The musings of a final year medical student

Monday, 23 March 2015

Which political party really cares about the NHS?

So, the 2015 UK General Election is looming. As someone who is interested, I am both passionate and confused as to what different parties hope to provide for us. Politics is something I do try to keep up with, but to be quite honest the more I learn the more it perplexes me. 

One of my greatest concerns is the NHS. I don't want more cuts and I don't want a private healthcare system. Opinions are very much divided on the efficacy of our free healthcare system, but all the same I am a supporter of it. As a medical student, I feel very strongly that when I qualify I want to give care to people without handing over a huge invoice. Healthcare should be a right, not a privilege. More and more there is speculation as to how long the NHS will last. I shared a Channel 4 documentary on my Facebook account that explored some of the funding issues. The documentary claims that 2 billion pounds is spent per week on the NHS. I would highly recommend this documentary. Patients that await costly treatments such as IVF and gastric bands are interviewed and the outcome of their request is recorded. It is heartbreaking to see when treatments cannot be offered because of cost. However, without the NHS more and more of these pricey treatments will be unavailable to those who need it.

I have tried to make this post as unbiased to any particular party and rely purely on party websites and media coverage. Please let me know if I've got my facts wrong!

Okay, let's start off with the Tories. A Facebook petition popped up today on my homepage claiming that David Cameron has handed over £780 million to private healthcare firms.  The link tells us that some of these companies, which will carry out important procedures such as heart operations, have track records of poor healthcare. This data has been found by NHS regulatory analysts. Allegations are spread that these private companies are linked to the Tory party, too. Labour's shadow health secretary Andy Burnham says "It is outrageous that large chunks of the NHS are being parcelled up and sold off without the permission of a single person in this country." The article highlights one private firm, called Vanguard, who is set to carry out heart operations but is simultaneously being investigated for botched eye operations under another NHS contract. The article also gives a link to The Guardian's coverage of this news story. Three of the eleven firms that are to be implemented have been complained about. The link to The Guardian's article is here. What isn't clear is why David Cameron did this; what benefits can we yield from this transaction? You can sign the petition against this here, if you want to. 

According to their website, they've done a cracking job of reducing the deficit by half. That's great. They then go on to slag off Labour and mention that "Labour  racked up the biggest budget deficit in our peacetime history." Their claim is "That's why we're taking difficult decisions now - because the alternative is to burden our children with more debt and put the recovery at risk." 

The reason why they should be assessed with caution is because of all the NHS cuts we have witnessed since they were put into power and the ambiguous claims (see above paragraph) that they're basically prepared to do whatever it takes to get the deficit reduced. However, they believe that by strengthening the economy this will allow the NHS to thrive.  I struggle to understand why a limitation of NHS services yields better patient care? In addition, I don't feel too comfortable with their attitudes to benefits: "By capping benefits, we’re rewarding work and helping thousands of people get off welfare and look forward to a brighter future." Quite a strong assumption there that people on benefits don't deserve them, so they're not going to get them. Do the unemployed people not get a brighter future, too? 
To their credit  they have made some commendable improvements to the NHS:
"Reducing bureaucracy to pay for more than 8,000 more doctors and 6,000 more nurses on wards – so frontline services deliver for you and your family
Making services more efficient for patients – the number of people waiting more than a year for treatment is down by 98 per cent
Launching a new Cancer Drugs Fund, which has already helped more than 60,000 people"

The Conservatives then go on to say that they will ensure GP access 7 days a week by 2020. Think what you want about that possibility, and how that could affect not only a patient's lifestyle but also the doctor's. Given that there is already a demand for more GPs, they would have to spread even more thinly on the ground.
To summarise, The Conservatives have no concrete statements on their website agreeing to prolong the National Health Service. They are making changes which they are convinced (or at least are trying to convince us) will improve NHS care. The life expectancy of the NHS is unknown.

