CROYDON COMMENTARY: There is a looming crisis at Mayday Hospital, but according to DAVID CALLAM, our national politicians are failing to do anything about it
Privatisation is an overused word, especially in the argument surrounding the future of the National Health Service.
The private sector has been at the heart of the NHS since its inception.
General Practitioners, the service’s most trusted stalwarts, are and always have been self-employed sole traders or partnerships.
Now our GPs are being asked to play a greater role in the day-to-day management of the service because, we are told, they know better than an army of overpaid, semi-detached managers.
Let me offer an example of better care from a pilot GP commissioning group in nearby Bexley. Doctors were concerned about the level of charges for diagnosing heart disease, so they cast around for a more cost-effective alternative.
They found a private-sector clinic in Harley Street that offers a better test, using a faster, more modern procedure that is non-invasive and therefore more comfortable.
The cost is just 60 per cent of the amount charged by the local NHS hospital. And that cost includes transporting the patient by car from home to the clinic and back. The new system delivers a clearer scan more quickly, allowing faster and more precise diagnosis. Everybody gains, but most especially the patient.
Some will argue that taking work away from a local hospital will make it less viable; that a hospital is expensive to run and charges for individual procedures must reflect that fact; some will even argue that it costs what it costs and we should make the money available regardless.
Let me be clear. I defer to nobody in my admiration for the NHS. It has been a good and reliable friend to me and my family. I would erect a statue of Aneurin Bevan, its founder, in the foyer of every hospital in the country, to remind us how much we owe to his brilliant ideas.
But the service is nearly 65 years old. Medicine has changed totally since Nye set up his NHS and it is a tribute to his foresight that so much of it remains relevant.
The core principle – a service free at the point of need – is always worth defending. I’ll gladly man the barricades if some here-today, gone-tomorrow health secretary tries to dilute it.
But the service is surely flexible enough to adapt to changing circumstances? St George’s Hospital in Tooting sends some of its keyhole surgery patients to St Anthony’s, a private hospital in Cheam. If you ask a candid medico why, she will tell you that Tony does as good a job more cheaply than George.
The days of the general hospital are numbered. That’s not an original thought from Jeremy Hunt, the latest health secretary. Medical strategists have been saying so since Mr Hunt was no more than an admirer of Rupert Murdoch.
Even in the balmy days before the 2008 financial crash we couldn’t afford an all-bells-and-whistles hospital in every town. But we still had a few bob in the kitty, so no politician was brave enough to question the concerns of potential voters who believe life depends on close proximity to a general hospital.
I’m told many MPs would rather defy the party whip – career suicide – than publicly back the closure of a hospital in or near their constituency. Now they’ve mortgaged the country’s future to rescue greedy bankers, they may need to think again.
A recent NHS review confirmed Croydon – Greater London’s most populous borough – as a continuing location for a district general hospital. Rumours of downgrading were a mixture of political scaremongering and health service shroud-waving.
But Croydon University Hospital (formerly Mayday) rambles over a large site, taking up valuable land, burning excess fuel and wasting the time of medical and other staff who are forced to traipse the endless corridors umpteen times a day.
The hospital has been developed piecemeal, as funds allowed. London Wing, the squat greyish building facing London Road, was originally intended as the first phase of a new hospital. By the time it opened in 1984, money for the second and subsequent phases had been allocated elsewhere. As a result, the hospital still struggles to provide 21st century medicine in a residue of 19th century buildings.
There is no particular reason why the hospital should continue to occupy its present Thornton Heath site: indeed, there is a long-standing argument for moving it further south – closer to the centre of the borough.
A better designed, more cost-effective hospital could be built on a smaller plot simply by making it slightly taller. The present site could then be sold for housing, to recover a large part of the development costs of the new facility.
Would it matter whether a new hospital was built by the tax-payer or by the private sector? Development costs would be similar, while National Insurance contributions (supplemented by other taxes) would continue to cover treatment charges.
The fundamental difference is that the NHS would be able to inspect and license an arms-length, independent hospital more effectively.
Hundreds of patients died at Stafford Hospital because target-obsessed managers were not held properly to account by anyone outside the Healthcare Trust.
The promised introduction of Offsick, or whatever the government chooses to call its latest inspection quango, will only be as effective as it is devoid of political influence – beware low-flying pigs.
Had Stafford Hospital been outside the NHS comfort blanket, patients would have been treated elsewhere, while managers might have faced manslaughter charges.
As it is, the government has declined to “scapegoat” anyone. And it vigorously defends the position of Sir David Nicholson, now chief executive of the NHS in England, who once presided over the deadly Stafford shambles.
Traditionalists, who see any degree of privatisation as the road to perdition, have little to worry about. It would take foresight and courage to embark on an adult debate about the future of the health service.
The present government, likes its predecessor, does not show the slightest inclination to engage in that debate. Both find it safer to shout slogans at each other across the chamber of the House of Commons. While our representatives bicker about which political party has the safest hands, wards in Croydon University Hospital are said to be dangerously short of nurses.
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- Failing hospitals to be named and shamed (guardian.co.uk)
- Is the NHS Privatising? (absolutelykosher.wordpress.com)