How are we doing on the NHS?

By Diana Smith / @mulberrybush

It has been an interesting week for the NHS.

On the first day of the Conservative Party conference, I joined a part of the big society that David Cameron does not much care for – 10,000 people marching in the pouring rain. Different groups, and different causes, coming together to give voice to our concerns about actions this government is taking.

We skirted the outskirts of the conservative conference. We shouted rather loudly, but no one inside the heavily fortified compound seemed to hear.

In case you wonder what kind of people were there, I am a 56 year old small business woman, who has not been on any form of a protest since the 80s. I was pushing a complete stranger, a disabled 71 year old lady who is a CAB volunteer from the New Forest in her wheelchair. She was out on her first ever protest. There were many young people who cared deeply about fairness, building the future, and there were people old enough to have seen difficult times and who are fearful of what is coming next. There were rich and poor. What we had in common is that we were all extremely wet, and that we were angry and determined enough not to mind.

On Tuesday it was NHS day at the conference. Conservatives don’t do debate. Unlike the Labour and LibDem conferences (where anything can happen) it is all rather choreographed, so we know the speakers were giving the messages the Conservatives wanted them to give.

They began with a lovely lady from a GP social enterprise set up under Labour. She was clearly passionate about what she does and doing a great job. She is the best advocate that you could have for the kind of flexible personalised service that both Labour and the coalition aspire to. She also incidentally shows that there is no need for any structural change to be able to achieve this.

I have always felt that the Stafford Hospital story is central to this government’s thinking on the health service. This was confirmed by the appearance on the platform of a spokesman from the Stafford Hospital Pressure group curethenhs. The group is a symbol of all the terrible things that went wrong under Labour. Their story is the justification for the scrapping of targets and for radical restructuring of the NHS. The spokesman stuck to uncontroversial messages. The gist was there had been failings in basic nursing in some cases. Members of the protest group had found it much more difficult than they should have done to be able to get their complaints heard effectively, and they were all very grateful to the Conservatives for espousing their cause. I did incidentally get the impression that the spokesman does genuinely value the principle of a high quality free national health service, and would not wish to see the creation of a two tier health service in his name.

After that there was a lady from a private sector company that is going to be selling data to the health service. This will be made available to the public armchair auditors so that we can all monitor the performance of the health service, once the existing monitoring bodies have been scrapped. The data she provides will also help the private sector companies that most GPs will hire to commission services, to decide who gets treated for what, and to select the treatment they will buy for us at the best price.

And then we had the man from the big society, in his boiler suit. He is a volunteer, who in his spare time is providing first responder services to his rural community.

On Wednesday we got a useful set of figures from the Department of Health showing the effect that scrapping health service targets has already had. There has been a 56% rise in waiting times for diagnosis since July. These figures confirm many people’s worst fears. In order to create a market for private health, all that the government has to do is to make us wait longer for treatment. Long NHS waiting times and demand for private health providers go hand in hand.

This government has assured us that it is a listening government. They have issued a consultation on their proposals and the responses are now flooding in – The BMA, the Royal college of Nursing, the GPsand the Kings fund. They do not dismiss the proposals out of hand. They see the point of strengthening public involvement, but they are all saying that top down changes now are unnecessary, expensive, may result in a two-tier service, and cannot be expected to improve quality. All these experts say that the right way to move towards the changes the government wishes to see is through pilot schemes, involving those GPs who actively wish to take part.

This is the first big test of a listening government. When 10,000 angry people stood at the gates and shouted, the government did not hear. Will it listen to the quiet, careful voices of the people who understand the service best?