About me
Archive
About me

Why the NHS isn’t all about the “N”

close

Hold up! Before you read on, please read this...

This post was published more than 10 years ago

I keep old posts on the site because I often enjoy reading old content on other people's sites. It can be interesting to see how views have changed over time: for example, how my strident teenage views have, to put it mildly, mellowed.

I'm not a believer in brushing the past under the carpet. I've written some offensive rubbish on here in the past: deleting it and pretending it never happened doesn't change that. I hope that stumbling across something that's 10 years old won't offend anyone anew, because I hope that people can understand that what I thought and felt and wrote about then is probably very different to what I think and feel and wrote about now. It's a relic of an (albeit recent) bygone era.

So, given the age of this post, please bear in mind:

  • My views may well have changed in the last 10 years. I have written some very silly things over the years, many of which I find utterly cringeworthy today.
  • This post might use words or language in ways which I would now consider highly inappropriate, offensive, embarrassing, or all three.
  • Factual information might be outdated.
  • Links might be broken, and embedded material might not appear properly.

Okay. Consider yourself duly warned. Read on...

Andy Burnham has written a piece for today’s Guardian announcing that

For Labour, it all comes down to defending the N in NHS … By contrast, the Tories are ambivalent about the role of the centre, preferring localism in health as in other areas.

It’s probably churlish of me to point out that Mr Burnham has previously espoused about the paramount important of locally, rather than natioanlly, influenced healthcare (“The hospital and Primary Care Trust must listen to patients and local people and involve them in shaping the future of the hospital” – hardly a nationalistic approach).

To point him in the direction of the Conservatives’ 45-page Green Paper on the NHS in response to his claim that “on health, Cameron doesn’t do detail” would probably be missing the point.

And let’s just ignore Mr Burnham’s complete lack of insight into the effect of his target-driven culture – Patients being moved like pawns around a hospital-sized game-board to avoid staying in one place for too long – regardless of their clinical need.

Let’s just park all of those thoughts in the vastly overpriced hospital multi-storey, and concentrate on his main point. The ‘N’.

I’m an ardant supporter of the broad principles of the NHS. I think healthcare free at the point of need is a wonderful thing. But I don’t subscribe to Andy Burnham’s ideology of a national health service with national targets to tackle national problems.

The residents of Byker have different healthcare needs to the residents of Mayfair, and the needs of the residents of Tunbridge Wells or Toxteth differ equally again. Whilst it’s true that residents in none of the above places would relish waiting more than four hours in A&E, such meaningless targets do little to disprove the inverse care law which appears to be Burnham’s prime argument for focusing on the ‘N’.

In fact, quite obviously, the most imporant bit is the ‘HS’. The country needs a Health Service that is adaptable to the needs of all. Different locales will, necessarily, have different priorities. Giving Respiratory Medicine the same priority in the North East (where lung disease is relatively common) and in Southern England (where it is rarer) would appear to me to be a failing of a nationalised system, not a benefit.

Targetting outcomes seems eminently more sensible – The respiratory services in the North-East and the South don’t need to be equitable, provided the outcome – measured in cure rate, death rate, or howsoever seems most sensible to the respiratory physicians who are far more intelligent than me – is equitable.

That’s the kind of Health Service I would like. One with an ability to respond to the local health needs of local people – not by “national standards, national pay and national accountability” – all three of which have everything to do with bureauocracy, and nothing to do with healthcare.

This 1,396th post was filed under: Health, News and Comment, Politics, , , , .

Some recently published posts

What I’ve been reading this month / November 2019, 5 minutes long

What I’ve been reading this month / October 2019, 3 minutes long

What I’ve been reading this month / September 2019, 6 minutes long

What I’ve been reading this month / August 2019, 7 minutes long

A flying visit to Copenhagen / July 2019, 9 minutes long

Some random old posts

Money matters: Doctors vs Teachers / March 2006, 2 minutes long

Review: Gutenberg the Geek by Jeff Jarvis / August 2013, 5 minutes long

Eurovision: Your Decision LiveBlogged / March 2008, 12 minutes long

John Prescott to retire at next election / August 2007, 1 minute long

Legislation pretends to ban ageism / October 2006, 2 minutes long

The intelligence question and conspiracy theories / July 2005, 4 minutes long


Comments and responses

No comments or responses to this post have been published yet.

Compose a new comment



Comment

You may use these tags: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong> .

If you would like to display a profile picture beside your comment, sign up for Gravatar, and enter your email address above.

By submitting your comment, you confirm that it conforms to the site's comment policy. Comments are subject to both automatic and human moderation, and may take some time to appear.



The content of this site is copyright protected by a Creative Commons License, with some rights reserved. All trademarks, images and logos remain the property of their respective owners. The accuracy of information on this site is in no way guaranteed. Opinions expressed are solely those of the author. No responsibility can be accepted for any loss or damage caused by reliance on the information provided by this site. This site uses cookies - click here for more information.