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Last Updated: Monday, 30 April 2007, 12:42 GMT 13:42 UK
Blair tackles NHS critics head-on
By Nick Triggle
BBC News, health reporter

Operation
The government has made the NHS a priority
It is one of the supreme ironies of Tony Blair's decade in power that the NHS is so often described as being in crisis.

No one government in history has ploughed as much money into the health service - the budget will have tripled by next year since Labour came into power.

Since coming to power, he has seen waiting lists and death rates drop and a host of hospitals and other health centres built - albeit with a bit of help from the private sector.

But, according to the headlines, the NHS still lurches from one problem to the next.

Nurses are threatening to take industrial action over pay, junior doctors are taking to the streets opposition a new application system and 17,000 posts have gone in the past 12 months as NHS trusts struggle to get out of the red.

In a meeting with NHS staff at the King's Fund health think-tank on Monday, the prime minister tried to tackle the issue head-on.

He listened to speeches from senior NHS officials, many of whom praised the extra money, waiting list reductions and better pay.

Mistakes

But he was also told Labour had made some big mistakes.

Peter Carter, general secretary of the Royal College of Nursing said: "I have worked in the NHS for 38 years and I have never seen so much money [put in]. But I have also never seen so much money wasted.

"It is a tragedy for the public, for the NHS and for the government."

He blamed the decision to triple to 300 the number of NHS organisations responsible for local management of the NHS five years ago, pointing out there was just not the talent to run local health services.

Tony Blair
Just as the private sector has moved to a more customised service, so public services as a whole will move in the same direction
Tony Blair, prime minister

The number of trusts, now known as primary care trusts, has subsequently been halved to 152.

Jim Johnson, chairman of the British Medical Association, said doctors were "angry and frustrated".

He said a new funding system to encourage competition called payment by results was "crude", while the way the private sector had been involved was unpopular and undermined the NHS.

And Niall Dickson, chief executive of the King's Fund, pointed out that despite the focus on public health - there has been a high-profile white paper and a smoking ban is in the pipeline - there is still "rising obesity and stark inequalities".

The prime minister responded by stressing the need to get a "sense of balance".

He acknowledged introducing competition and choice to the NHS had been controversial, but said change was often "tough", but necessary as public expectations rise.

"Just as the private sector has moved to a more customised service, so public services as a whole will move in the same direction."

'Negativity'

But his address was also laced with humour. In one anecdote he told how he was harangued during a recent visit to hospital by a member of the public who asked why he could not get the media to report more positive stories about the NHS.

Later he went on to point out that when you ask individual patients about their experience of the NHS it is much more positive than the perception of the general public.

And this seems to be the crux of the issue.

In a press briefing after the address, he rallied against the "negativity" of the media, pointing out they could use selective quotes to dwell the bad side of the story.

And the prime minister said, like he has done for many other policy areas, that it will only be in hindsight that there will be an accurate judgement of the health service reforms.

But will the argument wash with staff?

Mr Carter does not think so. After the event, he said: "I think it is very difficult in the twilight of his premiership to come out with regrets about some of his mistakes.

"His intentions towards the NHS have never been in question, it is just that he has been let down by poor policy and poor stewardship in some areas."


SEE ALSO
Recognise NHS success, says Blair
30 Apr 07 |  Politics
NHS 'summer of discontent' fear
23 Apr 07 |  Health

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