Dr Phil Hammond, GP and broadcaster

The alleged response of Dr John Reid on seeing a panicked Tony Blair on reshuffle morning was “Oh f**k – not Health”. The response of many of the NHS staff was “Oh f**k – not John Reid”. One self-deluded macho reformer gets replaced with another.

Alan Milburn’s surprising discovery of family values after 12 years struck a chord with doctors, many of whom are wary of their new contracts precisely because the extra work involved will further erode their family time.

Milburn failed to spot this irony. Trying to force an already workaholic profession with high levels of stress, addiction and suicide to work even harder was always going to be his undoing. And with half the backbenchers campaigning against his reforms, a Chancellor who didn’t trust him and the Commission for Health Improvement threatening to announce a record number of no-star trusts, he got out just in time.

The problem, as ever, with politicians running the health service is that they create false hopes and expectations, promising the earth when all they can deliver is a modest molehill. The fully comprehensive, high quality NHS, delivered free of charge and according to clinical need has always been a political mirage.

Everyone knows how tightly the NHS is rationed, but no Minister dare admit it for fear of being blamed for the deaths of those who are denied adequate care.

For one glorious moment I thought Milburn wouldn’t be replaced, and we could set the health service free. Then up pops John Reid, a man who wants to be Defence Minister, to push forward the reform programme. So we’ll all be going over the top – the Somme once more – in some absurd attempt to fulfil Blair’s promise to turn round the NHS by the time of the next election (two years and counting).

New Labour wasted their first term in office by tying themselves to Tory spending plans and starving the NHS. Lack of manpower was always going to be the biggest problem, yet they addressed it too late. If they’d had any sense, they’d have agreed that the NHS was in a terrible mess from the outset, admitted they weren’t sure how to fix it and set up a Royal Commission to examine the options. Instead, they let the NHS slip into a coma from which no amount of billions can resuscitate it.

If a Health Secretary can’t win round his own party to back his reforms, what hope has he got with the NHS staff? A lot of people liked what they read in the NHS Plan, but the reality of trying to do too much, too soon has badly back-fired.

Managers are now rushing through reforms and trying to hit targets to save their skins, not because they believe it will benefit patients.

I’ve done fifty performances of my show, 89 Minutes to Save the NHS, around the UK, and I’ve yet to find any NHS employee who’ll admit to being praised, motivated or inspired by their management. Without leadership, all reform is doomed.

If John Reid’s got any sense, he’ll realise that the mental health of the staff in the NHS is the biggest barrier to recruitment and improvement. Giving the front-line doctors and nurses humane working conditions and realistic goals they agree with and have been involved in setting is the only way forward.

But with the election clock ticking, I fear we’ll get more blame, panic, coercion and buck-passing.

Dr Phil is back on tour with 89 Minutes to Save the NHS. Details at www.karushi.com

Guidelines in Practice, July 2003, Volume 6(7)
© 2003 MGP Ltd
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