Dr Michelle Tempest is an NHS hospital doctor and prospective parliamentary candidate for North West Durham.
The NHS is vast. It treats over one million patients every 36 hours and employs more people than the combined populations of Birmingham and Coventry. David Cameron has made the NHS his number one political priority. With headlines about Britain’s booming birth rate and bursting maternity units, this article examines how the NHS is coping, and considers the possible merits of calling healthcare town hall meetings as recently adopted in America.
The NHS is over sixty years old. During that time there have been significant social, demographic and technological changes. Healthcare services need to keep pace with society. Political planning has to recognise that things have altered radically since the inception of the NHS. Spending on the NHS has increased from £437 million (roughly £9 billion at today’s value) in 1948 to £100 billion in 2009. It’s a huge increase. Since Labour came to power they have increased the annual NHS budget by £66 billion. Money has poured in, but have the results kept pace?
The sad fact is that vast sums of money have been completely wasted, such as £12 billion squandered on the white elephant NHS IT system. As a hospital doctor, I have first hand experience of how taxpayers’ money has been spent on creating tick-box targets and layers of bureaucracy. Rather like Upstairs, Downstairs. Labour has left ‘us’ (patients and clinical staff) in the basement and ‘them’ (managers and politicians) up in the ivory tower, far far away from the front line. It’s clear from the numbers. NHS hospital managers have mushroomed to 39,900, exceeding the 34,900 clinical consultants.
Of course, you need people to handle the paperwork. Yet this love of management for the sake of it has gone much too far. It siphons money away from patient care. Even Labour Quangocrat Gerry Robinson said: "The NHS continues to employ ever greater number of managers with no clear evidence that it is being better managed as a result". It has become more like a scene from Yes, Minister, where the hospital top of the hygiene league table has plenty of record keepers but no patients. We have no choice but to think more carefully about how and where money will be spent. The Conservative Government if elected will inherit a public sector debt of £800 billion, or 56% of GDP up from 43% of GDP in 1997. This debt is expected to rise even further to £1 trillion by next year.
So, let’s consider the recent headlines that have exposed how thousands of women give birth in corridors and lifts. Conservative Shadow Health Secretary Andrew Lansley MP has highlighted how maternity beds have been cut by 22% since 1997, whilst birth rates have increased by 20%. On top of this Britain has the worst infant mortality rate in Western Europe. In addition, more than 300 babies a year suffer brain damage caused by a lack of oxygen during delivery. I am left questioning, how has the Labour Government let this happen on their watch?
On the Continent, a consultant obstetrician is usually present on every maternity ward and routinely leads complicated deliveries. Yet this is not so in the UK. Britain is almost unique in having the majority of normal births conducted by midwives. Midwives are very popular with parents and can provide great one-to-one care during delivery. But staff shortages have made one-to-one care difficult. A poll by the Royal College of Midwives found 91% of midwives believe care has suffered as a result of rising birth rates. We need numbers of midwives to keep pace with the increasing birth rate.
At potentially complicated deliveries, such as caesareans, there is a 21% chance of having a consultant doctor present. According to the Royal College of Obstetrics and Gynaecology, less than 40% of maternity units have the minimum recommended 40 hours per week of consultant obstetric cover. We know that this position will get even worse following the introduction of the European 48 hour week and the savage reduction in postgraduate training.
With so many managers, wouldn’t you have expected better planning? Conservatives need to show we can be trusted with clear long term thinking, rather than Labour’s short term muddle. It may sound expensive to increase clinical frontline staff, but it pales into insignificance in contrast to the cost of long term care for brain damaged babies. Scope, the charity that works for cerebral palsy sufferers, estimates that up to 13,000 people are affected by brain damage caused by avoidable birth trauma.
Public services often focus on their individual budgets – not the wider social impact and public cost. If we are to improve the NHS, we need to think outside narrow budget lines and look at things in the round. It may have seemed clever to some budget planner to keep the cost of maternity services down by not having consultant cover and insufficient maternity nurses. In fact, it costs us all. It costs more money, it costs quality of life and it costs the lives of babies.
We all need to get more involved in what is happening to our local NHS services. Town hall meetings may prove a great place to debate not just maternity services, but all local healthcare provision. There must be responsibility, accountability and transparency. Local politicians should not follow Gordon Brown’s example of hiding away in times of crisis; difficult issues need to be addressed. Barriers could be broken down with increased local accountability.
A Conservative Government that scraps the target culture, trusts clinical professionals, and puts patient care at the heart of the NHS will achieve a more holistic view of healthcare in society and go a long way to improve the NHS. But we all need to get more involved in the debate – it’s your health, so the NHS should be your service.