The Politics of Health

NHS reformSome years ago, I had to organise a meeting of NHS communications people at which a couple of Department of Health bods were to speak. The idea was to create a better understanding within the service of the needs of central government.

It should have been a routine, straight forward affair but my antennae began to twitch when I noticed a couple of hospital chief executives among the thirty or so people in the audience.

Things went boringly well until the London-based civil servant declared that as far as the audience was concerned, their most important priority was the Secretary of State for Health.

One of the hospital chief executives snarled at this and got to his feet, a vein throbbing angrily at his temple, and bellowed: ‘For your information, the most important priority every day of my life is the patient!’

Voices were raised, chairs were overturned, fists were shook (not really) and the meeting designed to create a spirit of understanding descended into unpleasantness that took quite a bit of smoothing over.

I laughed about it at the time, but looking back I now see it as a bit of a milestone in the politicisation of the NHS.

I already knew that there were often competing priorities between those working on the ground and those pandering to the whims of politicians and a big part of what I did was to act as a buffer between the two to let both get on with their jobs.

That two busy chief executives took time out of their day to go to that meeting to confront the beast as it were simply illustrates the way the wind of change was blowing.

The point of this trip down memory lane  is that it happened in the late 1980s and that NHS refusenik* wasn’t a chief executive, but a general manager as they were known back then.

The politicisation of the NHS did not begin under the last Labour government as Harriet Sergeant claims in her Daily Mail commentary, but was a product of Margaret Thatcher’s administration, or at least that was when the seeds were sown.

Of course it has got worse over time thanks to politicians of every hue messing and meddling with organisations and structures and deflecting those running the service from their rightful priority which should be the community they serve.

It is the only reason I can think of to privatise the NHS, to remove health services completely from the hands of politicians, but I doubt if that will ever happen, at least not while I draw breath.

* Why do we use this word incorrectly? A ‘refusenik’ was one who was refused permission to leave Russia, not someone who refused to go!

Nobody’s prefect. If you find any spelling mistakes or other errors in this post, please let me know by highlighting the text and pressing Ctrl+Enter.

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