Melanie Phillips

8 December 2005

Britain's ailing sacred cow

Published in: Daily Mail

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The Health Secretary Patricia Hewitt has caused general outrage by saying airily that hospitals should make patients wait up to two months longer for their operations in order to save money.

Asked if she approved of the decision by Staffordshire primary care trusts to impose a six-month wait for non-emergency surgery, she said it would make sense to delay such operations to help trusts reduce their debts.

This gave every NHS trust a green light to turn what is currently a maximum six-month waiting time into the minimum. Doctors are thus being put under pressure to go against their clinical judgment and deny patients the treatment they need when they need it, all because of gross government incompetence in running the health service.

The more patients that hospitals treat, the more heavily they get into debt. So rather than the health service fulfilling its purpose to treat sick patients, such patients are being used to treat the problems of the health service by being parked on the waiting lists.

Yesterday the NHS Chief Executive Sir Nigel Crisp echoed Ms Hewitt's comments by admitting that patients might have to wait longer for treatment because a quarter of NHS hospitals and trusts are failing to control their finances. This is surely the economics of the madhouse.

Having treatment on the NHS has become a lottery. You can strike lucky and find speedy treatment, modern facilities and efficient and pleasant care. But far too often standards fall woefully short.

When I broke my wrist a few months ago, I needed an immediate operation to set the bones. If the operation wasn't done within a couple of days, the bones would have set permanently in the wrong position. Although I was admitted straight away to an NHS teaching hospital, I was bumped off the operating list to make way for more urgent cases because, although there were surgeons ready and willing to set the wrist, not enough operating theatres were in use.

The following morning I was starved and gowned for surgery, and then bumped off the list again as the surgeons fumed. In desperation, I had to have the operation done privately to prevent my wrist from being permanently crippled.

While I was on the NHS ward - by chance I had been put into a side room - I was further discomfited by being woken in the middle of the night and told I would have to move immediately to make room for another patient. Upon further inquiry, it became clear that I would be moved onto a mixed-sex ward - of the kind that the government has said must be phased out. At that point my normal desire to be accommodating deserted me and I simply refused point blank to be moved.

Of course, the vast majority of front-line staff perform a heroic job in trying circumstances. But the impression was of a system that was hopelessly mismanaged, desperately paddling to keep its head above water but sinking with every day that passed.

The fact is that the government has simply lost control of the health service. Chaos appears to be widespread as the money runs out. Trusts in Surrey and Stoke-on-Trent have been postponing patient admissions for up to four months in order to move them into the next financial year, thus saving on this year's budget.

Surgeons are being told to operate on fewer patients as there is no money to pay for them. Efficiency is penalised. One surgeon in Cornwall was incensed to be told that the problem was that he was working too fast.

Other trusts are saving money by removing patients from waiting lists through a variety of sleights of hand. Now the government crows that the waiting list has dropped to below 800,000 for the first time since the late 1980s. But at what cost to sick people?

Across the country, NHS trusts are in dire trouble. The service as a whole is forecasting a

About Melanie

Melanie Phillips is a British journalist and author. She is best known for her controversial column about political and social issues which currently appears in the Daily Mail. Awarded the Orwell Prize for journalism in 1996, she is the author of All Must Have Prizes, an acclaimed study of Britain's educational and moral crisis, which provoked the fury of educationists and the delight and relief of parents.

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Melanie Phillips
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