A National Service in Name
I have just returned from a ministerial tour of the south-west, where I have been looking at a wide range of hospitals and care providers, from a hospice to a community hospital to one of the biggest hospitals in the country. It has been a fascinating experience and I have learned a great deal, which is of course the point of taking the time out to have a look.
I could write a column every day about the NHS, so complex, broad and interesting are its challenges and opportunities. I have deliberately not done so in my columns for the Star, as I enjoy the discipline of thinking and writing about something different every week, which is even more important now that for four days of the week and I am focused on the operation and improvement of England’s hospitals. But I will break my self-declared silence on this occasion to provide a broad observation that has been confirmed by my travels this week.
It is this; the name of our NHS – the National Health Service – is something of a misnomer. The NHS is many wonderful things but it is not yet truly ‘national’. Why? Because although it is free at the point of need across the country, which is its founding principle, and although it is funded by taxation, the service that is actually delivered is not quite so national at all. So, for instance, whilst we have had very troubled mental health services in Norfolk and Suffolk, in Cornwall the services are good. By contrast, our hospital in Ipswich is well run and provides a high standard of care but there are others very close to here that are having trouble. So although what we put into the NHS – taxes – are consistent and could therefore be described as ‘national’, what we get out is too inconsistent and differs from place to place around our nation.
How can this be? Well, it is a truism often repeated by people who work in the NHS that the service is very bad at learning from itself. As Nick Hulme, our excellent chief executive says, there is a solution to every health problem somewhere out there in the NHS – the trouble is that most of us may not know about it. I could see that in stark degrees down in the south-west: an exceptional small-ish hospital in Dorchester, for instance, doing great stuff that people in the next-door county knew nothing about.
How to fix? We are shining a light on all NHS services, so that you – taxpayers, patients, carers, families – know how your local services measure up. This has the added benefit of highlighting where there is good practice and where there is bad, so that the one can learn from the other.
In a sense, this is a recovery of one of the founding principles of the NHS, the one that is forgotten in our rightful pride at the first and foremost – free at the point of need. For in instituting the NHS, the great Nye Bevan said that it should “universalise the best”. For him and for his contemporaries, this was almost as important as the principle of the service being blind to a patient’s means. It meant that you could expect the same standard – as well as the same access – to services, whether you lived in Sunderland or South Kensington. And it is in realising that vision of universalising the best – in which I am engaged on your behalf – that we shall make our NHS a truly National Health Service.
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