Andrew Lansley had a dire article in the Telegraph yesterday.
Let me summarise it. He said:
a) We want to cut gov't spending.
b) The NHS spends a lot
c) People need more health care
d) We don't want the wealthy to pay for it
e) We have no idea how to achieve this goal
f) So we're going to pass control of the NHS to anyone - GPs, local authorities or private companies - anyone but the Department for Health
g) We will cut their budgets
h) They will find they cannot deliver health care
i) We will pass alaw saying that's not out responsibility
j) People will suffer, but it won't be our fault.
Am I being fair? Yes, I think I am.
The simple fact is that there is no plan in what Lansley is doing. If we really do have an ageing population, rising costs of health care and increasing demand from the over medicalisation of large parts of life which are rightly social problems (anxiety, stress, obesity, and so on are not medical issues: we make them medical issues though), and right now each of these is true then health care costs are going to rise.
What Lansley's plan fails to recognise is that:
a) The demand for these extra resources is real in the case of the elderly and in the case of new procedures;
b) The demand for increased medicalisation of life is fuelled by i) companies with products to sell (pharmaceuticals) ii) companies with products to sell (fatty foods, poor living standards resulting from demands for increased labour productivity etc) iii) companies making demands on government for increased tax cuts (resulting in reduced benefits, poor living standards, poor educational attainment etc., all resulting in stress - and depression, which is suppressed anger).
But Lansley does not tackle these issues, at all.
All he wants to do is pass the buck to anyone who will have it and ensure he has n responsibility for the resulting mess: remember, his Bill says the government will not longer be responsible for health care in the UK, that duty is passing to local authorities with no budget attached to it.
So what are the inevitable outcomes:
1) Old people without care;
2) People dying when prevention was possible;
3) Demand on the NHS rising as resources to meet it collpase;
4) A massive health failure.
That's the inevitable outocme of what Lansley is doing. That's the result of refusing to meet demand, and instead passing the buck.
This is not government. This is massively irresponsible demail of the truth: we need to spend more. That can only come from tax. And the NHS, a state run NHS, is the only efficient a to deliver these services: we do not have the resources to duplicate services: we hardly have the rsources to do these things once.
Lansley ducks all this. That's why his Bill needs to be scrapped.
Now.
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Hear, hear! But why is Her Majesty’s Opposition not shouting about this?
Don’t know
Wish they were
I’m baffled too
I am forced to conclude they are in agreement.
Red Ed’s habitual reluctance to shoot at an open goal is either extreme timidity or over thought political calculation.
Which is unforgivable in the situation.
C.F. Alex Salmond knocking everyone out of the park on this issue. The deer struck Hain should have been rescued by greenpeace, or better still, made to acknowledge the audience’s response.
I’ve written to my local Labour MP, Jim Dowd, twice asking him if he’s doing all he can to oppose the Coalition’s plans. I have heard nothing back. Some of my Labour Party friends tell me not to worry as it is “unlikely” any Labour MP will be backing Lansley. I’m not entirely convinced given the Blairites’ record, but if my fears are unfounded, this silent opposition is hardly inspiring. If Labour can’t speak up for the NHS, what is it for?
Basically that’s about it. The only place where I would quibble is at step j, where it may be more appropriate to reference the the “childcare” model and say, “People will suffer, but the media will blame the GPs/Local Authority/a.n. other – instead of ministers.”
I agree, thank you. But please allow me to comment re elderly – as if it isn’t bad enough hearing them being blamed for much of the ills of the public sector by people in Govt, I hear elderly people apologise for being old constantly!
Some good work was done 9 years ago about the ‘demographic timebomb’. We need to start thinking not in terms of how many elderly people there are, but how many dependants there are. This shows that the rise in elderly population, as large as it is, is not the economic drain implied. Still bad, but not that bad! Next, we need to bear in mind that people live longer because they are healthier and studies show that the intensified care associated with ageing generally occurrs at the same distance from death no matter what the age of death.
There, glad to unload that!
You’re absolutely right
Last 6 months is aways by far the most expensive in most people’s life for the NHS
When death is does not change that
BUT there is the problem comes before then because of over medicalisation of old age e.g. vast amounts of preventive medicine when there is no age related testing to show it works.
Why is it critical to reduce blood pressure in all old people? And what’t the choice – prevent heart attack to ensure people die of long lingering cancer? We don’t even know it works as tests are always on much younger people
With reference to the last paragraph.I find that a distressingly cynical attitude,as I expect others might also.
Both high blood pressure and prehypertension damage to your blood vessels. This in turn raises your risk of stroke, kidney failure, heart disease and heart attack-which might well cause severe problems or your demise well before any other cause.
I suspect your profession and work load might well put you at risk of hypertension-but I hope not,and and if it did happen,I hope you are duly “overmedicalised” !
