Those “five giants” are getting larger. The ghost of Beveridge haunts the country…

In the last decades, and especially in the devolved parts of the UK, the “five Giants” which Beveridge described have been growing. Post code unfairness in treatments and outcomes is a regular matter in the media, and the public have become immune – until they themselves fall victim.  Then it’s too late. Dead patients don’t vote, but their families do become cynical and restive… If readers wish to be reminded of the altruism which set up the original NHS read here: In Place of Fear A Free Health Service 1952 Chapter 5 In Place of Fear Neglect, short termism, and denial are the cause. In a media led society this is such a shame, but reflects the poverty of debate on ideological issues.

The Telegraph thinks the “hard” Brexit deal will be expensive for the Health Services: £500m?

Nick Triggle, while welcoming the pay rises for NHS staff says: NHS pay rise: Are there strings attached?

NHSreality has already commented upon the rationing of hearing aids, and that the delay in proper treatment may be linked to dementia

The Mail is on about lack of evidence for masks, and rationing robotic treatments… and that Rationing is cutting lives short.

Andrew Grice for the Independent sums up the current situation and dilemma for the politicians: NHS England is rationing its services – Hammond’s Budget didn’t go far enough – The Budget’s gaping hole was on social care; it is close to collapse and putting ever-increasing pressure on hospitals through bed-blocking, but got no extra cash

A debate about rationing the care provided by the National Health Service will be launched tomorrow, when NHS England begins a conversation about what it can and cannot afford to do.

Although there will not be a hit list of cuts at this stage, the implications will be clear enough: the Government has not provided enough money to meet goals including the 18-week target for elective operations; cancer treatment; mental health; public health and obesity and for a creaking social care system. In short, something’s gotta give.

NHS England’s gloomy prognosis will come at a bad time for the Government. Theresa May has made mental health a personal priority. A green paper soon about expanding help for children will generate some headlines, but without money and staff there will be little or no difference on the frontline until 2021.

Similarly, ministers’ hopes that Budget headlines about a “£2.8bn boost for the NHS” would buy some political credit will prove short-lived when the continuing cash crisis is laid bare. Philip Hammond’s injection was less generous than it looked: £1.6bn for next year, well short of the £4bn a year prescribed by three independent think tanks – the King’s Fund, the Health Foundation and Nuffield Trust…..

The Local Government Association estimates a £1.3bn funding gap between what care providers need and what councils pay. Although May acknowledged the problem during this year’s election, she got her fingers burnt with her so-called “dementia tax” and the issue has now been kicked into the long grass. We won’t get a green paper until next summer. That is woeful, given the additional pressure the demographic timebomb will put on health and social care.

While the debate over NHS rationing is inevitable, we need a much wider one about the state’s priorities. The 2010 and 2015 elections were followed by a government-wide spending review. There’s no sign of one now – another example of the reduced capacity of a government consumed by Brexit.….

Appropriately enough, the new statesman celebrates the 75th anniversary of the Beveridge report: Slaying the Five Giants: the 75th anniversary of the Beveridge Report

This entry was posted in A Personal View, Community Health Councils, Patient representatives, Political Representatives and activists, Post Code Lottery, 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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