Chirs Ham (kings Fund) is afraid to mention rationing. So is everyone else. A plague on all their houses?

Chris Ham is an influential figure, but even he is afraid to mention rationing: telling people what they cannot have.

After an hour distributing leaflets for the Liberals, and suggesting every recipient should at least vote, it became clear to me just how uninformed and disengaged the public are about politics and health. Their views are shaped by the media, and this is usually the Mail or the Sun. Sentences of 3 – 6 words, and none longer than 2 syllables greeted me. At the last election, the turnout was only 66% who voted, – or 34% did not. The conservatives won Pembrokeshire with 40% of those voting in 2015. This means Stephen Crabbe won our seat with under 27% of the potential electorate supporting him.

Short term horizons, and local perspectives dominate for all MPs. Saying the unpopular truth, or the hard facts, is seen as negative for votes. So the Health Services will be split, Wales will continue to have a mutual of 3 million people without serious choice for those in most of the principality. Paying the same taxes they will get worse services than the English.

And yet, the election will change nothing as the Labour heart of Wales is “cast iron” in the valleys.

A much fairer voting system will help the health service. Until this comes about it looks as if things are going to get worse. More water ( money ) will be poured into a leaking bucket, by all three major parties.

Image result for a plague on all their houses cartoon

Most medics and nurses say “A plague on all their houses”, and who can blame them? If the professionals are disengaged how can we blame the public at large?

Dennis Campbell reports in the Guardian 16th May 2017: NHS needs to change, says expert, and both sides of politics should support it

Chris Ham, head of the King’s Fund, says campaigning over the state of A&Es and maternity units may be ‘good politics locally’ but jeopardises better care

Politicians should support, not oppose, controversial changes to local hospital services in order to save lives, improve care and tackle doctor shortages, a former government NHS adviser is urging.

Professor Chris Ham, the chief executive of the influential King’s Fund health thinktank, said candidates standing in the election should not try to court popularity with voters by joining campaigns against the rundown of A&E and maternity units.

“What’s often good politics locally can also be bad medicine for patients,” Ham told the Guardian. “Where there’s a strong clinical argument that care will be safer by concentrating specialist services in fewer hospitals, local and national politicians should give their support and not stand in the way of painful but necessary change.

“We have to be realistic and accept that not every hospital can provide the full range of services like stroke care, some forms of cancer care and emergency surgery. The solution is to concentrate some of these services in fewer hospitals able to provide specialist care seven days a week. Patients might have to travel a bit further to get better care, but this is a price worth paying,” added Ham, who advised Downing Street on NHS policy while the coalition was in power.

Ham’s intervention comes as the NHS presses ahead with the biggest reorganisation of services seen in decades, in a bid to plug a £22bn looming gap in its finances, which has sparked protests in many parts of England. MPs should accept that widespread understaffing in the NHS means that centralising services has to happen, Ham said. The temporary closure last year of the A&E at Chorley hospital in Lancashire due to its inability to recuit enough medics illustrated that problem.

In recent months a number of Tory MPs who are now seeking re-election on 8 June have been fighting plans to downgrade A&E units used by their constituents.

For example, ex-minister Nick Boles plus neighbouring MPs Caroline Johnson and Robert Jenrick met Theresa May in February to oppose the closure overnight of Grantham hospital’s A&E unit triggered by it having too few middle grade doctors. Jeremy Hunt, the health secretary, then referred the unit’s partial closure to the Independent Reconfiguration Panel.

Andrew Griffths, Andrew Bridgen and Heather Wheeler opposed plans to downgrade Burton hospital’s A&E to a minor injuries unit, and warned that deaths could occur if patients had to travel the ten miles to Derby to get urgent treatment. “We are fighting for the survival of a vital service in Burton. I genuinely think that if it closes, lives will be lost,” said Griffiths, the Burton MP, in March. And Marcus Jones and Craig Tracey have lobbied health minister Philip Dunne against plans to downgrade the A&E at George Eliot hospital in Nuneaton.

“With services like A&E and maternity care, we do not have enough doctors and nurses to be able to offer everything everywhere. This may mean some A&E departments becoming minor injury units and some maternity units needing to be staffed by midwives rather than doctors.

“Given how sensitive these changes are, it is important that local candidates do not try to win favour with the electorate by opposing changes to local hospital services in a kneejerk way,” Ham added.

Labour has pledged to halt all the many planned changes to local hospital services under NHS England’s Sustainability and Transformation Plans programme if it wins power. It has promised a review and to give local people a say in the final decision.

Jeremy Hunt, the health secretary, branded the move “another nonsensical Jeremy Corbyn idea”, given shadow health secretary Jon Ashworth had previously cautiously endorsed STPs and defended the drive to centralise services.

“These local plans are developed by local doctors and communities, backed by the top doctors and nurses of the NHS, and will improve patient care,” Hunt said.

Image result for a plague on all their houses cartoon

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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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