I didn’t say such conditions should not be treated
I said the blanket treatment of them in the very old is questionable when there is no proof they work
I also made clear that this blanket treatment may simply be at cost of increasing cancer treatment, for example
The idea that we will all day is something sociey is poor at embracing
The Mail today, to its credit, has an item on the major care home providers as well as the major community care firm. The figures are astonishing. A huge part of the care sector for the vulnerable aged has been used as the basis for financial engineering on a disastrous scale. There is a parallel mess in some parts of the NHS. I am not sure whether it can now be sorted out at all and anything Lansley or anyone else can do is strictly damage limitation.
Its not a timebomb. Its an emerging situation which can be predicted and prepared for better than just about anything else of the many things we are menaced with.
Of course, if we do not choose to adapt thought and practice towards it, it will turn out badly.
With high unemployment, it would seem an ideal area for labour intensive and, if that’s important, low carbon work.
“Why is it critical to reduce blood pressure in all old people? And what’t the choice — prevent heart attack to ensure people die of long lingering cancer?”
How very right you are, Richard? A personal experience: my dad, who lives with me, was given a quadruple heart bypass 2 years ago at the age of 92. Although the operation itself was fine, he has suffered a couple of side effects which have made his life rather miserable ever since. Then we lost my mum and his enjoyment of life deteriorated severely. He has now been diagnosed with cancer of the kidney and there is nothing they can do. I wish he had never had the operation. His heart may have given up naturally before he had to endure the distress of losing his wife and then the possibility of his own physical suffering.
[…] emotional scale, anti-poverty campaigner and tax expert Richard Murphy has written a rather amusing “ABC” of the health secretary’s arguments in the Telegraph […]
One thing really puzzles me, where maybe the model of household economics does apply. I can understand why politicians say that an ageing population places greater demands on the NHS (though I think you make a very good point, that it is the healthy period of our lives that is being extended, rather than the unhealthy part). What I can’t understand is why the availability of more sophisticated, much more expensive treatments necessarily places greater demands on the NHS.
Rather than tearing the NHS apart, isn’t it better to manage people’s expectations? I know that today’s luxuries tend to become tomorrow’s necessities (and clearly what is not acceptable to anyone is that today’s necessities should become tomorrow’s luxuries!); but shouldn’t our politicians be telling us: The NHS will continue to meet people’s essential medical needs as it has done in the past, but will not expand indefinitely – unless people are prepared to pay indefinitely more in tax – to cover every new treatment, or every condition that newly becomes treatable?
It seems to me that the ageing of our population is a fact of life that we just have to deal with, but people’s rising expectations of what can and should be treated is not a fact of life and can be addressed. Politicians should guarantee that our children’s health care will be as good as ours — which may be challenging enough, given the demographics — but make it clear that it will not necessarily be better, whatever technological advances may be made and whatever our consumer culture may encourage us to expect. That seems to me a very reasonable position.
Of course, not much in politics is reasonable…
That is an extremely complex area of debate and as you rightly conclude is ultimately a political decision.
My naturally conspiratorial disposition is to look at the supply side of the equation, the role of the medical industries.
Their profits have to grow year on year with no end point (much like a malignant tumour) and the NHS is by far the main source of profits in the UK.
Rarely a week goes by that I don’t see a PR led breakfast news article on some rather expensive new treatment.
Blanket Statin prescriptions, based on a computer modelling exercise, was the last one to outrage me. In fairness the GP present pointed out the drawbacks, but the committee man far preferred the feet in the fire,head in the fridge averages his model had produced.
The abolition of NICE was certainly politically motivated, as it was an authouratative, centralised and independent regulator.
Why,and to what benefit, its complex and labourious functions should be replicated throughout a myriad of GP led consortiums escapes me.
I hope to publish my ideas for the NHS next week
R
Huw – “What I can’t understand is why the availability of more sophisticated, much more expensive treatments necessarily places greater demands on the NHS.”
It should not cost more – not when one considers the country’s economics as a whole – and therein lies the problem. Many new drugs, consultant-initiated drugs, for life-long conditions, cost a fortune. But some are so good they get the patient back to work paying taxes etc. were previously the person was retired on benefits for up to 40 years of life. The economy gets its money back. the offspring of the patient sees a parent who goes off to work each day, they get better food blah blah blah.
Machines that go ping diagnose the nasties quicker – again allowing the person to be a treasury donator once more and to stop needing ‘welfare’.
The above two examples also save in the long run re stuff like joint replacements, heart failure, lung damage (and that’s just in rheumatology!)
Tis a shame that the wider view is never seen, that every function, every sector, every bit of every sector is such a distanced, fragmented separate entity. that no-one sees the whole picture.
Ah, but there’s no money to made there!
PS Beware private companies promoting whole-body scans – this is most definately NOT the sort of ping thing people need – never tell me I have an undiagnosed aneurysm if there is a greater chance I can get through life with no sign of a problem