1250 days to save the NHS: A new approach

First a little about myself. I am 53 years old and have worked in health care for over 22 years. I have voted Liberal, latterly Liberal Democrat, for nearly 40 years now. I, like others, have been frustrated by the ongoing swing politics that has affected the United Kingdom since the last war. Whilst like many others I am saddened by the outcome of the referendum I know as a party we are committed to be outward looking and pro-European. This will mean maintaining and fostering close links our European neighbours. However we need to plan now as to how we can win the next General Election in 2020, and in doing so protect to NHS as a public service.

The voting public must be made aware what is at stake and we must put forward a radical but costed vision for the health service. In 1997 New Labour came to power and pumped money into the NHS whilst establishing targets for waiting times. This was a sensible approach, but in recent years this has evolved into ever-increasing ‘fines’ for failing to meet those targets. Therefore, despite the Conservative government’s much lauded promise ‘to increase funding’ for the NHS, the reality is that year on year hospital trusts fall ever further into debt, leading to cuts in staff & frontline services in real terms. This is neither a responsible or sustainable approach to meeting the needs of the public or the NHS.

I propose that when elected the party would immediately freeze ‘fines’ on hospital trusts for a period of two years. This would enable trusts to channel funds into staff recruitment and retention and also to plan spending to meet the demands of a growing and ageing population, after that initial period. Instead of ‘fining’ trusts for failing to meet waiting times at A&E. or delayed discharges at the end of treatment trusts would be paid a premium for meeting those targets, thus incentivising innovation & service delivery.

During this initial two-year period trusts would look closely at how services are delivered, for instance an A&E department could reduce waiting times by setting up a GP service at weekends. This could be done in most towns and cities by requiring GP surgeries to provide cover on Saturdays and Sundays on a 4-weekly rota basis. This would reduce the burden on A&E departments at weekends and allow the public to see their own GPs rather than an expensive and often over-stretched out of hours service. Also rolling out in-reach services to treat residents already living in care homes, but requiring I.V. treatment for chest infections or other similar conditions. Provided by a ‘rapid response’ team run by experienced nurses with access to doctors and the necessary medicines, who could ‘crisis’ manage these patients in their homes without the need to take into hospital via A&E departments. These services would be accessed by nursing staff working in the homes who had been trained to recognise ‘the deteriorating patient’ by using the NEWS (National Early Warning Score) assessment tool.

These measures would then allow hospitals to concentrate on treating acutely ill patients following accidents, injury & sudden onset conditions alongside planned services such as routine surgery on a day case basis and outpatient services. Historically we have either prioritised treating people in hospital or in the community, but I believe that with a little forward planning we could deliver both and they would complement each other, delivering an NHS that can meet the needs of Great Britain in the 21st century. To meet those needs we would need to train more doctors, nurses and related therapists. A commitment to reintroduce bursaries for student nurses would recognise their contribution and the fact that they have never taken part in industrial action (to date). We will also need to address the funding and delivery of social care alongside this, but that merits a separate discussion.

* Jon Taylor is a member of the Liberal Democrats from Worcester.