Bernard Ingham: There’ll be hell to pay if NHS reforms fail to deliver better value for money

WE all speak as we find. I find that I am not assailed by people I meet with horror stories about the NHS, however much they feature in the press. I am much more likely to be told how marvellous the hospital was, even when the patient has died.

Nor, from my limited experience, have I any personal gripes against hospitals, though I have no wish ever to experience again the seemingly continuous turmoil of A&E departments after accompanying my wife to one. I wonder what my granddaughter, a medical student, has let herself in for.

On the face of it, you might, therefore, think I have some sympathy with Nick Clegg in trying to apply the brake to the Government’s proposed controversial reforms. Only up to a point, Lord Copper.

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Hang it all, only a few months ago he signed up to the White Paper setting out the coalition’s proposals. To get cold feet now, for no better reason than a perceived need to practise “muscular liberalism” after electoral reverses, is pretty shabby.

Instead, I am sure of one thing: we cannot leave the NHS as it is. The basic justification for reform has not changed in 30 years: demand for a service free at the point of delivery has no known limit and, combined with an ageing population requiring ever more maintenance and almost exponential developments in medical science and technology, make it sooner or later unaffordable. We have to get a grip.

Instead, developments over recent years have made things worse. GPs, whom the Government would put in charge of an £80bn budget, no longer provide a proper service.

I have given up trying to make an appointment by telephone. Instead, I go round to the surgery and beard the staff in their den.

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I have never been able to get an appointment with my preferred doctor that week, still less that day. Yet the blighters’ pay has soared into six figures and there is no night or weekend service, just some anonymous locum at the end of a telephone. No wonder A&E departments are swamped.

This is as outrageous as the recent evidence of cruel neglect of 20 per cent of elderly patients in hospitals – provided not by some axe-grinder but by the official commission that monitors the quality of health care. When doctors are reduced to telling nurses to keep patients fed and watered, we inevitably wonder what the NHS is coming to.

And those of us of a certain age develop a sense of foreboding over when their time comes to languish in a hospital bed.

All this confirms for me – just as surely as do the regular revelations about outrageous credit card spending by central and local government – that the public sector is out of control.

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This may be grossly unfair on the better establishmentsbut there is enough accumulated evidence to suggest that the taxpayer and patient too often come second to official comfort and convenience.

We have reached this stage after 30 years of governmental preoccupation with “reforming” the NHS.

By all accounts, Health Secretary Andrew Lansley, after six years study, has forgotten more than most of us will ever know about its operation. As patients and taxpayers, we can only hope he has got it right.

His failure – in line with the Government’s chronic inability to explain its policies properly – is to convince us that he is on the right track in the face of NHS staff shortcomings, the current frankly unacceptable service from GPs, inevitable union obstruction from BMA top to Unite bottom, and the ostrich syndrome in Labour and some Lib Dem ranks.

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I worry even more because of the pace with which the NHS Reform Bill has been brought forward. It is true that some of its ideas owe something to the Thatcher years and that she took the better part of a decade before presenting serious proposals.

So, could Nick Clegg be right, for whatever nefarious reason, to try to prolong the present “pause and listen” phase of the Lansley project? Not if he is just politicking.

I don’t think people bother two hoots whether their care is provided by the public or private sector so long as it is delivered well when they need it.

It is a bit late in the day now, but there are only three questions worth posing: will the Government’s plans work, improve patient care and deliver better value for money? If not, there will be hell to pay in more ways than one.

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