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The NHS: Opening the Debate on the Left. Part One

Creating and Maintaining a 21st Century NHS.


Ask yourself why the British People Love the NHS?


1)        It is free to all at the point of use.

2)        It is accountable because it is paid for by the people.

3)        You will get first-class treatment no matter what the cost or your socio economic/ educational status.

4)        You will be treated with dignity and respect.

5)        In a dire emergency you have all the worry removed.


As Labour Party people we lionise the NHS as our greatest triumph, and laud the fact that we have created a consensus where even the most right wing Tories would never dare suggesting financial cuts to the service.


I suggest that we have created a situation where there is no connect in people’s minds between spending on health and a rational debate.


For example; some people on the Left have extreme reactions to the idea of the Market being involved in the NHS.


The reality is that 90% of financial decisions taken in the NHS are market regulated, from cleaning contracts to the £8 billion spent on brand name drugs in 2009 so the idea that we should ignore the market is just not practical.


“We are spending more! Vote for us!”


In 2001 Gordon Brown announced that spending on the NHS would double by 2009, to £77 billion. This was achieved by a combination of tax rises (NI) and the investing the rewards of economic growth and a stable economy.


The pharmaceutical companies salivated at such largesse by a major economy.


Dr. Ron Pollack’s report of 2008 on behalf of Alan Johnson’s review into the industry said, "Drug companies’ commitments to research and development are dwarfed by those companies’ expenditures for marketing, advertising, and administration. Spending on these areas has increased by tenfold in the case of Pfizer, in just six years since Brown’s announcement”.

Pollack came to this damning conclusion; “"If meaningful steps are taken to ameliorate fast-growing drug prices, it is corporate profits, expenditures on marketing, and high executive compensation that are more likely to be affected, not research and development."

We have to ask some basic questions here.

1.          What are we getting for our £77 billion?

2.          Is it value for money?

3.          Can we make savings?

4.          Is it desirable, or indeed pragmatic just to keep spending?


“To Squeeze or Not To Squeeze?”


Why are things so much cheaper in relative terms, compared to twenty years ago, whereas costs are going up and up in the NHS?


One reason could be because customers “squeeze” outlets, such as Supermarkets for lower prices. Just like employees squeeze their employers for higher wages, householders squeeze tradesmen for cheaper plumbing works, and so on and so on. That is why the market gets steadily more efficient. Because we all “squeeze” each other.


This leads to my first proposal.


Every Single Contract From Drug Provision, To Cleaning and Catering Must Be Subject to a Full Audit.


The Office For Budget Responsibility which the Coalition has set up can take the lead in setting the ball rolling. The remit must be tough, but accountable and transparent, reporting to the Health Select Committee first, then the Government.


Key questions should be;


1)        How does the implementation of the said contract measurably benefit patient care?

2)        Who is responsible for supervising the contract?

3)        What would happen if the contractor were changed?

4)         What evidence of cost awareness by the contractor is available over the last year?


The impact of such a review would at the minimum to encourage a culture of efficiency because the Market dictates that if a contractor is perceived to be wasting a client’s money, the contract will not be renewed. At the maximum end we may see a wholesale renegotiation of service providing as contractors are exposed in a public environment to wasting public money at a time when we are looking to make savings.


The culture of just throwing money at the NHS has to stop and the Left, because of the fact that we are trusted by the public has the opportunity to take the lead and set the agenda.


Coming Next: How to Deal with "Big Pharma" and the NHS Drug Bill.


About dermotrathbone

Writer and co author "Through Red Lenses". Activist Unite the Union, Save Our NHS Hull. Fan of Yorkshire County Cricket Club, Hull FC, Munster and Ireland Rugby. Views are mine alone and may not reflect the organisations concerned.


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