By John Leech, Lib Dem MP for Manchester Withington
John Leech talks exclusively to MM and gives his thoughts on why he supports the coalition government’s calls to cut red tape.
I think the NHS does a great job in looking after our health and well-being. Both the frontline health workers and the office staff managers and professionals are constantly striving to improve provision. So why did all three parties say in their 2010 manifestos that reform was needed?
The Labour manifesto, for instance, said “to safeguard the NHS in tougher fiscal times, we need sustained reform” that would include giving patients a right to choose to be treated by a private hospital. Labour also said they would in future be “tougher in ensuring value for money”.
The Tories, meanwhile, said they would put GPs in charge of healthcare provision and my party, the Lib Dems, promised to improve care by giving local people a greater say in how their NHS services are run. So why was this? If the NHS does such a great job, and I think most politicians would agree with me, then why is any reform needed? Are politicians out of touch with reality?
The reason why there’s a consensus that the NHS cannot stand still and must continue to do an even better job is because our country has rising healthcare demands. The fact that many of us are living longer means the NHS will see more and more people with chronic conditions such as heart failure, dementia, arthritis, chronic lung diseases and diabetes.
On top of this, new medicines and technologies for improving treatment are becoming available all the time, and these cost money. So even with increases in its budget – an extra £11bn is going in over this parliament on top of the historic high of over £100bn a year – the NHS needs to make the available funds work harder.
That is why healthcare professionals and managers need help in rising to the challenge of treating an ageing population and ensuring we get the benefits of the latest medicines and treatments. So I support the government’s objective to get off the backs of our hard-working NHS staff, stop tying them up in red tape and make sure they are free to improve the health of local people.
We had the plain daft situation under the previous government where hospitals were paid on how many patients they treated and were monitored for how fast they got treated. So an increased number of people being hospitalised was actually a sign of success. But our hospital doctors and nurses are not running factories. They should not have been discouraged by ministerial meddling from putting any energy into activities that would stop people having to be admitted to hospital in the first place.
The King’s Fund said it has heard specialists were instructed not to give telephone consultations with GPs. If people were successfully treated to avoid needing to go to hospital, that meant less money for the hospital. This has prevented more specialists coming into surgeries to nip problems in the bud before they become so serious that people need operations.
I want to see more community-based specialists like the Bolton Diabetes Centre that was set up in 1995 and provides support to GPs and shared consultations. This led to fewer people ending up in hospital with diabetes. We need to get away from an obsession with waiting lists, and instead relentlessly focus on making our populations healthier, so fewer people end up in hospital in the first place. This is urgent in Manchester, where life expectancy is lower than the national average, and in our most deprived areas men will die 10 years earlier than in the least deprived areas.
So the Government’s proposal of new clinical consortia, where GPs, hospital doctors, nurses and patients will decide how to best meet the healthcare needs on their patches, is a good one. It means that rather than us being saddled with outposts of Whitehall telling hospitals and GPs what to do to meet arbitrary targets, our local NHS services will be able to get on with doing an even better job.
They will work to ensure that NHS patients get a say in how they are treated – and, if they want, to go to a private hospital. There is cross-party consensus that patients should get this choice. But what I have had no truck with under the previous government, and I’m pleased that ministers are now ending, is giving special favours to private hospitals – either by guaranteeing them work, or allowing them to cherry-pick the easiest work.
The previous government was wrong to allow the private hospitals to only do the most routine, highest volume operations, and to get fixed sums regardless of how many patients chose to see them or not. This meant that £19m of money intended for healthcare in Greater Manchester was handed to private hospitals for operations that never took place. I’m pleased there will be less price competition than there was under Labour, and I’m pleased that if patients don’t choose private hospitals, those hospitals will not receive a penny. And with the scandal of private hospitals being paid more for the same work a thing of the past, no more money meant for healthcare will be wasted on profit.
The clinical consortia will work hand in hand with local authorities to stop people from getting sick in the first place. It’s an outrage that the poorest areas are less well served by the NHS, and that health inequality rose under Labour. That means local councils will be charged with ensuring that everything they do, from housing, to transport, through to education, improves the health of their populations. Local health and wellbeing boards will give patients and their elected representatives a greater say on what services are provided.
Britain is the most obese nation in Europe and poor mental health is one of the biggest problems we face today and we need to up our game to turn this around. So ministers must get out of healthcare practitioners’ way and let them do what they do best — listening to what their local communities want and need, not to what the man in Whitehall is saying.