A few months ago, I asked two friends of Jeremy Hunt what they thought the biggest obstacle to his NHS plans were. They paused for a moment, and then replied at the same time: “Winter”. So it seems. Fleet Street and the net are anticipating of an “NHS crisis” during the coming months. Today’s Daily Mail, for example, reports a rise in the number of patients left in casualty units, says that David Cameron has demanded contingency plans if A&E units become full, and anticipates a speech tomorrow by Sir Bruce Keogh, the Medical Director of the NHS, about “what needs to be done to avert a major crisis in A & E”.
None of this is surprising. For all the complaints about the ring-fencing of the NHS budget while others have not been so protected, the squeeze on health service spending is unprecedentedly tough. Only in one year each of Margaret Thatcher’s and Tony Blair’s premierships did it rise at one per cent or less: the Coalition is keeping it down to 0.1 per cent a year. Some hospital managers will take the easiest course in response – namely, to close wards, crowd casualty, and see ambulances queue up outside A & E. I have been predicting this course of events since the start of the Parliament. The timing has been uncertain, but not the event itself.
A further injection of cash won’t provide a cure, though if the “NHS crisis” becomes acute enough, George Osborne, or rather the taxpayer, may stump up. (Labour is not committed to the Government’s level of spending, a fact that is not as well known as it should be.) Jeremy Hunt, on succeeding Andrew Lansley as Health Secretary, could have settled for doing what some expected him to do – namely, try to improve the Government’s public relations on healthcare, and leave matters more or less at that. Instead, he has tried to burrow to the roots of the problem, which he believes is the G.P contract left to the Coalition by Labour.
The Health Secretary’s view is that the target-setting contract cut the time that G.Ps can spend with their patients, thus propelling the latter towards A & E units. He is also trying to act as a champion of patients’ interests: his piece on this site yesterday about the Quality Care Commission, which the Daily Telegraph today picks up, is a case in point. The horrifying revelations about what happened in some hospitals on Labour’s watch support Hunt’s argument, but the problem for him is timing. The timetable for negotiations on the contract stretches towards the spring through winter – and an “NHS crisis” that today’s papers are busy anticipating.