This election should be the spur for a real debate about the NHS’ future

Election NHS

The NHS has finally made the front pages and will now undoubtedly be a key part of the election debate.  Despite the Tories best efforts to keep the NHS out of the news the pressure from increasing demand, reduced supply, cuts in training and workforce, cuts to local authorities and of course the devastation of the Health and Social Care Act has resulted, as widely predicted, in another NHS ‘crisis’.

Pressure on A&E is indicative of wider pressures on GPs, community services, the voluntary sector and social care. A&E should be just that – for accidents and emergencies.  Such departments are staffed by highly-skilled, experienced and therefore expensive staff.  Despite this, numerous scholarly reports document an astonishing scale of ‘inappropriate’ attendances, that are neither accidents or clinical emergencies.  Strategies to divert people to alternatives services include Walk in Centres, NHS Direct, 111, Urgent Care Centre, GPs or pharmacists.

Self-diagnosis, however, is not proving to be the public’s forte.  Not only do we often fail to work out what is wrong with us, we also flounder when it comes to knowing where to find treatment. Often we end up trying more than one of these alternatives.

The middle-aged and younger generations, as well as parents and carers of children are high users of A&E.  These are the groups who need to be more involved in this election debate about the NHS.  These are people who expect a high level of good quality service, as opposed to being grateful for anything.  For them, the current offering is counter intuitive.  Popular support for increased NHS funding will be hard or impossible to achieve if we are simultaneously scolding people for using the parts of the service that they find most convenient.

The NHS is based on a simple principle.  We pay as we are able to for a service that is free when required.  Maintaining this pact requires the NHS to meet the needs of people as they are today and will be tomorrow.  Accessibility and convenience are important.  A quality service, 24 hours a day, and within four that means we can sort emails, work, tweet or do the shopping while we wait is attractive.

If we continue to tell taxpayers that A&E is not for them, and a similarly convenient quality service is also unavailable, how will they view the NHS?  Either they will baulk at paying more for a service that they find inconvenient, or they will demand something different.

For the Tories the choice is easy.  They are using the current crisis to introduce the idea the NHS is not affordable.  That trajectory ends with reduced entitlement, top-up charges, private insurance, and private GPs and urgent care services.  Labour must use the coming campaign to demand something different.  NHS democratisation that allows people to take control of their own health choices.  We must promote a better understanding of the relationship between cost, quality and level of service.  This is an issue that impacts directly on all our lives and that has the capacity to engage the electorate and ultimately save the NHS.

Karin Smyth is Labour’s PPC for Bristol South. She tweets @karinsmyth