There has been a ‘write-in’ campaign against the ‘intrusion’ of private sector providers into the NHS.
It’s an old ideological battle that dates back to when Barbara Castle was Secretary of State.
The reality is that most of our interactions with the NHS are through private providers because overwhelmingly our GPs are private contractors.
As it happens I‘ve received a batch of statistics from ministers which measure improvements in the NHS.
We are spending record sums on it, more in fact than any political party ever promised and our health expenditure compares favourably with other wealthy nations.
Notwithstanding to-day’s alarm from the GMC that our doctors are about to depart for the antipodes, the plain fact of the matter is that there are now more clinical staff -doctors and nurses- working in the NHS than ever before in its history. This includes an additional 50,000 nurses added since the last election.
In Local terms the statistics are that Hampshire & Isle of Wight Clinical Commissioning board has been allocated £3.43 billion for 2024/25. In the Southampton University Hospital NHS Foundation Trust, which serves most of my parliamentary constituency, there were 124 more full-time-equivalent doctors and 274 more nurses in September 2023 than there were in September 2022.
I could go on, but all these statistics are all about inputs. What is of concern to patients is the outputs: the number of successful treatments and appointments. In this respect the NHS lags behind the performance of comparable healthcare systems in other wealthy nations where survival rates for many conditions are better and waiting times are shorter.
We kid ourselves with the mantra that we have the best healthcare system in the world. Were it so, it is surprising, that nowhere else in the World has anyone copied it.
Over my time in Parliament, in opposition and in government, numerous clinicians have come to give me their insights about NHS. With few exceptions however, they have been short on remedies to fix the systemic problems that they identify.
I am certain that politicians, irrespective of party, are amongst those least qualified to run the NHS.
Accordingly, the whole thrust of Policy from 2010 was to take the politics out of it through the creation of NHS England, a body largely independent of government. Let politicians determine how much the nation can afford to fund the NHS, but let the professionals run it.
Alas, such is the nature of our politics that whatever goes wrong in the NHS, ministers will get the blame. Increasingly they now find that, despite being blamed, they have few levers to pull -having handed so much of the power over to NHS England.
Symptomatic of our political focus, in Parliament I find that every week I am inundated with invitations to attend meetings and receptions organised by all-party parliamentary groups (APPGs) campaigning for more NHS resource for their own particular disease (there is such an APPG for every known medical condition, perhaps with the exception of rigor mortis). Badgering politicians is no way to determine clinical priorities.
As to my own remedy, I think the NHS is far too big to be manageable – it’s the world’s largest employer, its culture is too bureaucratic and too centralised, it needs to be broken up and made much more locally accountable; it must become much more flexible and nimble in using the private sector.
Wes Streeting, Labour’s Shadow Secretary of state says he won’t let ‘middle class lefties’ interfere with his own plans to make use of the private sector… Well, good luck with that.