What's Up Doc?

The essential difficulty with the National Health Service is rather like that of caring for grandma in your own home. Whatever you want to do, hope to do, intend to do or have to do she is always there to complicate matters.

So all the complaining about how Cameron and the Coalition should have put the NHS on the back burner while they tackled other major issues is nonsense. The NHS is so big, so complicated and so challenged by changing demographics never mind developments in the science and technology of medicine that it cannot be given a lower priority for attention and decision.

It is a very long while ago since the 1970’s and there was the local Area Health Authority which had to be attended. There similar tensions then. These were compounded by Westminster coming up with “initiatives” and “programmes” to paper over the most obvious cracks.

These came with funding for the now but not later which the politicians wanted to grab at. The mutterings of the financial man about who this might impact on future budgets were brushed aside; as were the reservations of the medical people about how these highly spun things fitted what were foreseeable added demands.

In the meantime at Westminster there were elections to be fought and personal reputations at stake. Survive at Health and you might make one of the choicer offices of state. Get a shed load of bad publicity and off you went, if you were lucky The Lords, if not to Brussels.

Our current Health minister, Lansley was always on a loser. The serial wreckage inflicted by the Private Finance Initiatives, lumpen reorganisations and the application of the fetich of modern finance and business models of the previous government were bad enough.

That the gross misspending had made it all much worse is almost impossible to sort out. Whether the ideas embodied in the present legislation will do much good is a question.

Just how far are the ideas that lie behind the assumptions out of date or no longer tenable by the time of the third decade of the 21st Century? Just how much will any government be able to spend? Who will it be spent on?

If the bill is simply yesterday’s soufflé presented at the behest of a government department over run with consultants, lobbyists and commercial interests then little or nothing has changed. We will just stumble from one chaotic form to another.

With a Coalition Cabinet infested by a Liberal Democrat party already running for cover, a spectacular lack of awareness or reliable information in the media, the protectionist stance of the existing professional bodies and a public whose understanding and information is very limited there are all the signs of yet another grim and costly debacle in a major public responsibility.

Like having grandma to stay we may be arriving at a situation where there are no answers and our NHS becomes something of a continuing major liability nagging away, wrecking the budget, impossible to deal with and to which there seems no end.

So what do we do with the extra grandma’s and grandpa’s never mind the many others who were never planned for? Did we ever expect extensive liver problems amongst so many younger people?

Is your knee beginning to play up?