The crisis in Accident and Emergency departments across the NHS has become acute over the past seven months. The explanation offered by Jeremy Hunt, the Secretary of State for Health, that the GP contract negotiated by the Labour government in 2004 is to blame, therefore fails to match the chronology.
Of course, the worsening of out-of-hours GP services that resulted from that contract has not helped. But it only added to a long-term trend of people going straight to A&E for conditions that they would previously have taken to their family doctor.
The immediate cause of the problem is the 111 non-emergency phone service, which was piloted in some areas last year and extended to most parts of England at the start of last month. As The Independent on Sunday reported last week, the 111 service was rushed into operation before it was ready. We also reported that NHS England, formerly the NHS Commissioning Board, identified the failings of the 111 service as the main cause of the A&E crisis when Mr Hunt asked it to investigate. Its report did not mention the 2004 contract.
Mr Hunt's attempt to blame the last Labour government is unworthy of him, and spoils the good start he made in the job since David Cameron appointed him in the reshuffle of September last year. Until recently, he had succeeded in the most urgent task entrusted to him by the Prime Minister, namely to keep the NHS out of the headlines after a long run of bad news under Andrew Lansley.
Mr Lansley must shoulder most of the responsibility for the current problems – although it was Mr Cameron who appointed him in the first place. And it was Oliver Letwin, minister for Government Policy, who was sent into the engine room of the great top-down reorganisation that the Conservatives promised not to inflict on the NHS, and who emerged, wiping his hands with an oily rag, saying all was well and ticking over nicely.
It was Mr Lansley who wasted two and a half years by trying to impose a revolutionary scheme on a vast, ramshackle machine, which needed evolutionary reform. Big projects, especially if they involve computers and public money, have a tendency to run on long after they should have been stopped, as the BBC finally admitted last week, pulling the plug on its £100m Digital Media Initiative. And it was Mr Lansley who said he was abolishing Labour's "top-down" targets when he was renaming them as benchmarks, leaving NHS staff confused about their objectives, including the important one of limiting A&E waiting times to four hours.
If Mr Hunt is serious about restoring confidence in the NHS, therefore, he needs to do better than blaming Labour. He needs to acknowledge the 111 problems and fix them. And he needs to have a long-term strategy for the growing demand for A&E, including the growing pressure from the failings of long-term care for the elderly.
Instead, the Conservatives seem to be casting about for radical ideas for choking off demand for NHS services at source. We report today on a party consultation paper floating ideas such as capping the number of GP visits patients can make, which would surely increase pressure on A&E departments.
The problems of the NHS are deep and serious, and will be hard to contain at a time, stretching for all the foreseeable future, of unchanged real-terms funding. Mr Hunt's attempt to score cheap political points does not match up to the needs of the moment.Reuse content