Tom Bennett is a Conservative candidate for councillor in Kensington & Chelsea, and works as a management consultant.
It is impossible to read a newspaper these days without being reminded of the enormous sustainability problems facing the NHS, and how it is currently being stretched to breaking point.
In January, the Red Cross reported that the NHS was facing a humanitarian crisis, and this is only likely to get worse given current demographic trends.
Beyond increased A&E waiting times and the severe rise in bed-blocking, the IEA has calculated that if the UK’s breast, prostate, bowel and lung cancer patients were treated in Germany or Belgium, 13-14,000 more lives would be saved every year.
Meanwhile, political debates surrounding the NHS have become increasingly partisan, and less objective. The last two elections have highlighted just how much of a political football the NHS has become.
Reports in 2015 that the Labour leadership had called on its supporters to ‘weaponise the NHS’ were rightly condemned, but the Conservatives must appreciate that their party is just not widely trusted on the NHS, either by staff or by voters. The unfortunate implication of this for patients is that the Government faces significant obstacles when seeking to enact much needed reforms, including those that have had demonstrable success in our European neighbours.
It is therefore time that the Government create a genuine cross-party solution to the NHS and social care, and de-politicise this crucial institution.
Firstly, the Government must come to terms with the fact that it is not delivering, and quite possibly cannot deliver, necessary reform within the NHS. A recent House of Lords report into ‘Long-Term Sustainability Of The NHS And Adult Social Care’ stated clearly that “a culture of short-sightedness […] prevails in the NHS and social care” and that that this short-sightedness “of successive governments is reflected in a Department of Health that is unable and unwilling to think beyond the next few years.”
The saga of the new junior doctors contracts demonstrates the difficulty a Conservative Government would face in addressing this. For any business or organisation to enact meaningful change, its leaders must have the respect and trust of its employees. The relationship between the Health Secretary and junior doctors is now so poor that the only way he could lead them to achieve a meaningful change would be to propose the exact opposite.
This relationship is unfortunately symptomatic of the overall relationship between the NHS and the Conservative Party, to the point where Government backing is now a hindrance to new ideas rather than a help. For example, any move towards outsourcing specialist activities to private organisations better equipped to deliver them, giving CCGs the freedom to choose providers regardless of location, or giving patients tax rebates if they choose private care, would immediately be decried as “Tories privatising the NHS,” regardless of whether it could provide better patient care and improve sustainability.
The political implications of this situation for the Conservative Party are also clear. A post-election survey by Lord Ashcroft showed that the NHS was the number one issue on which Labour voters decided their vote, with 33 per cent stating is was their main reason for backing Corbyn, compared to 11 per cent citing spending cuts, and eight per cent naming Brexit (the second and third most important reasons).
The proportion of Conservative voters who picked their party due to the NHS was three per cent. Having gone into the last election wildly underestimating the appeal of Corbyn’s Labour party, the Conservatives must now see that a Corbynite government is very real prospect, and the NHS is their biggest liability in preventing this from happening.
In order to make real change in the NHS possible, to allow a long term strategy to develop, and to remove it from Labour’s electoral arsenal, the Government needs to take concrete steps in moving it out of the political sphere.
It should set up an independent commission or body, and transfer to it the responsibility for setting policy for the NHS and adult social care. This body should contain members of all parties, though ideally not current MPs, as well as non-political figures respected within the medical world. Much as with the Bank of England, the Government would still have responsibility for appointing the Governor or Chairperson, but beyond that it would be an apolitical body.
Transparency would still be important, and each proposal should still receive rigorous examination by the press and industry experts. The key difference is that, in this politically neutral context, proposals would be examined on their merits, and not by their association with a political party.
To some, this move might seem to be an abdication of responsibility by the Government, but its greatest responsibility is the welfare of patients, and to ensure that much-needed reforms within the NHS and social care can take place. Healthcare has become so politicised, and the Conservatives so distrusted within the NHS, that a paralysis of decision-making now exists.
Gordon Brown made a dramatic decision in 1997 to relinquish responsibility for monetary policy to an independent Bank of England, and few people (John McDonnell excluded) would now say that it would benefit from being returned to political control. It is now time for the Conservative Government to take similarly decisive action on health and social care policy.
If they do not, the sustainability crisis within the NHS and social care will continue to escalate, and the Conservatives should expect to be punished for it at the next election.