the votes of those disaffected with the two main parties and with politics itself went in large numbers, not reflected in seats, to Ukip. The impact of Ukip was felt as much by Labour as by the Conservatives.

The election resolved the identity of the government but little else. England, Scotland, Wales and Northern Ireland are now all dominated by different parties and the union lies in the balance. This country’s membership of the European Union may well be settled, if the government holds a referendum in the year to come. If the prime minister’s renegotiation is rejected he will probably resign. Even if he wins, Mr Cameron has pledged not to fight another term. The second half of this parliament will be dominated by the question of who the Conservative party will choose to be the next prime minister. In the absence of any viable opposition, politics is, for the moment, a wholly-owned subsidiary of the Conservative party. Under the unexpected leadership of Jeremy Corbyn, whose rankings are irrecoverably low, Labour has gone backwards. The shattered Liberal Democrats will take more than Tim Farron’s cheery demeanour to recover. This poses a constitutional question of some importance as, with no alternative government on offer, opposition is reduced to mere lament. Mr Corbyn’s leadership will be tested in May, in the London mayoral election, which Labour ought to win, in elections for the Scottish parliament and for local government in England.

This will matter because the government faces some tough problems. The deficit is still to be cleared and debt is piling up. The NHS keeps demanding more money yet is constantly on the verge of crisis. Universal Credit is a good answer to the benefits conundrum but it is beginning to seem that it might never arrive. The same can be said about the decision over airport capacity. It is even possible that Britain may end the year no longer a member of the European Union. It is hard to avoid the feeling that the issues are big but the politics, at the moment, is rather small.

This entry was posted in A Personal View, Professionals, 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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