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Five year healthcheck for Labour
Tony Blair
Has Tony Blair's government begun to reshape the NHS?

Mavis Skeet and Sharon Storer. Names to reckon with for New Labour.

Two women whose own personal experiences of the NHS found them jettisoned into the headlines.


It's how the money is spent that counts and there is still so much more to do

Mrs Skeet died after cancer surgery was delayed - while a furious Mrs Storer confronted Tony Blair during the 2001 General Election campaign to complain about conditions at a Birmingham hospital.

Their stories which exposed unforgivable shortcomings of the health service, still haunt ministers who know that their political futures rest on being able to turn the welfare state around.

The Chancellor's budget pledge of a 40bn boost to the health service over the next five years is certainly the treatment many in the health service were looking for.

However, it's how the money is spent that counts and there is still so much more to do.

More staff; more capacity and more equipment - especially in the area of information technology - will be needed if the government's ambitious reform programme is to be realised.

What a long term commitment of cash helps to do, is enable more sensible planning, something the NHS has been crying out for.

But that's the future - what about now?

Waiting in pain

Far fewer people are facing inordinately long trolley waits - more than 12 hours - than they did in the past, but delays in casualty still continue.

These are largely down to staff shortages and blockages further up the hospital chain like bed blocking - a problem being addressed by putting more funds into social care.

Mavis Skeet
Mavis Skeet died after a delayed cancer operation
Last week a charge nurse from Portsmouth spoke publicly about "third world care" in his A&E department, of patients being resuscitated on the floor and those that had died, being simply left in a side room.

Three-quarters of patients are now being seen within four hours although 13% of those who need to be admitted haven't been found a bed within that time.

So, the target that states that by 2004 the entire process should take no more than four might be hard to fulfil.

Cancer mission

Waits for treatment are also slowly improving but the government's targets have been criticised for skewing clinical priorities.

Although cancer and heart disease have been given top priority doctors complain that patients with more minor complaints may be treated first simply by virtue of the fact that they've been waiting longer.

With one or two exceptions, the promise that no patient should wait longer than 15 months for treatment has been fulfilled - but the target to get patients onto the waiting list in the first place was missed - but only just.

There are now more people waiting for operations but the length of time they're waiting has been slashed.

The flip side to this though is that there are now more operations being cancelled - a consequence says the government of more surgery being carried out.

Staff shortage

Honouring the promises to reduce waits still further, will depend on how quickly the NHS can acquire new staff and entice existing ones not to leave.

Much of this will rely in the short term on recruiting from abroad until enough home grown talent can be trained.

Enter the private sector. When Labour took the reins of power in May 1997 partnerships with private healthcare providers were rare.

Indeed health authorities and trusts are actively warned not to strike deals with independent sector. But the landscape is very different now.

Private hospitals are now conducting thousand of operations for NHS patients every year.

By removing its ideological barrier to private healthcare Labour has bought itself more time.

Winning hearts

The government will argue it's had to be flexible in it's thinking in the way healthcare is delivered - it's now asking NHS staff to do the same.

In response those that take on new duties will be rewarded and innovative hospitals will gain more freedoms - under a system of what ministers are calling "earned autonomy".

Quality of care is also a key part of the government's health reform programme.

Hospitals are now regularly inspected; compared through league tables and credited with financial freedoms where credit is due and in the wake of the Bristol babies scandal, new laws on whistle blowing should offer staff protection if concerns are raised.

Doctors are now appraised and soon will have to prove that their training is up to date. But the result say so many working in the health service is a system cluttered with paperwork.

Stalinist claims

What we've seen over the past five years is a health service being kicked into shape as part of a tightly controlled programme directed from Whitehall.

Proposed bans on consultants working in the private sector and sanctions for those who failed to meet targets are examples, say critics, of what's become an almost Stalinist form of central control.

But slowly, very slowly the tanker is being turned around. And the promise now is for more power devolved to patient and frontline staff.


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See also:

12 Mar 02 | NHS Reform
19 Jul 02 | UK Politics
06 May 02 | UK Politics
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