Nhs

A nice, cuddly NHS would be bad for us

Recently the NHS postponed a large number of non-urgent operations to cope with what is known as the ‘annual winter crisis’. Naturally, this outcome was treated as a scandal in the press, and there were predictable calls for Jeremy Hunt to resign. But the fact that non-urgent operations are postponed is not by definition bad. It might be evidence that the NHS is working well. Or at least that it is doing what it is supposed to do, which is to deploy necessarily finite resources on the basis of patient need, rather than some other criterion — such as profitability or ability to pay. Making people wait for less urgent

Martin Vander Weyer

Carillion’s crash is not a parable of the evil of outsourcing

Carillion is a disaster on all fronts, but my sympathies go first to the fallen contracting giant’s sub–contractors. Upwards of 30,000 smaller firms were already facing 120-day payment delays and may now have to fight court battles to get paid at all, driving many hard-pressed entrepreneurs to bankruptcy. But the political spotlight won’t help them, because Labour spokesmen who despise small business as well as large will merely use the case to attack the concept of outsourcing public services for private-sector profit. And that debate will continue to miss the central point that Carillion has not crashed because it held too many school-meal contracts, but because of delays and cost

The case for more NHS cash is growing

Theresa May likes to boast at Prime Minister’s Questions that mental health spending is increasing. The problem is that this is rather difficult to see on the ground. The King’s Fund today published a report saying the gap between spending on hospitals and mental health widened further in the last year. The think tank even said that there was an increased risk to patient safety in more than a half of mental health trusts because of staffing shortages, and that ‘the government’s mission to tackle the burning injustices faced by people with mental health problems will remain out of reach if things stay the way they are’. The King’s Fund’s

Smooth operators

In George Bernard Shaw’s play The Doctor’s Dilemma, written early last century, the knife-happy surgeon invents a nut-shaped abdominal organ, the ‘nuciform sac’. It is situated near the appendix, ‘full of decaying matter’, and requires removal, assuming the patient can afford the fee. The surgeon, Cutler Walpole, has the line: ‘The operation ought to be compulsory.’ Bernard Shaw labours the point that removal of the nuciform sac equals 500 guineas, and not removing it equals nought guineas. He then suggests, wickedly, that we want our surgeons to be mortal, ‘quite as honest as most of us’, not God-like. Which of us, he asks, would not be influenced by the financial

The NHS cannot heal itself

Rationing did not end in the 1950s. The largest-scale rationing programme is still in existence: our beloved National Health Service. Its austere regime is part of our national life. We no longer queue for bread or sugar, but we most certainly do to see the doctor. We no longer wait in line at the butcher’s, but we do in A&E departments and on interminable lists for appointments and procedures. There are no books or coupons, but rationing it remains. Indeed, the government has announced it is withholding elective operations and routine appointments this month. Rationing by any other name would smell as sweet. And, like our drawn-out post-war rationing, it

Should we blame patients for the NHS crisis?

The whose-fault-is-the-NHS-crisis game has taken some strange twists and turns this week, with the debate bouncing from patients costing the health service £1bn last year to Jeremy Hunt having to apologise to patients for cancelling their non-urgent procedures as a result of the increased pressures on hospitals. Political debate tends to prefer black-and-white and easily identifiable scapegoats, but the health service is too complex for that. Take the missed appointments story. Yes, patients failing to turn up cost the health service a staggering amount. But who are those patients? It turns out that the most likely people to do what the NHS classes as a ‘DNA’ (did not attend) are

There’s a much bigger crisis in the NHS than the winter pressures

Whose fault is the current NHS crisis? Today Jeremy Hunt apologised to patients whose operations have been cancelled as a result of serious pressures on hospitals. There are ‘major incidents’ at 16 hospital trusts, and the Royal College of Emergency Medicine is warning that patients who do end up in crowded and chaotic emergency departments ‘are much more likely to have a poorer outcome and even die as a result of their experience’. The Health Secretary said the current situation was ‘absolutely not what I want’, while Theresa May argued that ‘the NHS has been better prepared for this winter than ever before’. The government has not met Simon Stevens’

