The current issues around reconfiguration of the NHS in London illustrate powerfully that there is a deep chasm between what the public wants from our emergency services and what the future Tory offer is likely to be.
Almost every day it seems there is another twist in the continuing battle over the deeply unpopular proposals for cuts to the NHS in London. In a fresh turn in the argument about provision in north-west London, we heard that the ‘four London casualty departments handed a “death sentence” by NHS bosses could win a stay of execution’. Meanwhile, in south-west London, consultation on the proposed closures to the A&Es at St Helier and Epsom looks likely to be postponed once more. And in Lewisham, the Labour led council has agreed to take legal action against the secretary of state’s decision on the downgrading of the services at the hospital there.
The public is instinctively suspicious of the motives behind the proposed cuts to services. On Question Time recently, the insistence by Vince Cable that funding for the NHS had been ringfenced was met with scorn by the London audience. Not surprising when the programme was recorded on a day when we also heard that waiting lists for the top 10 NHS procedures had risen by a third. The government and NHS management looks dangerously out of touch with public opinion. Hospital bosses at the Whittington Hospital in north London were apparently surprised at the public outrage that was accompanied by news of the selling off of a large proportion of the hospital’s buildings.
Demonstrations about the changes in all four corners of the city are bringing unlikely protesters on to the street. When mothers with buggies start marching in the numbers seen recently in Lewisham, for example, any government should think seriously about whether the direction of travel within the NHS is politically sensible not least when healthcare professionals are also vocal in their concern about the changes.
Policymakers should take note and consider whether those demanding that their local hospital retain A&E and maternity services have a point worth incorporating in future plans. At the very least, policymakers need to recognise that patient and public concerns about the NHS changes are genuine and that it isn’t unreasonable to want a hospital that is accessible and easy to reach. While it might be true that there is now general acceptance that having specialist services for some conditions such as stroke leads to better outcomes, most people don’t believe that bigger is always better.
The current debate and thinking on both sides is muddied by the fact the drive to cut the number of A&E and maternity units is accompanied by a political drive to cut budgets and increase private sector involvement in the NHS dramatically and increase private use of NHS facilities with up to 49 per cent of NHS beds and theatre time potentially going to private patients compared to two per cent with Labour. Patients and the public at large simply don’t believe that the intention in the changes is to improve care. While we may be getting the market ideology of profit-making in health provision, we do not seem to be getting a ‘customer comes first’ approach.
People do not trust the Tories with the NHS. Opinion polls show that levels of trust in Labour on the NHS are much higher but with single issue groups such as the National Health Action party attempting to grab the limelight on the NHS, we cannot take this trust for granted.
A large part of the scepticism towards the Conservatives is due to quite clearly broken promises on the NHS. ‘There will be no top-down reorganisation of the NHS’ is possibly the most cynical pre-election pledge to have been made and then broken by Cameron. Ed Miliband has said that the change that is needed in the NHS is ‘change which upholds the values of the NHS and makes it work in the era in which we live’. This is a sound starting point for developing clear policies founded on values but we do need to establish what we can do and what we will do to resolve the problems being stored up by the current changes.
We don’t know yet exactly what the outcome for patients of the shift to GP commissioning and other current changes will be. If we do win in 2015, what is happening now will leave us a toxic legacy and there will be a dilemma of improving and investing in the health service but without the cost and upheaval of a major reorganisation of the type we are witnessing.
Building bridges between beleaguered professionals, trade unions and an incoming Labour government will be crucial. However, the NHS was created for patients and the patient, patient needs and what patient wants has to be at the heart of Labour policy on our National Health Service.
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Fiona Twycross is a Labour Londonwide assembly member and campaign coordinator for the GLA Labour group working with the London Labour party on the 999 SOS Campaign. For more information on the campaign, go to www.999SOS.org.uk
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Photo: digital cat