Tough medicine

PUBLIC healthcare in Yorkshire is about to go through its second revolution in little more than a decade. This time, however, the changes will see cuts in spending, hospital departments closed and care moved into the community. It is a world away from the eve of the 1997 election, when Tony Blair told voters there were "only 24 hours to save the NHS".

It is no wonder that doctors, nurses and patients feel such

frustration. The swift expansion of the NHS in Labour's first two terms, followed by the financial crisis, has left the Department of Health facing the longest and deepest period of austerity in its history. This may feel unfair, given the recklessness of bankers and laxity of politicians which caused the financial meltdown, but it is inevitable.

Ministers therefore have to look for where the cuts – with the one per cent rise in health spending more than cancelled out by inflation – will be kindest. The obvious initial answers are to slash waste and reduce the number of managers, as well as the number of negligence cases faced by primary care trusts, but civil servants have to look beyond these.

It is right they consider cutting the time patients spend in hospital and eliminating unnecessary outpatient follow-ups. What they have to ensure, however, is that the sick still get the best care when they are on wards.

Tackling the worried well, as GPs recently attempted to do by encouraging those with minor problems to stay away from surgeries, would also make a difference. There is a fine balance though between putting off time-wasters without scaring off the vulnerable. It should not be the case that those who shout loudest get the most attention.

The urgency of Mr Blair's words is not true today but, once again, the NHS needs to be saved.