Thursday, April 08, 2010

Health: Labour promise more targets, more verbosity

It seems unfair that I should point out some of the weaknesses and contradictions in Conservative health policy, and leave the red team out. So, I've had a look at the Labour website to see what they've got in store for us...

A lot of platitudes, is the first thing that hits me;

We will ensure that the NHS is always clinically driven, patient centred and responsive to local communities, and based on need not ability to pay.

I do find myself wondering whether any political party would call for an NHS which was anything but clinically driven, etc, etc. However, there are signs that their control freakery has by no means reached its limits.

we are turning waiting time targets into legally enforceable guarantees for all patients: a maximum two-week guarantee on cancer referrals, and a maximum 18-week guarantee for hospital treatment, as well as rights to free health checks and to evening and weekend access to GPs

Legally enforceable? Does that mean that, if I don't get my cancer referral in two weeks, I can go to court to get it? Given that such legal action could take years to go through the courts, what is the point? And who pays? If a healthcare provider fails due to the ill health of a consultant, what happens?

There is an impressive list of achievements at the end of the statement, you know the type, tractor production up 37.2%, that sort of thing. However, there has been a cost. In fiscal year 1997, the United Kingdom Government spent £41.6 billion on health care. By fiscal year 2010, spending is expected to be £118.7 billion. I make that about twice as much in real terms (if someone would like to check that, I'd be grateful, but it looks about right).

For that kind of investment, I'd expect a hell of a lot of improvement, but most voters are unlikely to sense that they've got it.

We can safely assume that the centralising, target-setting trend will continue:

We will give hospitals incentives to focus on quality as well as quantity through the introduction of powerful financial incentives which will link payment to quality, including patient satisfaction.

I do worry about the notion of allocating funds based on patient satisfaction, but incentives that require vast amounts of data gathering will merely cause more bureaucracy, contrary to the search for efficiency savings. Let us be blunt here, the public don't like bureaucrats, don't believe most of the statistics that come from government, and those that do don't for the most part, refer to them when making health care decisions.

What is missing is a big idea, and this looks very much like 'one more push'. It's harmless, and aspirational. I just don't think that it's affordable...

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