Jack Dacombe is based in London and writes the Conservative blog MediaTory.

It is a brave man who dares write a reasonable critique of the NHS these days. So, in light of the recent media deluge of anti-Jeremy Hunt sentiment, I thought I might share a short tale of my own.

It involves a friend of mine whose NHS experience began in late September 2014, when she went to the doctors with a searing pain in her knee. She was promptly informed that she had badly damaged both her ACL and meniscus, and would require surgery – so far, so good, in terms of service.

Fast forward ten excruciating, hobbled months. After an initial wait of over six months for an MRI (rescheduled once), and a subsequent three month delay in seeing a consultant (rescheduled thrice), she is finally perched, flamingo-like, in ‘Clinic 2,’ ready for her 3 pm appointment.

Only there is a problem. According to the apologetic and sheepish receptionist – clearly this sort of mishap occurs all too regularly – the consultation was at 10am, despite her letter clearly stating otherwise. Not to worry though – the appointment was cancelled in the system anyway, by persons unknown.

When a benevolent consultant eventually manages to squeeze her in, one look at the MRI enables him to explain that she has been struggling around on a knee barely held together by threads. Despite that diagnosis, she is still required to limp across the hospital campus in order to deliver her own notes to the relevant department.

I’ll let that story sink in for a moment. In today’s ‘modern’ NHS, a patient with a shredded knee has to endure a wait of almost a year for treatment, and is then required to hand deliver her own doctor’s notes. The whole process is utterly farcical: it’s akin to JP Morgan waiting three days to execute a client trade and then sending the confirmation by carrier pigeon.

None of the blame for this lies with the point-of-care staff. God knows they work hard enough and, in the case of the nurses and some of the support staff, deserve a decent pay rise. No, this is the fault of a clunking, antiquated system, and the bureaucrats who suckle at its teat.

There is a stubborn, rose-tinted adamance in the left-wing support of the NHS in its current state. It is one of the symbols of the success of post-war Britain – a marvellous social care service that prioritises on severity of condition, rather than weight of wallet. It’s a national treasure, like the Palace of Westminster or the England football team.

Unfortunately, like those two institutions, it has seen better days.

Bloated by decades of poorly planned expansion, the NHS is an outdated behemoth, lumbering along in a most inefficient manner. At its inception in the 1940s, it was a well-oiled machine, providing timely, free healthcare for all who needed it. The NHS was the envy of the world.

Of course, medical requirements were a lot simpler 70 years ago. Doctors nowadays have to cope with a litany of social diseases and mental health problems that were unheard of in the NHS of yesteryear, whilst a shrinking world has brought all manners of tropical ailments to our shores.

Then of course there’s the pressure of a constantly growing population who, on average, live 20 years longer. The NHS simply wasn’t designed to cope with this volume and variety. For years, the NHS playbook has been hastily expanded with rushed addenda, with the emphasis on speed of implementation rather than careful planning.

It’s human nature to expedite decisions aimed at enhancing treatment. What is unacceptable – and here we reach the rot at the core of the NHS – is the additional layer of bureaucracy added with each ‘improvement.’ With the numbers of beige paper-shufflers multiplying year-on-year, the NHS system has become clogged.

With salaries wildly out of proportion to their actual worth, bureaucrats are tying up cash that’s needed at the point of care. Staff wages aside, there is a dire need to upgrade the logistics and data system. For a hospital to lack the IT capacity to take digital notes, and to safely and reliably transfer records between departments, is quite staggering.

So what to do, then? To attempt a major privatisation would merely spur Labour into trotting out their hyperbolic slogan of “___ days/weeks/months (delete as appropriate) to save the NHS”. The Tories shouldn’t want to anyway: state-run healthcare is one of the key pillars of British life.

Improvements will not come easy, though. The NHS has always been a sticky issue when it comes to modernisation – especially with dead-weight administrators falling under public sector protection – and the government won’t want to risk public ire. However, something must be done.

Either the NHS must consent to a vigorous top-down restructuring and streamlining, but remain, for the most part, state-operated, or enforced selective privatisation must occur.

What doesn’t help matters is the overzealous onslaught on Jeremy Hunt. It’s churlish to claim he’s ‘trying to destroy the NHS’ or that he ‘doesn’t care about the sick or their doctors.’ It’s this sort of histrionic reaction to proposed NHS changes to that has preserved its woefully inefficient state.

Those filling column inches and airwaves imply that the Conservatives are caressing their BUPA cards and plotting the downfall of free social care, when all they want to do is drag the NHS into the 21st century. Labour are right: the NHS does need saving, but you can only help those who want to help themselves.

If the NHS continues blindly down its current path, it’s the patients that will ultimately suffer.

21 comments for: Jack Dacombe: The NHS must modernise or privatise

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