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)