This country is wedded to the idea of a National Health Service. How well that works is, of course, the important part of the marriage. The government’s long-awaited ’10 year plan’, Fit for the Future, outlines how it hopes matters can be made better. Necessarily broad in scope, its overall aims are to be lauded. And yet …
Doctors for the NHS is ready to support and have a dialogue with anyone whose aims include upholding the founding principles of the NHS. On which, Fit for the Future scores well. Its ambitions are to make the NHS better for patients and staff, more locally based, more digitally savvy, and more attuned to preventing ill health rather than fire-fighting with treatments all the time.
As several have already commented, this has been tried before. We don’t begrudge or disparage the efforts to try again: the UK’s health service is still a service to struggle for and improve for all. We would not expect a document that is essentially strategic in scope to list minute detail. But in its broad strength also lies its weakness: how will the current desperate shortfall in GP numbers be addressed, before new GPS can be trained and recruited? How does the new envisioned local service dovetail with social services, a necessary step if the aim of preventing sickness is to stand any real chance? Will this be a widening door to hard-pressed practices and trusts to employ scores more PAs and similar roles, while doctor training remains in a parlous state – the makings of a nightmare future, unfit for any nation? Will the unwise step to set up yet another form of private-public development (similar to PFI) be taken for the sake of short-term expediency, handing the private sector eye-watering sums for years to come when public investment would have given a far better return? Critically, how are we all to pay for all this – hospitals cannot simply be shut down while new local centres are being built and people recruited. That means a lot more money. Already, the cries to put up taxes grow stronger – the logic here is undeniable. Political promises, sometimes, have to be broken. That can be forgiven, if the reasons for it are made plain. In this case, better public services and the type of NHS that Fit for the Future promises are the prize. The explanations are there – if the political courage to give them can be found. For that sake of a continuing NHS, it must be.