Pretty well hidden in the Guardian web site this morning is an article about comments made by retiring NHS chief executive Sir David Nicholson. It is reported that he said:
The NHS in England faces a number of patient safety scandals unless there is a significant shakeup in the service that has seen unused hospital wards close, hi-tech surgery centralised and GPs banded together into bigger practices.
Warning that the NHS would face an ageing population, more people suffering from long-term conditions and a stagnant budget, the service's outgoing boss Sir David Nicholson said it would need to make £30bn in savings over the next eight years. He said cuts alone were not an option: "There is a limit to how much more can be achieved without damaging quality or safety." He gave the example of paying below-inflation rates of pay, which could save £8bn but would demoralise staff.
Nicholson said the result of such a scorched-earth policy, which has been implemented in Ireland, would mean paring back the NHS to dangerous levels. "If we allowed things to go on, we would squeeze hospitals more and more," he said. "As 75% of spending is on staff we would be looking at reducing staff on wards. That would have a really bad effect on patient safety."
Now, his direction of argument was that the savings required should be planned, not muddled as this was the only way he thought that 5% a year could be saved. And he warned charging was not possible. But as he has then noted, that must mean more centralisation of service, or, as the article notes:
Officials said the public will have to shoulder greater responsibility for their wellbeing – citing those with long-term conditions such as diabetes, depression, dementia and high blood pressure.
I have to admit I am bemused by the comments on depression and dementia, in particular.
The possibility that would solve this problem and meet demand - which is funding a better NHS - seems the one that is ruled out. But why? It is the one I think people would vote for. And yes, they do want local hospitals, and they do want local GPs. And that's why they'll pay for them.
Where is the party that will say so, please?
At which point I realise I have just invited Clive Peedell (a man I much admire) and the National Health Action Party to comment.