New Statesman Scotland - Policies that make life difficult

Education, education, education? Missing the point, dear daddykins. It's health, health, health, always and for ever, from womb to tomb, bloody birth to dessicated dementia. It's life and death. I mean, you want the voters to stay alive, presumably, so they can keep you in power?

Well, I've got news for you, Father Tony, from here in the Shetland Islands to the grimmest reaches of the moneyed south: we're dying. And it's your fault. You and your pathetically ignorant colleagues, the privileged scythe-sharpeners who have engineered a cowardly, wasteful health policy that is, to be blunt, killing people.

Excuse the lack of temperance, but I'm upset. For this is part of my daily life, this health business. It is central to our family, as my wife is a member of that increasingly beleaguered species, the single-handed, rural doctor. She is in the front line of initiatives that are destroying morale among doctors and causing an across-the-board deterioration in healthcare. In Shetland, an exceptionally fine GP service is being ravaged by the ignorant and the careless.

Some questions: how about the millions of pounds being spent on computerising general practices in a way not thought out and using vastly expensive software that does not do the job it's supposed to? How much has been spent in Scotland on computers for doctors that are now obsolete? Why are GPs being forced to spend hours of each day battling with the moronic requirements of blundering technocrats? When no benefit in patient care has been shown to result. None.

Drugs. Why are doctors being told to change, on their records, the names of medicines available only from one company under a trade name so that they look like generic drugs, thus giving the impression that money is being saved, even where it is impossible to obtain a cheaper alternative? While drug companies are still holding the NHS to ransom, still colluding to keep prices of competing drugs artificially high?

Beds. Why is every outworking of the private finance initiative - that cancer on Labour's soul - reducing, not increasing, the number of beds available in any given hospital? And who came up with the notion that fewer beds always full means more efficiency? Britain has the highest bed- occupancy rate in Europe, and this is what one exhausted consultant told me it means: vastly extended ward rounds, inconsistent care, delays in treatment for emergencies, even when they're already in hospital, and incoherent and inconsistent diagnoses. Because the beds occupied by patients under the care of one specialist will be scattered throughout sometimes huge hospital complexes, with non- specialist nursing covering them and specialised equipment often unavailable.

Which raises the question of nurses. Despite some of them being great, some of them are crap, and the notion that salvation for British health lies in the hands of half-trained nurse-practitioners is a medical blasphemy. I mean, nurse anaesthetists? The most dangerous, most difficult, most responsible job, some would say, in all medicine, going to someone who's not even fully trained? Do me a favour and shoot me first. And this is not to reduce waiting-lists. It's to save money.

Here in Shetland, the most moronic notion of all - a central on-call service that would remove the need for local doctors, even those in remote areas, to tackle emergencies - is a genuine killer of an idea. For decades local GPs have provided instantaneous emergency cover where, even on the main island, it can take an hour and a half to get an ambulance to a patient, due to simple geography. To save money - and for no other reason - someone with no detailed local knowledge, and none of a patient's history, will supposedly save people's lives, night after night after night. It's a joke made by people with absolutely no sense of humour. Or brains. Or concern for patients. Only snivelling ambition.

Yes, I'm upset. I'm upset about the patient with a life-threatening but operable cancer who has been told that there is no way he can be dealt with for at least two months, be-cause there is nobody to operate on him. I'm upset about the callous disregard for patient care shown by those who should know better and feel more. I'm disgusted that this is a direct result of government policy.

I can see the election campaign looming, and I can hear the horrible slogan in my head: "This government is killing Britain." The horror and the pity lies in its truth.

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