The Health Secretary, Alan Johnson, conveyed two messages about the future of the National Health Service yesterday. The first, addressed as much to those in the conference hall as to those outside it, was that the Blairite age of frenetic structural change is over. The second, addressed more generally, was that from now on user-friendliness will be a major criterion of success. Future change, he said, would be "clinically led, locally driven and constantly focused on a personalised service for the patient".
And this is welcome news. At least, it seems, ministers have been listening to the sometimes humdrum complaints of those who use the NHS. From those in full-time employment who find it difficult to make an appointment, let alone a convenient appointment, with their GP. From pregnant women who see someone different at every ante-natal appointment and have no guarantee that an experienced midwife will attend the birth. From in-patients who contracted a super-bug while in hospital. From those placed at a disadvantage by the postcode lottery that exists for certain services.
So forgive us just a little scepticism. While Mr Johnson is right to see user-friendliness as a priority, top-down edicts will be no more than a wish-list so long as GPs and hospitals see their salvation in pleasing Whitehall target-setters rather than inconvenient patients.
It was Mr Blair who said more than a decade ago that it should not be beyond the wit of government or health administrators to eliminate mixed wards. Disgracefully, mixed wards are still with us – and went unmentioned by Mr Johnson. His call to combat super-bugs by the mandatory deep-cleaning of every hospital will be a waste of time and money unless all NHS staff who have contact with patients regularly wash their hands and keep clothing and equipment sanitary. And while the Government has only itself to blame for signing up to such an expensive GPs' contract, it is patients who suffer from their doctors' lack of incentive to work outside office hours.
Standards of public health in Britain, especially in the more deprived areas, are markedly inferior to those in much of Europe. The inconvenience of much primary care surely contributes. Meanwhile computerisation of records – which should have helped patients exercise the promised choice – has suffered all the problems associated with government IT projects. Ministers, for their part, have too often relied on headline-grabbing initiatives to give an impression of action, when what was really needed was an improvement in the basics, such as cleanliness, efficiency and humanity.
Mr Johnson offered a bit of both approaches in his speech yesterday. We hope the focus on patients is the one that prevails.