Budget for the Backbenchers (The Budget 2003)

Member Name: drdel

Product:	The Budget 2003
Date:	26/04/02 (51 review reads)
Rating:

Advantages: more money

Disadvantages: alan millburn spending it, wastage likely, populist spending policy

First of all, unlike others, I do not hold strong affiliation to any given party, I like to judge policies and actions on their merits.

For those who have not read my ops before,I am a doctor working in London, so I suppose you could say I have a vested interest in the changes effected by the budget. In this op I will be focusing on the main policy change in the budget that affects all of us, specifically the rise in national insurance for the purposes of paying for better healthcare.

On the face of it, Gordon Brown seems to have produced a classic labour budget. An increase in tax to pay for public services. Whether you approve of that political philosophy is a matter of debate, I won't be debating that here. The real question I think is on everyone's minds is, will the extra money make a difference, and as an addendum to that, when will we see the benefit?

Unfortunately, that is the achilles heel of this change in policy. It is a massive political gamble, no doubt, the reason being that it means that the NHS will be under the spotlight in the next election as a result. People will want to see if the extra money that they are paying is producing tangible results. Therein lies the problem.

Governments are political animals, they are dependent on the public support to survive, and any government of whatever political persuasion, wants to survive in power above all else, including the health service. To do this they will have to produce evidence to justify the extra tax, and that means I fear, a waste of a lot of the money.

What the health service really needs if it is to be kept in its present state, is reinforcement of its foundations. Hospitals without ceilings falling in, wards with clean carpets and a hygienic environment. More hospitals, doctors and nurses to lower waiting lists and times. To get all those things you need to bring about a change in culture within the health service. If you want to increase nu
rses, you don't travel around to all the third world countries and steal theirs, you have to make nursing an attractive career. If you want more doctors you need to do the same, not import them from South Africa and Europe. You need to have a structure to doctor and nurse training involving incentive to perform. The government at the moment simply threatens those hospitals that underperform.

The government also seems to be ploughing your money into setting up national bodies of various functions to go around the country and scrutinise different hospitals, wasting time and money getting doctors and nurses to fill out endless audit forms and performance tables. Unsurprisingly, hospital trusts who do not have the resources to meet the standards are fiddling their books, because they know the only way they will get more money is to perform well.

This type of big brother culture needs to stop and your money should not be wasted there.

The other problem with all this money is believe it or not, no one knows how to spend it. Half a billion pounds last year was not spent.

I have always belived that government should be involved as little as possible in the running of the health service. There should be devolvement of power to local health authorities because the demographic of health care needs is different in different parts of the country. Did you know that the government decides how many medical school places are available each year? That is a scandal as far as I am concerned.

Finally, Alan Millburn has to be removed. You cannot have a health minister who has gone on record as saying he does not like doctors. I simply do not trust him to spend my money or yours well. He abolished the NHS Executive, which was a policy making body, and installed himself as head. He is also dishonest, making wild promises to the general public whilst saying a different thing to us doctors. Example, he tells the public he wants to increase
the number of doctors, he tells my speciality that we have too many trainees, and he reduces them. So it is predicted that there will be a shortage of consultants in my speciality. His latest wheeze is to spend your money on training doctors to be nicer to patients! It is in the papers today. He is using your money to pay teams of psychologists to train doctors in improving their communication skills. I am not saying that this is not important, but compared to other pressing needs in the NHS, is this really a priority? In my experience, we are actually quite nice to our patients.

In summary, what the NHS needs is an overhaul of its culture. The government needs to put patients first and be honest to them about the expectations for the future. It needs to make the NHS an attractive and exciting place to work, where its employees are valued and respected, and where British men and women will want to work so we do not have to steal other countries doctors and nurses.

Most of all the money needs to go where it is needed, patient services, and hospitals that do not perform need to be given the means to improve.

Unfortunately I think their was an air of cynicism about this budget. The backbenchers were getting jittery, and this is the sort of budget that appeases them, however it remains to be seen whether the people that matter, the patients first and foremost benefit from this change in policy.

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