by Sam Fowles
I really miss the days when the worst we thought Jeremy Hunt could do to the NHS was privatise it. At least you knew what you were getting with privatisation. But what Mr Hunt is doing, incredibly, manages to be worse. It is an act of legislative contortion which would have done credit to Mitt Romney on his most pliable days: In an (apparent) attempt to “get tough” on standards and ensure the high quality of the NHS, Mr Hunt has made certain that it cannot possibly offer anything but a substandard service.
At least one can see a logical argument of privatising the NHS. It may be exceptionally wrongheaded, but the case has a logical progression: Competing providers will force standards up as a result of their competition for consumers. The problem with this is, of course, that demand for healthcare is inherently almost completely elastic. As such, the impact of market forces on quality and price of provision will only ever be exceptionally limited, leading to monopolistic tendencies and, inevitably, substandard service. But at least there is a justification based on some sort of reasoned analysis.
Mr Hunt’s response to the Francis Report is a masterclass in irrationality.
One of the central issues in the report was poor patient care. Beds were not changed, patients were not fed; essentially the care and attention necessary for a decent quality of existence were absent. Unless the nurses at Mid Staffs spent their days playing scrabble and watching repeats of Monarch of the Glen (in my experience, pretty much the only thing on hospital television) one might perhaps assume that neglect is a function of understaffing. Stunningly this was also one of the conclusions of the Francis review.
Much of the review focused on governance issues, particularly regarding oversight organisations and community engagement (which Mr Hunt’s substantive proposals have singularly failed to address). Those sections which concentrated on the day to day running of wards recommended a more labour and resource intensive model. This is hardly surprising. One doesn’t have to be an expert in healthcare management to realise that if, as a patient, you get more focused attention more of the time, you’re going to have a better experience. The logical corollary of this is that, if everyone is to have more focused attention more of the time then the hospital might need to employ more people to provide it.
