If It Ain’t Broke, Don’t Fix It – A Lesson From NHS Direct (Part 4/4)

Here’s the final part of my piece on NHS Direct. If you’ve read all the others as they were released, how very masochistic of you. If not, click here for part 1, part 2 and part 3.

What can we learn from NHS 111? Apart from recognising that knowing your arse from your elbow is probably important if you’re going to be health secretary (seriously, I could unload a minigun into a conference of midwives, nurses and paramedics and do less damage to the NHS than Jeremy Hunt and Andrew Lansley have).

Firstly, politicians need to recognise that just because something is slightly broken that replacing it completely is not the answer. NHS Direct did a reasonably good job. It was not perfect, like most parts of the NHS (and a few of its staff members), it was bloated, inefficient and sometimes did the wrong thing. What it realistically needed was someone to come in and say ‘why in God’s name do we have algorithms in Laotian, Cherokee and Luxembourgish?’ and address other such silliness and then see if any other cost-cutting measures could be done. What actually happened was the Coalition reacted as if NHS Direct was a Mid Staffs level crisis and burnt the whole house to the ground to kill a few mice in the wall. NHS 111 doesn’t send people to the correct service than NHS Direct did. It doesn’t employ more clinical staff than NHS Direct did. Most importantly, people seem to be dying unnecessarily under NHS 11 than under NHS Direct.

Secondly, we, as the general public, need to somehow force political parties to buck up their ideas when it comes to the NHS. I’ll write about this more in forthcoming articles but none of the major parties seem to have any comprehension of what pressures the NHS is actually under and what it will take to fix it. Instead they rearrange services to do essentially the same thing under a more confusing structure (with additional privatisation) and crow that that will fix the NHS and make people healthier. It won’t. What will is putting more money into the bits that work well, and trying to improve the bits that don’t work well. For example, perhaps not asking GPs (already the most efficient service in the NHS) to open 7 days a week with no extra funding.

Thirdly, we need to stop voting in humongous cretins to run our health system. Again, I’ll be doing more detailed posts on our current political ideologues, but here’s a short profile of the last five Health Secretaries:

  1. Jeremy Hunt – believes that homeopathy is anything more than an expensive placebo
  2. Andrew Lansley – cretin of the highest magnitude, roundly criticised by both the Royal College of Nursing (RCN) and the British Medical Association (BMA)
  3. Andy Burnham – only ran a public enquiry into Mid Staffs after multiple requests to do so, 2800 people died after the first alarm was raised
  4. Alan Johnson – seemingly quite good
  5. Patricia Hewitt – expanded private sector involvement in the NHS, and managed to get 12,000 doctors to march across  London in opposition to a computerised training cock-up

Not sure I need to say much, but we can hardly complain about how politicians are messing up the NHS if we keep electing people with seemingly less sense than a rabid orangutan.

We need sensible middle-of-the-road politicians who are willing to realise that NHS improvements probably need to happen over years-to-decades, rather than months-to-years. We need them to notice that rhetoric around a 7 day NHS isn’t going to suddenly spring into existence neither the doctors, nurses and support staff to run it nor the money to pay their wages. We need them to realise that mental and social health services can’t continue to be negelcted to the point that vulnerable patients (or clients or consumers or whatever corporate nonsense we’re supposed to call people nowadays) end up in A&E because the unsupported healthcare assistant has nowhere else to send them. 

Will we get this? I’d like to think so, but I’m not hopeful. What can we do? Given that I’ve already written a stupidly long piece, I think I’ll address that another time. 

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