Kate Andrews

It’s time to stop burying hard truths about the NHS

The philosophy of the National Health Service, as stated on its website, is that ‘good healthcare should be available to all, regardless of wealth’. This is why, in theory, Britain’s health service ‘covers everything’. Not this month. Last night, NHS hospitals were made to cancel all non-emergency surgeries until February in order to divert resources to this year’s flu epidemic, which is causing mass overcrowding. As a result, outpatient clinics will be shut down for weeks, and 50,000 appointments have been cut from the schedule. 50,000. Even in today’s world, where statistics are everywhere that number cannot pass by fleetingly. 50,000 patients, often in pain as they wait for a hip replacement,

Could cancer break the NHS?

Could cancer break the NHS? This was the provocative title of a debate at the British Museum hosted by The Spectator and sponsored by Philips. Two of the expert panellists suggested that it just might. Others were more optimistic. But all seemed to agree that, for the NHS to survive, bold action was required. First, Neil Mesher, CEO of Philips UK and Ireland (UKI), presented some frightening statistics. One in two people will be diagnosed with cancer – a proportion that is rising because we are living longer. Greater awareness of cancer, too, means that more people are being referred for tests – so much so that the demand on

Surgeon’s Notebook

Memory, neuroscientists tell us, is fallible. It is a dynamic process whereby each time we remember something, it will be changed. Our first memories are probably even less reliable, but I think mine is of Christmas 1953, when I was three. My mother was German and we celebrated Christmas in the German way. An English Christmas is a dull affair in comparison, with presents handed out by underslept parents on a cold and drab Christmas morning, around a tree decorated with electric lights. German Christmas would start on the first Advent Sunday with my mother making a wreath of fir branches and red ribbons, with four red candles. On each

Fixing social care is key to the future of the NHS

On 12 September, The Spectator hosted a round-table dinner, sponsored by Bupa, to discuss the future of healthcare in Britain, involving MPs and practitioners. This is a summary of the evening’s discussion. We are forever being told that the health and social care system is in crisis thanks to government ‘cuts’. The trouble is that political parties which try to be honest about the rising cost of healthcare, and come up with solutions as to how we will fund it, tend to be given a rough reception – as the Conservatives discovered when they launched their manifesto for this year’s election, which saw their proposals for social care funding damned

Is the NHS open to new technology?

At a dinner on Tuesday 26th September at the Spectator’s offices, sponsored by Philips, entrepreneurs, doctors and healthcare experts discussed how new technology could ease pressure on the NHS – and whether the health service was equipped to take advantage of it. Guests included: Naushard Jabir, founder and CEO of Vida, Paul Bate, Director of NHS Services at Babylon, Professor Simon Wessely, President of the Royal Society of Medicine, Helen Whately MP, Dr Claire Novorol, chief medical officer at Ada, Neil Mesher, CEO of Philips UK and Ireland, Sola Adeleke of Aurora Medical Innovation, Nicholas Timmins, senior fellow at the King’s Fund and Dr Jakobsen, chief scientific officer of Immunocore

Spectator Briefing: A new battle of ideas

When I started out as a political journalist, I was always thrown by the word ‘policy’. To most people it sounded so dull and wonky whereas for me, it was – and is – easily the most exciting aspect of politics. How to fix the NHS, tackle poverty, solve the housing crisis, make state schools as good as private schools? This is what Westminster should be about: a battle of ideas. So we’re introducing a forum for this battle: Spectator Briefing, where we’ll seek a variety of voices and go into greater depth than would be suitable for Coffee House. There will be graphs, more links to PDFs and we’ll

Why is the UK’s supposedly impartial statistics watchdog joining the Boris-bashing?