Then, in contrast, Labour. We all know Labour are pro-NHS, but what does Labour intend on doing to ensure our NHS can survive? Their website claims that thanks to the Tories we have our ridiculous A&E waiting times. Maybe those cuts didn't work out that well. But Labour, please tell us how you're going to fix this problem, rather than reminding us that we shouldn't trust the Conservatives. They also guarantee you can get a GP appointment within 48 hours if you elect them into government. Sounds like great stuff, but where's the strategy? How is this actually going to work? How much will it cost, and where's the money going to come from? Furthermore, they want to prioritise mental health more. It's great to see that a political party is addressing this overlooked topic. They want to implement better training to NHS staff in order to aid diagnosis and treatment for these individuals. They also say "We will change the NHS Constitution to give people the right to psychological therapies for mental health problems like anxiety and depression – helping to give mental health the same priority as physical health."
In addition, they want the NHS treatment to be an all-encompassing lifestyle assessment; this means taking into account physical health, mental health and social issues. They argue that at present "The current health and care system is still based on three fragmented services: physical health in the mainstream NHS, mental health on the fringes of the NHS, and social care in council run services. Increasingly, however, people’s needs are a complex mix of the physical, mental and social. For all its strengths, the NHS was not designed to fully recognise this." 
A contradiction to the Conservative government's aims is highlighted: "They (the Conservatives) made it harder to see your GP, by scrapping Labour’s guarantee of a GP appointment in 48 hours, saying that this was “no longer a priority”. They cut funding for Labour’s GP extended opening hours scheme, and as a result fewer practices are open at evening and weekends." How does this complement the Tories's aspirations for 7-day GP practices???

What becomes clear is how the constant digs that each party dishes out about their opponents overshadow the true content of each party's manifestos. I'm more interested in hearing pragmatic approaches to solving our problems than seeing each politician pointing their finger at their enemy. Labour continue to shame David Cameron: "David Cameron promised that under him there would be no top-down NHS reorganisations. He broke his promise. It just goes to show: you can’t trust the Tories with the NHS. In fact, the Tories have wasted £3 billion on a top-down reorganisation which puts competition and profits before co-operation and patient care, and ties hospitals up in competition law.
Scandalously, as part of David Cameron’s reorganisation, over 4,000 NHS staff have been laid off and then rehired, many of them on six-figure salaries.....It always falls to Labour to save the NHS from the Tories. We will do it again." 
In terms of action, they intend on ensuring a free health service at point of use, remove enforced competition and ensure private patients are not prioritised over others. Overall, we know Labour wants the NHS to live. It wants to tackle key issues and has listened to the demands of the general public. However, the exact methods of problem solving are yet to be uncovered. At the same time, should we be worried about Labour's infamous budget-breaking track record? Will flooding investment into the NHS worsen or improve our overall economy? It seems Labour has great ideas to improve quality of NHS care, but what are the changes going to be that allow the NHS to keep going, rather than bringing the deficit right back down to where it was when they were last in power? What are we going to have to give up to allow these changes?

Moving onto the LibDems. Even though we lost faith in them when the tuition fees went up, it's worth browsing over what they've got to say about the NHS. Once again, the first thing I notice is naming and shaming. "The Tories and Labour have put the NHS at risk. It was Liberal Democrats who stopped Conservative privatisation plans and reverse some of Labour's policies which meant private health companies got special favours. In fact, Labour paid private companies £250 million for operations they didn't even perform. Liberal Democrats have made sure that can never happen again." 
Like Labour, the LibDems want to give more focus to mental health: "We are using £400 million to help people with mental health problems get the right support early on, such as talking or psychological therapies. We are also introducing waiting limits, so people will know for the first time how long they have to wait for mental health treatment." Unfortunately that's all I could find on their website! I scoured their pages, but there seems to be mostly emphasis on their alternative economic strategy and pensions.

Finally, the Green party. According to their website: "We don’t believe that the public’s health should ever be up for auction. That’s why we are completely opposed to the Conservatives’, Labour’s, and Liberal Democrats’ policies of introducing market forces and competition into the NHS – a process which is placing the interests of corporate profits ahead of the nation’s wellbeing.
We will:
Fight for a publicly funded, publicly provided health service free at the point of use.
End the creeping privatisation of the NHS and repeal the Health and Social Care Act 2012.
Make mental health a much higher priority with resources to match this status."
So good, pro-NHS and also wanting to tackle mental health. But how else is the NHS going to be sustained? 

Other minority groups haven't been covered in this post. 

I think what we can take from this is that all of them are a bit rubbish at showing us hard evidence as to how we can sustain our NHS. Parties clearly love to contradict and downplay each other as a petty way of getting more votes. I can see why they do it, but it does get to the point where it's just plain boring. I wonder whether further NHS reformations will be worth it if potential over-spending could worsen our economy. PLEASE give me more stats and links if you have any regarding this matter. Tell me what you think.


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