The NHS logo displayed on a hospital wall. Photo: Scott Barbour/Getty Images
Show Hide image

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

Getty
Show Hide image

In the 1980s, I went to a rally where Labour Party speakers shared the stage with men in balaclavas

The links between the Labour left and Irish republicanism are worth investigating.

A spat between Jeremy Corbyn’s henchfolk and Conor McGinn, the MP for St Helens North, caught my ear the other evening. McGinn was a guest on BBC Radio 4’s Westminster Hour, and he obligingly revisited the brouhaha for the listeners at home. Apparently, following an interview in May, in which McGinn called for Corbyn to “reach out beyond his comfort zone”, he was first threatened obliquely with the sack, then asked for a retraction (which he refused to give) and finally learned – from someone in the whips’ office – that his party leader was considering phoning up McGinn’s father to whip the errant whipper-in into line. On the programme, McGinn said: “The modus operandi that he [Corbyn] and the people around him were trying to do [sic], involving my family, was to isolate and ostracise me from them and from the community I am very proud to come from – which is an Irish nationalist community in south Armagh.”

Needless to say, the Labour leader’s office has continued to deny any such thing, but while we may nurture some suspicions about his behaviour, McGinn was also indulging in a little airbrushing when he described south Armagh as an “Irish ­nationalist community”. In the most recent elections, Newry and Armagh returned three Sinn Fein members to the Northern Ireland Assembly (as against one Social Democratic and Labour Party member) and one Sinn Fein MP to Westminster. When I last looked, Sinn Fein was still a republican, rather than a nationalist, party – something that McGinn should only be too well aware of, as the paternal hand that was putatively to have been lain on him belongs to Pat McGinn, the former Sinn Fein mayor of Newry and Armagh.

According to the Irish News, a “close friend” of the McGinns poured this cold water on the mini-conflagration: “Anybody who knows the McGinn family knows that Pat is very proud of Conor and that they remain very close.” The friend went on to opine: “He [Pat McGinn] found the whole notion of Corbyn phoning him totally ridiculous – as if Pat is going to criticise his son to save Jeremy Corbyn’s face. They would laugh about it were it not so sinister.”

“Sinister” does seem the mot juste. McGinn, Jr grew up in Bessbrook during the Troubles. I visited the village in the early 1990s on assignment. The skies were full of the chattering of British army Chinooks, and there were fake road signs in the hedgerows bearing pictograms of rifles and captioned: “Sniper at work”. South Armagh had been known for years as “bandit country”. There were army watchtowers standing sentinel in the dinky, green fields and checkpoints everywhere, manned by some of the thousands of the troops who had been deployed to fight what was, in effect, a low-level counter-insurgency war. Nationalist community, my foot.

What lies beneath the Corbyn-McGinn spat is the queered problematics of the ­relationship between the far left wing of the Labour Party and physical-force Irish republicanism. I also recall, during the hunger strikes of the early 1980s, going to a “Smash the H-Blocks” rally in Kilburn, north London, at which Labour Party speakers shared the stage with representatives from Sinn Fein, some of whom wore balaclavas and dark glasses to evade the telephoto lenses of the Met’s anti-terrorist squad.

The shape-shifting relationship between the “political wing” of the IRA and the men with sniper rifles in the south Armagh bocage was always of the essence of the conflict, allowing both sides a convenient fiction around which to posture publicly and privately negotiate. In choosing to appear on platforms with people who might or might not be terrorists, Labour leftists also sprinkled a little of their stardust on themselves: the “stardust” being the implication that they, too, under the right circumstances, might be capable of violence in pursuit of their political ends.

On the far right of British politics, Her Majesty’s Government and its apparatus are referred to derisively as “state”. There were various attempts in the 1970s and 1980s by far-right groupuscules to link up with the Ulster Freedom Fighters and other loyalist paramilitary organisations in their battle against “state”. All foundered on the obvious incompetence of the fascists. The situation on the far left was different. The socialist credentials of Sinn Fein/IRA were too threadbare for genuine expressions of solidarity, but there was a sort of tacit confidence-and-supply arrangement between these factions. The Labour far left provided the republicans with the confidence that, should an appropriately radical government be elected to Westminster, “state” would withdraw from Northern Ireland. What the republicans did for the mainland militants was to cloak them in their penumbra of darkness: without needing to call down on themselves the armed might of “state”, they could imply that they were willing to take it on, should the opportunity arise.

I don’t for a second believe that Corbyn was summoning up these ghosts of the insurrectionary dead when he either did or did not threaten to phone McGinn, Sr. But his supporters need to ask themselves what they’re getting into. Their leader, if he was to have remained true to the positions that he has espoused over many years, should have refused to sit as privy counsellor upon assuming his party office, and refused all the other mummery associated with the monarchical “state”. That he didn’t do so was surely a strategic decision. Such a position would make him utterly unelectable.

The snipers may not be at work in south Armagh just now – but there are rifles out there that could yet be dug up. I wouldn’t be surprised if some in Sinn Fein knew where they are, but one thing’s for certain: Corbyn hasn’t got a clue, bloody or otherwise. 

Will Self is an author and journalist. His books include Umbrella, Shark, The Book of Dave and The Butt. He writes the Madness of Crowds and Real Meals columns for the New Statesman.

This article first appeared in the 25 August 2016 issue of the New Statesman, Cameron: the legacy of a loser