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How Big A Danger To Cameron Is An NHS Crisis?

Last Updated: Friday, February 15th, 2013

Not winning the Eastleigh by-election…another “Omnishables budget” in March…the crash of the Universal Credit, because the computers don’t work, or real-time reporting of changing incomes causes chaos for claimants, or both…a trouncing in the May elections…public worry as 2014 and the entry of Romanians and Bulgarians into Britain looms…

The causes of problems for the Government in general, and David Cameron and the Conservatives in particular, are well-rehearsed.  But I wonder whether the biggest battering of all that both might receive could come from an old-fashioned “NHS crisis”, complete with closed hospital wards, protesting staff, and ambulances parked outside full A & E wards.

On Wednesday, the Times reported that a King’s Fund quarterly survey has found that the number of patients waiting more than four hours in A&E is at its highest level in a decade.  “NHS organisations are increasingly pessimistic about the ability of health services and adult social care to absorb further cuts,” the paper said.

That the health service is experiencing the biggest funding squeeze in its history – 0.1 per cent a year during this Parliament.  And demand on the NHS continues to rise exponentially as the population ages, the cost of new drugs rises, and lifestyle-related diseases continue to grow.

After years of record spending, logic suggests that something has to give – that the attempt by the service to meet “the Nicholson challenge” of saving £20 billion in efficiency savings by 2015 will founder, because the Government’s healthcare reforms won’t improve the system fast enough to compensate for the spending scale back.

As the Times pointed out, the majority of hospitals will finish the year in surplus, and  the NHS had cash reserves of £4 billion at the end of the last financial year.  None the less, it will be worth watching the world of British healthcare closely during the spring, when one financial year ends and another begins.

That is often the time when crises in the NHS tend to erupt – bad winters are another.  Jeremy Hunt has prepared assiduously for such an event, presenting himself as the voice of patient anger over the Mid-Staffordshire Hospital scandal.  And there are of course more hospital inquiries to come.

It is a role he has played since his appointment, consistently making the case for greater transparency, better patient access to records and the use of data to show where good practice exists in the health service and where it doesn’t.  And as consumer expectations continue to rise, it may be that public expectations of the NHS rise with them.

However, evidence suggests that the health service continues to be central to how the British see themselves and their values.  One poll I saw suggested that the Danny Boyle Olympic spectacular, with its jolly nurses, had its finger on the popular pulse: the Queen was third in the popularity stakes behind the armed forces and, top, the NHS.

Nigel Lawson, the former Chancellor of the Exchequer, once described the NHS as the English religion.  David Cameron said early in his days as Opposition leader that his political priority could be summed up in three letters: NHS.  But the controversy over the health bill has damaged his reputation as a defender of the service.

He will be extraordinarily lucky to get away without an NHS crisis before 2015.  If it comes, Hunt will have a torrid time, Conservative ratings will dip further, the Liberal Democrats will protest – and George Osborne will, I suspect, have little choice but to hurl another dollop of money at the service in order to quell the crisis.

By Paul Goodman



ConservativeHome’s Deep End: For economic recovery we need stronger unions. In a globalised economy, the only way of “making labour more powerful in its relations with capital” is to increase the demand for British workers by boosting their productivity. So, while Britain does need stronger unions, this should be stronger as in better – and, in particular, better at campaigning for, and directly providing, the education and skills that give individuals clout in the market place, not on the picket line.

ConservativeHome’s Deep End: Sweden – Beacon of the right “Few western nations have emerged from the financial crisis so assuredly as Sweden has – thanks, in part, to a banking system that was reformed years before the global storm of 2008.  Of course, one can always point to Sweden’s special advantages – a relatively small population in a large country packed with natural resources. Two centuries of continuous peace has also helped, not to mention the good sense of the Swedish people in staying out of the Eurozone. Nevertheless, what Sweden demonstrates is that, even in the most accommodating of circumstances, the state has its limits – and, that once those limits are breached, reform is not only possible, but necessary.” Read more:

Paul Goodman: When will we see a Danny Boyle-style pageant showing nurses mistreating their patients? “None the less, the Health Secretary’s aim of being angrier with the failures of the NHS than any patient has a point. Elsewhere, NHS patients are everyday consumers – with ever-shifting tastes and constantly rising expectations.  Healthcare can’t be shielded from the trend indefinitely (food standards certainly aren’t: consider the horsemeat row).  And there are more Mid-Staffs-type scandals coming down the line.  The schemes of governments will gradually improve healthcare less than Douglas Carswell-style consumer pressure and information. When a “cutting-edge theatre company” produces a satire parodying the Boyle extraganza – unfair as it may be – we will know that healthcare culture change has well and truly arrived.” Read more:

Michael Portillo: Manifestos in the age of limited choice The Conservatives have made their bed and must lie in it. But Labour faces the agony of choice. So too do the Liberal Democrats. It won’t be easy to write a manifesto that justifies their record in government by lampooning Labour’s alternative, yet leaves the way open for coalition with the Eds should the opportunity arise. And there had better be no pledge, like that on student finance, that requires them afterwards to say: “I’m sorry”.

We may have passed through trauma, but this is no 1945. No party will propose a brave new world. Voters may wish to judge the manifestos by their earthy realism. In that sense, the party that promises least may offer most. Read more:

Harry Phibbs: The Conservatives should not increase Inheritance Tax “Politicians often cynically assume that voters support tax cuts for themselves and tax increases for others. But the popular revulsion at the unfairness of Inheritance Tax is so strong that this does not apply. That was why George Osborne’s pledge in 2007 to raise the threshold to £1 million on this pernicious tax was so popular even among many people who do not have assets worth over £300,000. Allister Heath, writing in City AM this morning, blames the Lib Dems for the Inheritance Tax rise. Mr Heath is being kind to Mr Osborne. According to his biographer, Janan Ganesh, ditching the Inheritance Tax pledge was not something Mr Osborne resisted. A great mistake. Bad politics. Bad economics. Bad morality.” Read more:

Roger Scruton: The Health and Safety culture is killing volunteering and the benefits of risk “The extent of health and safety regulations is now staggering. It is not the cost of them alone which should trouble us. It is their effect in confiscating one of the most important of human virtues, and one on which civil society ultimately depends – which is the virtue of risk-taking. Without this virtue there are few if any social initiatives that will be of lasting benefit. Moreover it is possible to teach enterprise to the young only through activities that also teach them to take the risk of it. By means of health and safety regulations the state gradually colonises all social activities and makes them dependent upon its permission – a permission that is less and less granted, as the bureaucrats discover new ways of amplifying their powers.” Read more:

Tim Montgomerie: It’s not just horsemeat. Food may be about to become very political. “Laura Sandys (recently one of ConHome’s Little Guy Conservatism heroes because of her focus on consumer empowerment) wants a consumer champion – perhaps inside DEFRA. At the moment she worries that ministers and departmental officials may be too focused on producer interests. She also wants to see food (as well as finance) on the national curriculum. She believes that schools have a big role to play in ensuring the next generation become more intelligent purchasers of supermarket and financial products.

Owen Paterson has only been in his brief for six months and has faced big controversies over the badger cull, shale gas, Ash dieback, flooding defences and now this. DEFRA is becoming an important brief but he has a record for gripping previous issues and I’m sure he’ll do so again. Enlisting Laura Sandys’ insights will help him to succeed.” Read more:

By Paul Goodman

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