The NHS logo displayed on a hospital wall. Photo: Scott Barbour/Getty Images
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Iain Dale: the NHS is letting England down – and letting patients die

Hundreds of man hours lost to the economy, and a severe failure when it comes to cancer patients. It's time for NHS reform.

When the coalition came to power in 2010, many people wondered if it would embrace the target-driven culture that had obsessed the previous Labour government. The Conservatives expressed a desire to abolish NHS targets altogether, yet have so far failed to explain how they plan to improve capacity. Weakening targets have led to capacity issues in many parts of the NHS, despite claims by managers and consultants that we can do more with fewer beds and that people prefer to be treated at home no matter what their affliction. Labour introduced targets to improve outcomes, but then was mystified by how poorly we ranked internationally.

Take cancer. For years Britain has outspent many other countries in cancer research and treatment yet our survivability record is shockingly poor. The Organisation for Economic Co-operation and Development brands it “unacceptable” and it’s easy to see why. In 2013, the OECD reported that women with breast cancer were more likely to reach the five-year survival point in almost all European countries other than Britain, with only the Czech Republic, Poland and Ireland trailing behind. This ought to be a source of national embarrassment and yet we are constantly told that we have the most enviable health service in the world.

Part of the reason for this lamentable performance is our chronic lack of funding for life-saving cancer drugs. What’s more, there’s the restricted availability of radiotherapy, even though the machines needed for treatment sit unused as NHS England refuses to fund certain kinds of cancer care. Figures quoted in the Sunday Times last July show that the number of patients being offered advanced radiotherapy is actually falling. Since NHS England took control of radiotherapy in April 2013, 10 per cent fewer people have been treated. The number given transformative SABR treatment for rare and complex cancers has plummeted by 70 per cent in little over a year.

The Liberal Democrat MP Tessa Munt, whose Freedom of Information request produced the figures, has said: “NHS England is simply letting patients die.” Campaigners wonder what agenda is driving NHS England policy.

If the body’s new chief executive thinks that employing 50 new highly paid managers is more important than improving cancer survivability then, Houston, we really do have a problem. Some think the biggest problem in the area of cancer survivability is the continuing blight of late referrals by GPs. But is naming and shaming badly performing GPs the answer? Won’t it just mean GPs will refer everyone?

Outcomes are adversely affected by the NHS’s operations, which seem to run on a five-day, rather than seven-day basis. Are people not supposed to get ill at weekends? Surely we should be moving towards a seven-day NHS, with equality of service provision throughout the week? Here we have 21st-century medicine straitjacketed by a 1940s system.

Why is it that GP’s surgeries offer appointments at times when most people aren’t available to go to them? I run a publishing company and must lose hundreds of man hours of work each year as employees go to visit the doctor, as if that’s a reason why they should be allowed time off. That may sound harsh, but multiply the effect across the economy and we’re all losing out.

Iain Dale is the author of “The NHS: Things That Need to Be Said” (LBC Books)

This article first appeared in the 27 February 2015 issue of the New Statesman, Russia vs the west

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Who will win in Manchester Gorton?

Will Labour lose in Manchester Gorton?

The death of Gerald Kaufman will trigger a by-election in his Manchester Gorton seat, which has been Labour-held since 1935.

Coming so soon after the disappointing results in Copeland – where the seat was lost to the Tories – and Stoke – where the party lost vote share – some overly excitable commentators are talking up the possibility of an upset in the Manchester seat.

But Gorton is very different to Stoke-on-Trent and to Copeland. The Labour lead is 56 points, compared to 16.5 points in Stoke-on-Trent and 6.5 points in Copeland. (As I’ve written before and will doubtless write again, it’s much more instructive to talk about vote share rather than vote numbers in British elections. Most of the country tends to vote in the same way even if they vote at different volumes.)

That 47 per cent of the seat's residents come from a non-white background and that the Labour party holds every council seat in the constituency only adds to the party's strong position here. 

But that doesn’t mean that there is no interest to be had in the contest at all. That the seat voted heavily to remain in the European Union – around 65 per cent according to Chris Hanretty’s estimates – will provide a glimmer of hope to the Liberal Democrats that they can finish a strong second, as they did consistently from 1992 to 2010, before slumping to fifth in 2015.

How they do in second place will inform how jittery Labour MPs with smaller majorities and a history of Liberal Democrat activity are about Labour’s embrace of Brexit.

They also have a narrow chance of becoming competitive should Labour’s selection turn acrimonious. The seat has been in special measures since 2004, which means the selection will be run by the party’s national executive committee, though several local candidates are tipped to run, with Afzal Khan,  a local MEP, and Julie Reid, a local councillor, both expected to run for the vacant seats.

It’s highly unlikely but if the selection occurs in a way that irritates the local party or provokes serious local in-fighting, you can just about see how the Liberal Democrats give everyone a surprise. But it’s about as likely as the United States men landing on Mars any time soon – plausible, but far-fetched. 

Stephen Bush is special correspondent at the New Statesman. His daily briefing, Morning Call, provides a quick and essential guide to British politics.