UNCONTRADICTORY:

NHS 'enjoying best year' - Hewitt (BBC, 4/23/06)

Despite huge job losses and mounting financial problems, the NHS is enjoying "its best year ever" according to Health Secretary Patricia Hewitt.

The service faces a financial deficit of up to £800m and some 7,000 job losses have already been confirmed.

Every year closer they come to it falling apart completely is better than the year before.

MORE:
A painful lesson on healthcare in the NHS Bermuda triangle (Simon Jenkins, 4/23/06, Times Online)

To the public the present NHS “crisis” must be baffling. Not a day passes without a bad news story in the press. Deficits are soaring, hospitals going into virtual administration, drug treatments being decided by the High Court and 6,000 staff about to be sacked. Even in fashionable Kensington and Chelsea the health trust has recently found itself with £6m in invoices not accounted for and the auditor not noticing. The same auditor, Price Waterhouse Coopers, is then called in to audit the loss, doubtless adding its own invoice to the pile.

Yet I can dimly see method in Blair’s pain and gain. There is at last an NHS “narrative”. Waiting lists are down and gleaming hospitals are rising at least in the big cities. The much-quoted £800m deficit is no big deal in a service costing £72 billion. It is only getting publicity because, at last, the government is refusing to rob Peter to pay Paul. The pus of inefficiency is finally starting to ooze from the NHS patient.

The British health service had by the mid-1980s become an unsustainable racket. Doctors were running hospitals according to mind-bending restrictive practices. Theatre productivity was pitiful. Nurses and paramedics were treated by doctors as serfs. A&E patients were handed from one clinician to another in a ludicrous make-work scheme. Drug companies, computer firms, management consultants, negligence lawyers and staff unions were walking away with the till each night.

By 1987 the Tories had doubled spending and the money had vanished. Margaret Thatcher lost her temper. Wailing to Panorama about the “bottomless pit” of NHS costs, she set in train what became the 1990 NHS Act and two decades of reform.

Any Briton who smugly insults public administration in France or Italy or Paraguay or Papua New Guinea should study Britain’s NHS, c1990-2006. Thatcher’s reform began as essentially sound. She introduced fundholding doctors and trust hospitals, forcing GPs to be more resource-minded and trying to release hospitals from the grip of a reactionary medical profession. A bureaucratised NHS would be supplanted by a market-led local one.

The 1990 Act was scuppered first by the Treasury and then by the Labour party. The Treasury refused to allow hospital trusts financial autonomy, even denying them freedom to negotiate their own wages. They lost control of their costs and simply dumped the bill on the exchequer. Yet as a recent report for auditors KPMG by Rupert Darwall — a director of the Reform think tank — has shown, Thatcher’s fundholding yielded a more dramatic fall in waiting times than did Labour’s extravagance.

Posted by Orrin Judd at April 23, 2006 8:23 AM