Charmer needs help with a reality check, help with some better policy advice and...

Chrometophobia

Standing in front of an NHS ambulance, sleeves rolled up, looking like he’d just washed it, Charmer delivered his big health-policy speech.

If his ideas for the NHS are as good as they get for every other part of Whitehall, education, defence, prisons, social care, digital… everything… 

… Labour aren’t ready for government.

Top of Labour’s to-do-list, Mental health. Recruit and train the equivalent of the entire population of Oban to become mental health workers… 8,500.

Train to do what? Where, how, how much, by when? 

Dunno.

Yes, male suicide is a tragic end to a life. A disaster for families. A catastrophe for so many. 

Reducing the numbers? 

Try; secure work, safe places to live, education, hope and achievement. Put the joy back into living. Something the NHS, however many the targets, cannot prescribe.

The cost of lives so obviously linked to the cost of trying to live a life.

A speech, cushioned and padded out with ‘how wonderful the NHS is’. Filled-in by ‘how tough it all is’. Stuffed full of ‘how fabulous the staff’…

… but with all the actual content of a Japanese futon.

Up-sum… waiting is bad, prevention is good. Don’t mention the money.  

Charmer doesn’t have the money for a Blairite, NHS-renewal. Such as he has plans, they’re likely to take two terms of office for Labour to ease them into fruition. 

Seven thousand-odd new, Labour doctors a year. That’ll double the number of doctors in training. That means doubling the training resource in universities, lecturers, staff, accommodation and the like.

Doubling the number of hospital placements and doubling the number of supervisors.

The mechanics are pretty much the same for nurses and remember, applications for their training places are down nearly 30%.

I’d guess Uni vice-chancellors will want at least a couple of years, to get organised and staff-up. How Trusts will cope with double the number of trainees… 

Dunno.

Charmer will reinstate all the targets. If they’re met, we’ll celebrate. If they get missed, it’ll be too late to do anything.

Bring ’em on and bring money.

Shifting care out of hospital into GP waiting rooms? 

We get about 93% of first contacts with the NHS (the GPs) for around 11%, or less, of the budget. Change it by all means. Shift money from secondary care. 

However, most Trusts can’t really balance their books without creative accounting and ICBs have pretty much thrown in the towel.

Moving debt around the system instead of money… isn’t a policy.

Charmer won’t talk money and has no new revenues. He says technology will release cash.

More use of the NHS App, he says. Over a million people a week use it now, 75% of the adult population have it. You can use is for all sorts, prescriptions, repeats, GP appointments, plus choose-n-book. What else? 

Add Deliveroo and they might sponsor it… that’s money. 

Decision support? It’s started. It’ll need huge AI data sets. That means huge money.

There isn’t anything in Labour’s plan that isn’t already being done. Syndicating waiting lists… try West Yorkshire. Closer working with social care… go to Bromley-by-Bow.

With a fair wind, no more strikes (Charmer is silent on the topic because a settlement involves money) and a reasonable Winter…

… the NHS will make big inroads into waiting lists; the chaos in A&E will have subsided; ambulance response times are improving; cancer waits will be back on track; there’ll be a funded workforce plan for the NHS to organise around; the primary care recovery plan will have started to get traction and…

… the NHS will look a very different place.

Charmer wants to fix the fundamentals. No! There is nothing wrong with NHS fundamentals. The fact they’ve survived Brexit, Covid, flu and strikes tells us how resilient they are. 

If Labour had the experience and confidence they’d realise their policy should say; 

  • We recognise the NHS needs a period of recuperation and renewal. 
  • We’ll fully fund NHSE’s workforce plan and renew industrial relations policies.
  • We’ll set to work on a cross-Whitehall initiative to improve the social determinants of health
  • We’ll get social care functioning as well as it should, by creating a career structure for care workers and guarantee a fair-pay agreement for them. 
  • We’ll give the NHS a year’s breather, to get back on track, take stock and decide what’s next…

… by then the economy should be recovering and we pledge a funding deal, to secure the future.

Charmer needs help with a reality check, help with some better policy advice and…

… help to over come his chrometophobia.  

(Go on, look it up, you know you want to!)