Stay up to date with notifications from The Independent

Notifications can be managed in browser preferences.

What have they done? What should they do?

Jo Dillon
Sunday 04 May 2003 00:00 BST
Comments

The National Health Service is still, after more than half a century, Labour's biggest and brightest idea. Set up in 1948, the NHS was founded on the principles that healthcare should be available to all, regardless of the ability to pay, and free at the point of use. The service now employs more than a million people and costs more than £50bn a year to run. This will rise to £69bn by 2005. In a typical week 800,000 people will be treated in NHS hospital outpatient clinics, more than 10,000 babies will be delivered, ambulances will make more than 50,000 emergency journeys and NHS surgeons will perform around 5,250 hip, heart and kidney operations.

What were the problems?

Sustained underfunding of the service had left the NHS gasping for breath. Staff shortages – particularly personnel trained to carry out specialist tasks – put the system under further strain. Waiting lists were at record levels and the hospital building programme was stalling. Patients were waiting too long for life-saving operations and emergency treatment. Morale among health service workers was low, exacerbating staffing problems as trained professionals left the service. Bureaucracy was eating up billions. That was in 1997. By 2001 it was not much better.

What did New Labour promise?

Money and reform. They vowed to cut waiting times for stroke, cancer and heart disease by increasing funding and recruiting more doctors and nurses; to re-ignite the hospital building programme with a pledge to build 100 new hospitals by 2010; to bring down waiting times to nine months for major operations and four hours for emergency treatment;to enhance the status and morale of NHS workers.

In short, in return for re-election in 2001, Labour promised that they would do what had never been done before:turn round the NHS supertanker.

What have they done so far?

An extra £5.2bn went into the NHS last year, although only £1.3bn of that was used to hire crucial new staff. Gordon Brown pledged an extra £42bn in the years to 2007-08 when funding will reach £110bn. Strict targets have been set to get waiting times down. Private finance initiatives have been agreed to get building programmes under way. A contentious programme of reform, centring on plans to create a new tier of foundation hospitals to give trusts greater freedom from hated Whitehall control, is being developed.

What do they need to do next?

Listen and learn. While there are strong signals that the money coming from central Government is getting through, hospitals continue to complain of over-centralised control, which leaves them hamstrung when it comes to getting the money they need for the things they need, when they need them. Targets, too, have been blamed for distorting clinical priorities, and the Government is under pressure to adjust or scrap them. To meet an increasingly consumerist approach to healthcare, more money and staff will be needed and treatment will need to be dramatically more efficient. Above all, the NHS needs to develop flexibility, imagination and a keen sense of the needs of patients and medical staff rather than those of administrators and statisticians.

The Health Chief

Mark Britnell, 37, is chief executive of the successful University Hospital NHS Trust in Birmingham. He has seen it win top star ratings and a glittering Commission for Health Improvement report this year, and is full of figures, thanks toGordon Brown's millions: "I have noticed a more profound change than I expected. Clinical staff are starting to realise what the modernisation agenda means." Problems remain: a shortage of qualified radiographers and pharmacists, "toxic targets" – hospital speak for Government targets that cause other problems – and the debate about foundation hospitals (he wants UHB to become one). But he aims to "implement ideas sooner rather than later for the benefit of patients".

The Patient

Margaret Hadley had a kidney transplant at the Queen Elizabeth Hospital in 1995 and, at 69, is still a patient from time to time, most recently when she suffered a minor stroke on Easter Sunday. Staffing levels were low over the bank holiday and a skeleton night staff had just come on shift, but Mrs Hadley had a bed, albeit in the liver ward, within the target four hours. "It was all very much better than 12 months ago," she said. There were plenty of nurses, she saw more doctors on the ward than on previous visits, even the food was better. Then there were the finishing touches that made her stay more bearable – she had a television at her bedside and the use of a portable telephone. While being in hospital is never pleasant, Mrs Hadley said: "It was as good an experience as it could have been."

Join our commenting forum

Join thought-provoking conversations, follow other Independent readers and see their replies

Comments

Thank you for registering

Please refresh the page or navigate to another page on the site to be automatically logged inPlease refresh your browser to be logged in