tbaldwin said:
The NHS really ain't my specialist subject and I may therefore be talking even bigger bollocks than I normally do (and I might also be falling for mass media myths), but...
The statistic that there are more managers than hospital beds does lead me to suspect that the extra cash isn't always being spent in the right places and that therefore any new initiative should - at the least - be treated with caution, since it may be intended to save money in other directions.
Since I think hospitals are particularly evil places that everyone should be discouraged from staying in unless absolutely necessary, I am all in favour of treatment at home where practicable. As long as it's properly funded and not just an excuse to sack a couple of nurses in favour of keeping an administrator. Similarly, NHS Direct, for example, is - I think - progressive as long as it's not treated as a cost-saving measure.
Sorry, this lacks the degree of absolute certainty that I've seen elsewhere on this forum. I guess that what it amounts to is this: I'm fairly certain that if we were starting the NHS today - allowing for funding from general taxation, and a free service on demand - it wouldn't be structured like this. From my knowledge, it seems good on the technology and a bit crap on the lo-tech stuff.
But, as a society, we're not going to go back and start again. At least, not with the politicians we've got. So (in entirely reformist mode) it's a question of whether each government adds or reduces the bureaucracy that seems to have the NHS in its grip. And New Labour appears to be adding. Yes, the cash input is improving and the service output is improving, but the two don't appear to be in direct relation.
And, really, is this the best we can hope for? Is this as good as it gets?
(Christ, that was a real effort - trying to talk about New Labour without resorting to insult and sarcasm. An interesting exercise.)
