Sunday, 29 December 2013

NHS crisis and its causes

In a few weeks time I hope to be visiting Medway Maritime and the A&E department to look at the hard work being undertaken by staff and management to improve the situation in a struggling situation.

It is true to say that the last 12 months have not been good for our local NHS. We have had the botched implementation of an ideologically driven Conservative programme to privatise key healthcare services; we have had the hospital placed under special measures; we have had maternity and mental health services cut. The merger with Darent Valley was put on ice permanently and with the botched closure of NHS Direct in Chatham it has been a pretty full year of bad news. 

The pressure is compounded locally in my mind by the Tory-led Local Authority changing its funding formula for adults in care focusing solely on those who are in the highest category of need. It is clear that people are slipping through the cracks and ending up in hospital. In addition we have a tired bunch of Tory backbenchers seemingly unable to accept public health demographics are worsening on most key measures; alcoholism, obesity, smoking etc. This is more worrying as Public Health is now a Council responsibility under the government reforms.

Our Tory MPs are simply focused on the wrong priorities. Not a week goes by without another desperate attempt to reach out to deserting Tories to UKIP. Discussions around health tourism are base and ignore the problem. If there was ever an example of a government desperate to outbid on grubby headlines on migration or Europe we have reached that point now. A government that has utterly ceded the centre ground and whose membership is evaporating. Like with foodbanks simply being photographed smiling at a hospital wont wash if the product of failure is the same policies you voted to support. Those working in the NHS are the angriest about the ideology driven by Tories.

The recent A&E admission statistics are a case in point. The Tory government has now had months to prepare for the potential for increased admissions. The warning signs were there in Medway from the leaked correspondence from medics working in Medway Maritime all the way back to Spring. Yet the stats above highlight a worrying theme. 

The Tories claim Medway A&E department has never been up to scratch hence the need for investment now; perhaps in size and capacity it hasn't been but until the Tories took over targets were never missed on admissions by the scale we have seen in the last 12 months. Even this time last year the department was in a far better shape.

The A&E admissions crisis has worsened in just over 12 months.

The botched NHS Direct privatisation; cuts to Adult Social Care budgets coupled with senior leadership focus on re-organisations is in my mind the root cause of the problem.

All of this self-induced by this government; we did not need to pursue aggressive reforms, that had no mandate, at the exact point in time when things were working and when funding and demographic pressures required stability. We did not need to sell off NHS Direct (based in Chatham) to a multitude of private providers. We could have bitten the bullet and not solely given funding to the much smaller number in the higher categories for adult care. Direct Payments policies are flawed when it comes to elderly people with early onset dementia. Perhaps not having a millionaires tax rebate whilst instead offering greater support for the elderly could have been more appropriate.

It is true that under Labour the NHS did have provisions imposed on standards and targets. With the influx of billions of pounds of money the risk was always that it would sink into a blackhole without codified outcomes on operations, cancer diagonsis, heart disease etc. A few of the original PFI agreements were not well considered; but remembering we inherited an NHS in 1997 where over half the hospitals were older than the NHS itself and were utterly unfit for purpose. Most people on polls recognised things did improve. The Labour Manifesto position in 2010 for a National Care Service still has merit. 

Despite all the health twitter accounts in Medway and the glut of Press Officers  the truth is quite clear. The service has got worse since May 2010 and no amount of flinging the odd million or so here and there will make it better. 

If you have botched the fundamental structure, undermined the principle foundations, and have done so during a period of sustained demographic and economic stress the reality is for all to behold. 

The election in 2015 will be fought over our local NHS. If the last 12 months is the record then it is truism that you simply can't trust them with our cherished service.

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