So Gordon Brown has come up with a novel plan to cut health spending – let the sick treat themselves and also decline to help those who are deemed not to have looked after themselves properly. Welcome to the 60th anniversary of the National Heath Service, New Labour style.
After pouring endless amounts of money into the pockets of management consultants, senior managers, the pharmaceutical corporations, private clinics and contractors, the NHS is in a worse state than ever. MRSA and other infection rates remain high, increasing the chances of coming out of hospital in a worse state that when patients go in. Seven years after the government announced that mixed wards would be abolished, 25% still share a ward or bay with members of the opposite sex. Cancer survival rates in Britain are among the lowest in Europe and a postcode lottery means you need luck on your side to be near the right sort of health care.
As usual, the government’s new plans for self-care are presented as an “opportunity” for patients. Brown hinted at the new policy in a message to NHS staff yesterday, promising a service that "gives all of those with long-term or chronic conditions the choice of greater support, information and advice, allowing them to play a far more active role in managing their own condition". But the real story behind the notion of “personalised service” is that the Department of Health is struggling to meet Treasury targets to cut spending by £8.2 billion over the next three years. The department's "Value for Money Delivery Agreement" – details of which were leaked to the Daily Telegraph - sets out how the NHS could meet the “efficiency savings” target.
In a bid to reduce costs, NHS patients could be expected to administer their own medication and new guidelines could mean people with chronic conditions:
• monitoring their own heart activity, blood pressure and lung capacity using equipment installed in the home
• reporting medical information to doctors remotely by telephone or computer
• administering their own drugs and other treatment to "manage pain" and assessing the significance of changes in their condition
• using relaxation techniques to relieve stress and avoid "panic" visits to emergency wards.
The plans have gone down like a lead balloon among patient groups. The Arthritis Research Campaign said it risked providing health managers with "an excuse for neglecting elderly patients", with a spokeswoman adding: “"Some GPs don't take arthritis seriously enough, and the result of this could be to give them another excuse to tell arthritis patients just to go away and take their tablets." The Patients' Association said it was concerned that “financial pressures will take precedence over clinical needs" while Peter Weissberg, the medical director of the British Heart Foundation, said: "People affected by heart disease need specialist care. Whilst we support changes that empower people to look after their own health, we would be very concerned if they led to any reduction in the availability or quality of expert care for those who need it."
The best way to mark the 60th anniversary of the one of the great achievements by working people is to take action to defend and extend the principles of the NHS as a health service free at every level and totally in the public sector. That would involve, for example, a campaign for social ownership of the drugs corporations and the elimination of the vast bureaucracy that dominates the sector. None of this is possible while the capitalist New Labour government is in power and would certainly be unachievable under the rule of its ugly sister, the Tories. We should take Brown at his word when it comes to self-treatment and act to get rid of his government, working towards a fairer, more democratic society when people not profit come first.
AWTW communications editor