Leading Article: Somehow, we must find the money to shore up our ailing health service

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The Independent Culture
THERE ARE times when the news strikes the ordinary person as nearly incredible. In today's newspaper, we report that over the Christmas holidays there was just one intensive-care bed available for emergency occupancy in the whole of London. In Liverpool and the North-west there have been just two beds available at any time since the beginning of November. Is that planning? Is that adequate hospital provision for our vast urban conglomerations? One Paddington rail disaster, one multi-car pile-up could so easily overwhelm this absurdly small capacity.

Back-up plans in the NHS involve airlifting critically ill patients hundreds of miles, if the handful of empty high-dependency beds proves insufficient over the Millennium weekend. A moment's reflection reveals that to be but a costly stopgap that would drain more resources from local hospital authorities (which must send a doctor and a nurse to accompany patients to distant hospitals) and force worried relatives to find accommodation in unfamiliar cities to be able to visit and comfort their loved ones.

It is true that such shortages seem to come round every winter, as cold weather brings about illnesses in the elderly and many people, including nurses and doctors themselves, succumb to flu. But to say it happens every winter is no excuse; such shortages should not be occurring in any winter. While it is understandable that an unexpected crisis may tax NHS facilities to their limits, there is no good reason for fully predictable demands not being met.

Alan Milburn, the Secretary of State for Health, is not unaware of the shortcomings of the service for which he is responsible. For some months, he has been making policy speeches arguing the case for more funds for the health service. Labour Party focus groups, which reveal that the shortcomings of the NHS are the voters' biggest concern, have added power to the case he must make to the Chancellor to secure those funds.

The Conservative Party takes the view that the shortages will never be made up by money from the Treasury, as the taxpayer is already paying a great deal and the sums necessary are very large indeed. Its solution is to bring more funds into health care from the private sector, through private insurance schemes.

The end result of that route, argues Mr Milburn, would be to reduce the NHS to a core service treating only the poor and needy. To maintain the basic structure of the NHS as a single system meeting the needs of all citizens, Mr Milburn favours such innovations as ear-marked taxes, such as that on cigarettes included in the last Budget.

In the short term, Gordon Brown will probably unlock his famously well- stocked war chest to find some money to splash out on pre-election largess for the NHS. In the longer term, a permanent increase in funding will have to be found somewhere else. On that issue the two leading political parties have very different instincts, even if they start from the same premise - that more money must be found.

The clash of debate that should ensue must yield policies to end the shame of a hospital service unprepared to deal with major emergencies.