Okay, it’s a rainy Sunday, but surely the new chief of the UK Statistics Authority has better things to do than send angry tweets to the Foreign Secretary? Alas not. Today Sir David Norgrove, the newish chairman of the UK Statistics Agency, tweeted out a letter declaring himself ‘surprised and disappointed’ that BoJo has ‘chosen to repeat the figure of £350 million per week, in connection with the amount that might be available for extra public spending when we leave the European Union’. He says that this ‘confuses gross and net contributions…. It is a clear misuse of official statistics’. Sir David Norgrove writes to Foreign Secretary about use of

Beyond the stethoscope: transforming the NHS with new technology

For technology manufacturers, healthcare is already big business, and, with an ageing population increasingly comfortable with technologies that would’ve been unthinkable even a decade ago, the opportunities to innovate are only going to increase. The Future Health Index, a global report commissioned by Philips, supports the fact that it is not just the UK’s younger generation that are embracing these technologies. However are these products – from popular or trendy FitBits to state-of-the-art imaging equipment – really going to revolutionise the country’s medical care? And will the NHS require a head to toe change of ethos to accommodate them? Spectator editor Fraser Nelson is joined to discuss all this by

Health and personal choice

Public health specialist Sir Michael Marmot has blamed ‘the cuts’ for the rise in dementia among the elderly, resulting in a decline in the rising rate of life expectancy. But parroting ‘the cuts’ does nothing to treat the cause. If Sir Michael wants to tackle that problem, the ancients can tell him how. It has to do with lifestyle. Ancient medicine, like ancient Gaul, was divided into three parts: drugs, surgery and lifestyle. This last part permeated every aspect of life. Food and exercise were taken to be the most important, but sleep, sex, bathing, massage, mental activity, and so on — even clothing — could all come into the

The NHS is one year older, yet none the wiser

The NHS is one year older, yet none the wiser. Having spiralled into perpetual crisis years ago, no one can pretend the gargantuan system is looking great for its age. Its fragile condition has all of us worried – not least because of the millions of lives that are forced to depend on our monopoly health service. The NHS’s woes are thought by some to be the result of some evil right-wing push towards privatisation – and by no means a reason to hold back oodles of praise for the healthcare system. If anything, the health service’s troubles have served as a call-to-arms to defend the status quo. But despite the jabs and digs

Why do nurses quit? Because they care | 3 July 2017

Sometimes, on Sundays, I visit Richard, a friend who’s 95 and lives alone. The idea originally was that I’d be doing Richard a favour, but the truth is he cheers me up far more than I do him. I visit because I like him, but as the weeks go by, I’m afraid I’ve also developed a grim curiosity about what it’s like to be in your nineties. Meals-on-wheels, crumbling knees, hernias, cannulas, the way a day dissolves into unintended naps… ‘Can’t we talk about something more cheerful?’ says Richard, as we sit knee to knee. But I’m obsessed, like a tourist taking notes on some awful country they must one

Real life | 15 June 2017

And so, as it must, the pilgrimage to find a local GP surgery begins. This is a great British tradition, and I have been honoured in my lifetime to have taken part in many and varied official registerings at different NHS surgeries. Having been ceremoniously relieved of my first GP in London, and invited to find another one because they had redrawn the boundaries, last year I was on the road again after they closed the second one down. I found myself at a surgery on a sink estate where the first language — and indeed the second, third and fourth languages — appeared not to be British and where

Letters | 25 May 2017

NHS in a mess Sir: Max Pemberton is quite right to say that the NHS is close to collapse, but I’m not sure a Royal Commission is the answer (‘This is an emergency’, 20 May). The problems facing the NHS have been obvious for years, and need, as Max points out, a strong politician to take unpopular decisions, not an expensive Royal Commission to decide what the issues are. The other problem with a Royal Commission is that it would draw its membership from senior doctors, retired politicians, and other members of the establishment, some of whom are responsible for the mess in the first place. Dr Chris Nancollas Yorkley,