NHA BANBURY

Dr Peter Fisher, retired Consultant Physician, Horton General Hospital; President of the National Health Service Consultants' Association (NHSCA).

 

"The NHS is now hitting the headlines daily, a positive thing in making it uppermost in the minds of the electors - but it is of great concern that all sections of our health care system appear to be under unparalleled pressure.This is leading to comments such as it being unsustainable and the siren voices calling for a different method of funding are again being heard. 

"Calm thought is called for. There are no free lunches, no fairy godmothers; the only source of funding for our health care is ourselves, the British people. It is the responsibility of government to raise this money from us in the fairest and most cost effective manner. Direct taxation is the clear winner on both counts.

 

"The reasons for the increasing cost of health care have been well described; better and more expensive drugs and procedures, an ageing population etc, but these are common to all developed countries, amongst which we remain one of the wealthiest.

 

"The recent Commonwealth Fund report gives the NHS high marks, despite us spending a lower percentage of Gross Domestic Product (GDP) and having fewer beds and health personnel than most comparable countries. But it has to be noted that the report was based on the situation before the 2012 Health and Social Care Act had taken effect.

 

"It is not going to be easy to meet the challenges of the future but there are a few key pointers to what should be done.

 

"Firstly we have to break down barriers that have built up, or been placed, between the various sectors, the hospital service, primary care and social care.

 

"Secondly we have to make sure that public money is used wisely, not wasted in unnecessary bureaucracy or diverted to private profit.

 

"Before 1990 the NHS was not perfect, but it was managed in a simple and cost-effective fashion. Since then successive governments have subjected it to recurrent reorganisations, each of which has added complexity and cost to its administration. In recent years there has been incremental growth of the amount of patient care contracted out to private organisations. This has accelerated dramatically since the Health & Social Care Act 2012.

"As far as the managerial system is concerned, the watchword should be “keep it simple” because it is cheaper and less confusing for all concerned, both staff and patients.  Since the splitting of the NHS into “purchasers” (now commissioners) and “providers” the administrative costs have risen much faster than the overall budget and this market based system is now calculated to cost an additional £10billion per year – a ”luxury” we clearly cannot afford. 

                                                       

"It is vital therefore to acknowledge that we have taken the wrong path and need to retrace our steps, not by yet another disruptive top down reorganisation but incrementally with the goal of reintegrating the NHS as a publicly funded, publicly provided and publicly accountable service.

 

"The major parties seem unable to accept this."