So its back to basics with ABCD when it comes to health policy. Ambulances, Backlogs, Care and Doctors & Dentists. All the right priority areas as long as you add in W for Workforce!
The new Health Secretary was never going to present an all-singing, all-dancing plan for the future of the NHS only two weeks into her new job. But what these announcements do is signal her priorities, in particular her desire to put you the patient as much in control of how, when and where you are treated as possible. It also showed some refreshing pragmatism from Therese Coffey, who is no starry-eyed ideologue, but rather a no-nonsense, say-it-as-you-see-it kind of politician. The legacy of Covid’s disruption to the NHS is a long one, and compounded a situation where the NHS was already under strain.
The main highlights of her announcements were:
* Changing funding rules to recruit extra support staff, freeing up over one million appointments per year. By changing the funding rules, GP practices will be able to recruit additional support staff, such as GP assistants and advanced nurse practitioners – allowing GPs to focus on treating patients and freeing up over one million appointments per year.
* 7,000 new beds so ambulances can hand over patients more speedily. Too few general ward beds means patients can’t get moved out of A&E quickly enough, causing the long waits.
* • Publishing appointment data at practice level for the first time ever – helping patients to better understand the care they will receive. By publishing appointment data at practice level, we will support patients in getting better access to information about their treatments, allowing them to make decisions that best suit them.
* • Helping pharmacies to manage and supply more medicines, freeing up to two million GP appointments per year. By allowing pharmacies to manage and supply medicines, such as contraceptives, without a GP prescription, we will help to free up to two million GP appointments each year.
* • Allowing pharmacies to take referrals for minor illnesses from emergency care, helping to reduce NHS wait times for patients. By allowing pharmacies to take referrals from emergency care for illnesses such as coughs, headaches, and sore throats, we will free up valuable time and resources in emergency care departments, helping to reduce wait times.
* • Accelerating the roll-out of new cloud-based telephone systems, making it easier for patients to get through to their local GP practice. This will make it easier for patients to arrange appointments and receive advice about their care.
* • Calling on the one million volunteers who stepped up during the pandemic to support the NHS to come forward again. During the pandemic, over one million volunteers stepped up to support our NHS, and we are calling on them to come forward again in a national endeavour such as by becoming community first responders or Good Neighbour Scheme leaders.
There were some really good micro-ideas I have long argued for. As a Justice Minister, I altered the pension system that had been discouraging Judges from working longer hours (as in some cases it cost them money to do so) and pushing them into early retirement. The same applies to NHS consultants, and that is also now going to be addressed.
Dentistry is a real problem locally. We have some of the worst oral health in the country, so courses of NHS treatment are often highly complex, but dentists aren’t rewarded for that complexity, just paid the same for lesser work. There will now be more funding for complex work. I will want to see the detail, but this is very much a solution to a local problem.
I still want to see more on public health. Blackpool has the lowest ‘healthy life expectancy’ in the country, which is a measure of how long people live in good health. It sits in the mid-fifties, meaning people are dropping out the workforce earlier than they should, and almost a decade before they can receive a state pension. A lot has been done, and more needs to be done, to keep people healthy and able to stay in work rather than drop out.
So initiatives like the sugar tax do make a difference. Many of us will have trained our palate to cope with the differing aftertaste of sugarless soft drinks – notwithstanding the occasional can of red Coke – and it has already had a good impact on obesity and oral health. So why drop it and go back? It is not, in my view, a cost-of-living issue as the cheaper alternatives are cheaper now.
That is not to say there are not large structural challenges in areas like general practice that the current announcements don’t even begin to address. But these are the sorts of issues that I would get a Royal Commission to look at. Is the structure of primary care we – basically – decided on in 1948 the right one for 2022? Is it giving patients what they want?
Healthcare will always need more money and usually get it. An ageing population, a decline in public health indicators, both lead to ever greater demand.
We spend 44p in every £1 the Government spends on healthcare now – up from 25p in 2010. But we rarely ask whether the outcomes are better to the same extent – or why countries such as Australia and Italy get better survival rates for major diseases but spend less per capita. These are questions the groups above don’t like getting into.
And as the Economist wrote last year: “Prices of the services welfare states provide, such as health care and education, grow faster than the economy because of their high labour intensity and low rates of productivity increase. Though government inefficiency can make things worse, this ‘cost disease’ afflicts the private and public sectors alike. It comes with the territory”. (Economist, 20/11/21).
Workforce challenges persist – we may hit our targets on recruiting new doctors, but we find older ones leaving the NHS faster than we can replace them. Vacancies in both health and social care see providers poaching from each other.
And the worst news we got? The Communication Workers Union has included 999 call handlers in its latest strike plans … They do a fantastic job in incredibly difficult circumstances, but we simply can’t afford for them to go on strike.
Paul Maynard MP
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