NHS patients need swift GP access and an end to record waiting lists

Labour has a golden opportunity to fix the broken NHS – a once-in-a-lifetime chance to reform an institution that, until now, has been untouchable.

But I could have wept with frustration to hear Health Secretary Wes Streeting declare his solution is to convene a ‘national conversation’, with a promise to ‘rebuild the health service around what patients tell us they need’.

We all know what patients need: healthcare that doesn’t leave people sleeping on chairs in A&E or dying on trolleys in corridors, and GP surgeries offering efficient appointment systems rather than the 8am phone lottery.

What patients do not need is more prevarication and consultation. We all know where that will lead: a succession of gimmicky ideas and yet more billions shovelled into the bottomless pit.

Already, during Labour’s first 100 days in power, we have seen how handing out money has been their reflex response to NHS issues.

Junior doctors were paid off with a salary increase of more than 20 per cent, to reward them for taking strike action. Flashy proposals – such as weight-loss jabs and smart watches to be offered to obese benefits claimants – were announced with great fanfare.

During more than 50 years as a doctor, I have seen 23 reorganisations of one sort or another in the NHS – and none has delivered real change. They were all cosmetic, illusory or downright disastrous.

One of the first I witnessed was branded the Cogwheel Reorganisation, featuring promotional animations of cogwheels going round, which were supposed to make us all feel interconnected and essential. I was fresh out of medical school and full of optimism, but I was uncomfortably aware that we were being bamboozled. Those cogs were turning without driving any actual changes.

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And that’s what the Health Secretary is planning once more. This is unforgivable – because, unlike his predecessors, Streeting now has a massive opportunity to instigate real change.

It is not just that it is far easier for a Labour Government to do this, since whatever the Tories attempt they will be accused of privatising the service. It is also that, for much of its history, the NHS has been too revered – more of a national religion than a health service, as former chancellor Nigel Lawson said.

Now, though, that attitude is ebbing away. It’s true that older people, for the most part, are still in awe of it and wary of complaining for fear that treatment free at the point of use will be replaced by some form of rapacious health insurance system.

Younger generations do not revere our NHS in that way, however – particularly after the pandemic has left us with record hospital waiting lists of 7.6 million this summer.

They see that what we have now is a shocking system, with trauma patients dying in a queue of ambulances outside a hospital because there’s no space on the wards or even in the waiting rooms.

People under 30 can’t remember a time when the NHS worked. All they know is a system that is failing their parents and grandparents, inflicting delays, stress, suffering and death.

Public opinion is changing and young adults refuse to bow down to the NHS shrine. In May 2021, a YouGov survey found that 39 per cent of British adults believed that the NHS provided better healthcare than other European countries, while only 10 per cent thought the opposite.

When the same survey was carried out this summer, 33 per cent said that European systems deliver better healthcare and only 17 per cent thought the NHS superior.

Another poll asked people what the biggest problem with NHS funding is, and only 33 per cent said it was that ‘the NHS does not receive enough funding’, whereas 55 per cent said ‘the funding the NHS receives is not spent as effectively as it should be’.

In other words, there is a growing public appetite for radical restructuring.

Instead of setting up focus groups, Wes Streeting should be looking everywhere to seek out and copy the best of the most effective health systems on planet Earth.

Yesterday, in a letter to The Times, consultant surgeon David Rew cited the ‘life-saving excellence’ of the South Korean system with which he became ‘involuntarily familiar’. The Koreans, he explained, ‘scoured the globe for best-in-class exemplars of national healthcare provision’, coming up with a state-backed insurance system.

While that might not necessarily suit the UK, the principle is good: why waste time with a national conversation when other countries are already showing the way?

Last May, before the Election, I made a plea in the Mail for reform of the NHS and outlined six crucial changes.

The first of these was to acknowledge that the problems are deep-rooted, not superficial. They exist not only within NHS management but across the Department of Health and on both sides of the Commons, with politicians too timid to rise to the challenge of creating an NHS for the 21st century.

And yet Labour is showing every sign of continuing that timidity and delay.

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They should look for inspiration not just to South Korea but also to Japan, where one solution is already being enacted to great effect.

In the UK, more than 22 per cent of all hospital patients are over 75, even though this age group comprises just 8 per cent of the population. Put bluntly, elderly people place a disproportionate burden on the NHS.

It’s not surprising, of course – particularly since the decline of care at home by the extended family. People who are too frail to live in sheltered accommodation often end up spending months in hospital beds meant for patients needing acute and urgent treatment.

A system of intermediate care is needed – and that is exactly what Japan has.

We used to have it, too, until our cottage hospitals – chiefly staffed by nurses – were closed down. Bringing back such hospitals would alleviate a huge amount of pressure.

The idea that every hospital needs a full complement of doctors and surgeons is wrong-headed. So is the notion that doctors are a breed apart, some sort of exalted species that emerges fully formed from medical school. We are not.

With the right on-the-job training, there’s no reason why experienced health professionals should not graduate to become doctors. Many of them have learned a great deal more in their careers than can ever be crammed into a degree course.

By the same token, healthcare assistants should be able to climb the ladder and earn the qualifications to become nurses. It’s ridiculous to insist that everyone in the NHS has to ‘stay in their lanes’.

But if that seems radical, the most obvious solution is one that Labour politicians may find the most difficult.

We need to look at the parts of the NHS that work efficiently, and copy them. That means ‘privatisation’ can no longer be a dirty word.

Across the UK, pharmacies and opticians work well. We can get our medication delivered to the door, and book an eye test at a day’s notice. Prescriptions are comparatively affordable and free to many.

These services are offered by private businesses such as Boots, Specsavers and Lloyds. They work well – and they have to, because we are their valued customers and not merely service users.

So why can’t that model be applied to cancer or heart treatment, too?

Wes Streeting knows it can be done. But will he have the courage to admit it? Or will he cower behind an endless ‘national conversation’?