It is tempting to join in the general hilarity of the Prime Minister’s speech to the Tory Party Conference, portrayed at large as Carry On Up the Conference!
TM: (coughs and is offered a cough drop)
Chancellor: Have one of these!
TM: Don’t mind if I do!
TM: Oh dearie me, I can’t talk and suck at the same time!
Cut to shot of conference delegates and gales of canned laughter.
But the day before the speech the headlines shrieked, ‘Up to 8,000 deaths every year may be caused by rising bed-blocking’. And the day after, we have the grim news that the Royal Cornwall Hospital has been put in special measures after delays in processing test results, cancelled appointments and increasing waiting lists are likely to have led to deaths and blindness.
According to the Guardian’s article on the Royal Cornwall, “We were informed of two patients who had died of cardiac-related causes while delayed on the waiting list,” inspectors say in the report. “While it is not possible to say the deaths were directly linked to the delay, the trust reported it was highly likely.” Hundreds of patients with cardiac problems had experienced ‘notable’ delays along with 6.503 patients with sight problems.
The research which produced the ‘8,000 deaths’ headlines, published in the BMJ Journal of Epidemiology and Community Health on 2 September 2017 stated the already known statistic that 2015 saw the largest annual increase in mortality for almost 50 years. The research was an exploratory study which shows that the increasing prevalence of delayed discharges between the NHS and social care and the increased waiting time for acute patients has a positive association with the number of deaths and mortality rate.
In short, two of the country’s key support systems designed in principle to keep people healthy are failing in their task under the auspices of Theresa May’s government, which bears the ultimate responsibility.
The tone of May’s conference speech was set by a blithe autobiographical reason why she is a Conservative, ‘at its heart a simple promise that spoke to me, my values and my aspirations that each new generation should be able to build a better future…the British dream’. As her central theme, she praised and embedded the free market system at the heart of her agenda, as the engine of progress, the great innovator and provider of opportunity and equality, effectively acceding the responsibility of government to the market as she did so. She ended with an extraordinarily condescending approach to what could be paraphrased as the ‘common folk who don’t bother about great affairs of state like this as they scurry about their little lives’ and for whom she says she has dedicated her political career, working for ‘the most vulnerable’ and ‘giving a voice to the voiceless’.
On the NHS, May talked of, ‘investing more in mental health than ever before,’ whilst Jeremy Hunt solemnly nodded his agreement from the audience. She blamed out of date legislation from 3 decades ago for any problems currently being experienced. She talked of ‘our great national achievement: our NHS’. ‘Let us not forget’, she said, ‘that it is this party that has invested in the National Health Service and upheld its founding principles through more years in government than any other’.
To hear a Conservative Party leader describe the NHS as ‘the very essence of solidarity in our United Kingdom…a symbol of our commitment to each other’, in the face of the service’s near-collapse from the top down re-dis-organisation, de-funding and privatisation is surely to have passed through The Looking Glass. She talks of year on year per-head increases in expenditure on the NHS, of the greatest investment in training of doctors and nurses ever. She says they will always support safe, high quality care.
The reality on the ground is a list of serious issues confronting the NHS as a result of constant turmoil from NHS England’s endless series of ‘new’ models and test-beds, re-shaping the service to fit the 5 Year Forward View. There is the current report on delayed discharge and increased mortality; the CQC report on the Royal Cornwall; serious difficulty in recruiting to fill the GP shortfall (Pulse magazine reported earlier this year an increase from 2.1% unfilled GP vacancies in 2011 to 12.2% this year); constant A&E crisis; scapegoating of one group of patients or another as the cause of all problems; and more.
At a bare minimum it is unacceptable that Theresa May should position her party as the custodians of the NHS.
Let us assume for a moment that she does not understand the current progress of the NHS towards US-style Accountable Care; that she has been convinced that it is simply a change in the management style, not a radical undermining of the principle of universality. Then we are left with the possibility that the worst of this situation may lie in her blithe confidence in the ‘values’ of her party and her belief that only a further de-regulated free market economy can provide the strong economic background needed to support the NHS. In that case she would appear to be immunised to the truth.
Either way we are faced with the real possibility that has existed since David Cameron’s, ‘I’ll cut the deficit, not the NHS’. She either knows what is happening to our greatest public service under her government and lies about it. Or she doesn’t know in which case she and her party are not fit to govern.