The buzzword the Government now uses to describe its aspirations for the NHS is "personalised". Reading Alan Johnson's uninspiring speech on the subject, I concluded that this is a man not fully engaged with the scale of the task ahead.
I took part in a packed fringe debate on the health service at the Labour Party conference, organised by the Kings Fund think-tank, which recently published a report revealing that most of the extra £43bn given to the NHS had been spent on salaries for doctors, nurses and consultants, not on patients. I was looking forward to discussing this with Mr Johnson, who had promised to participate in the debate – but his junior minister Ben Bradshaw stood in, and claimed he was "still learning" his brief.
Mr Bradshaw revealed that the Department of Health is considering devising a written constitution for the NHS – giving patients a framework of what standards they should expect from the service. This could just produce more bureaucracy – there's a danger that patients could resort to law to seek compensation, diverting more precious NHS money in dealing with complaints.
Giving out scraps of paper called a "bill of rights" along with our prescriptions doesn't give better service, no matter how well intentioned. Mr Johnson talks of an NHS tailored to individual requirements, opening surgeries in the evenings and at weekends, offering health care within supermarkets, and extending the role of pharmacists. At the moment, doctors' surgery hours favour the very young and the very old, not those in the workforce. Doctors have better pay, but there is no onus on them to adjust their working hours to be available for all their patients.
Why should working people be offered a second-class, stripped-down medical service in the high street? They are entitled to expect that their local health centre – which their taxes paid for – should be open longer and the buildings put to better use in the evenings instead of switching all the lights off at 6.30pm. Primary Care Trusts should be forced to allocate funds so that complementary medicine and physiotherapy is offered in the evening and not just during the day. At the moment local medical centres are under-used when they are needed most – that's what personalised service means, not a charter. I suspect that Mr Johnson will not make any more money available for this either.
The Government has still not met targets for eliminating mixed-sex wards. Hospitals are still unpleasant places for many to stay, where noisy staff make sleeping at night difficult. Many have inedible food, and lack of cash can mean blankets and pillows are rationed, and language is manipulated so that a piece of curtain is deemed to give you a satisfactory level of privacy. The Government still fails to provide adequate funding for hospices, meaning that more than half of all terminally ill cancer patients will die in hospital, the least preferred option.
Finally, extending the age that women are screened for breast cancer from the current 50 to 70 to from 47 to 73 is pathetic. All women over 40 should be screened routinely – that's what I call a personalised service. Coming up with the money for a pitiful extra 1,000 midwives by 2009, when at least four times that number are needed, doesn't seem like providing much of a personalised service either. There is no need for the Government to waste time going around Britain consulting citizens' panels about all this. It's blindingly obvious.
A billboard that could backfire
In Milan, Muccia Prada's collection for spring 2008 was charming and original, and it was great to see intelligent clothes that don't demean women.
But elsewhere in the city, a furious debate rages over the shocking image on a giant billboard of a naked woman suffering from anorexia.
Oliviero Toscani, whose photos of Aids patients for Benetton a decade or so ago caused huge controversy, is responsible, and some designers have questioned why fashion should be linked again to what is a psychological illness.
Government ministers have welcomed these new shock tact ics, but health professionals fear they could glamorise the disease. Given the way society values celebrity and fame, this brave gesture could backfire.
* On Monday, rain couldn't ruin a jolly good day out at the Pateley Bridge show in North Yorkshire. Wonderful displays of huge turnips. Bales of hay. Closely fought baking competitions. Plus weird-looking poultry, including some that looked as if they were wearing toupees backwards.
Foot-and-mouth meant that there were no cattle – and there was much talk about how farmers have had a tough time lately. Although the Government relaxed the ban on farm-to-farm movement of livestock from Tuesday outside the Home Counties, another confirmed case of bluetongue, this time in Norfolk, will add to the farmers' worries.
And yet, at the Labour Party conference in Bournemouth you could be in a parallel world, where the Government is riding on the crest of a wave with ever-more favourable results in the polls – and the rural economy barely warrants a mention. Defra contrives to be as calm and low-key as possible about the possibility of financial ruin for farming industry – probably because most MPs have urban constituencies.Reuse content