At the time of our last major meeting on my daughter's transition to non-existent adult services, we were also trying to get delivery of bigger nappies following a growth spurt. A simple thing, you might suppose, given that she has been provided with pads for more than a decade. So why did this require two visits from community nurses, who must have better things to do, combined with endless form-filling, six phone calls and a five-week delay that left a distressed child and vast amounts of extra laundry?Now, you would expect the left to be howling in agreement with him about the unsatisfactory nature of this service.
Yet, because he is a speechwriter for David Cameron, they overlook the fact that he was also a former deputy editor of the Independent and begin screaming that he’s out to ‘cut public services’…
The answers reveal two truths about our public services as we gear up for the defining political battle of our generation over cuts. First, for all the fine intentions, they remain wasteful and inefficient. Second, there is nothing progressive about public services that persistently fail the most disadvantaged people despite the best efforts of many on the frontline.Well, quite. What’s more important, lefties? That people are employed by the state, or that disabled children get their most basic needs taken care of quickly and efficiently?
No, don’t answer that. I think I know…
If you still think the vast debts run up by the last government were well spent, here are some more questions. Why is social mobility falling; why are entire families trapped on welfare; why do schools fail so many of the most impoverished children; why do so many prisoners re-offend? And why does the NHS spend £110bn a year but, as a report last month revealed, still manage to let down abused and disabled children, perhaps its most vulnerable patients?Because, at a guess, that spend isn’t being directed efficiently. It isn’t considering the end user – the patient.
Because there’s no choice, unless you can afford to go private. And even if you do, you will still be paying to keep hospital managers in comfortable offices…
The answers are many, but lack of money is not among them.Indeed.
The proposed cuts will take public spending back to where it was five years ago at worst. Already public bodies are offering up sizable savings as they are forced to confront internal inefficiencies, like any private firm.Sadly, there’s no evidence yet that they are really cutting the things that they don’t need. Old Holborn has been Tweeting some outstanding examples of ‘business as usual’ lately…
Public servants know there is too much waste, too many pointless meetings, too many layers of bureaucracy, too much absenteeism. This is why 64,000 "whistleblowers" came forward with suggested savings in response to the Treasury spending challenge.Let’s see how many actually make it off the suggestions list and into real life, before we heap praise on that exercise, shall we?
The battles that determine the future shape of Britain will not be easy for those caught in the middle, whether users or providers. But the distant prize is worth fighting for: to emerge from the biggest cuts in recent history with services that genuinely serve the public and don't let down the disadvantaged.That should be what everyone wants, right? So why do I get the feeling that for many on the left, Ian's daughter is just collateral damage in the never-ending class war..?
4 comments:
The heavily publicised "swine flu pandemic" which actually didn't occur (as many of us predicted)left the NHS with a loss of 150 million quid.
The NHS also treats health migrants especially for abortions and maternity services which I don't believe they charge for.
Obese people don't seem to have a problem getting a £12,000 operation to stop them pigging out.
It seems the NHS needs to get it's priorities in order.
I wonder whether Ian Birrell was a victim of what my family has come to call 'means-testing by voice'.
I know two people in the same town in near-identical medical and financial circumstances.
One, with a strong local accent, received an immediate assessment visit and all the help she needed while her neighbour -'standard English' ergo 'posh' - was told by the same office to find home help and equipment from the private sector.
I suspect the NHS staff are simply hoping that anyone who sounds like they can afford it will eventually give up and stop bothering them, allowing staff to take credit for saving money while leaving the bureacracy intact.
There is no problem that a free market cannot solve.
Most people trust it to deliver the best clothes, cars, food and computers, but people rarely want a free market in what matters most – their healthcare.
LASIK eye surgery is an example of what happens when a free market emerges in healthcare.
"The first example was the LASIK corrective-vision procedure, which has become very popular over the last decade. LASIK is an elective procedure that is not covered by standard insurance, and consumers must pay directly for the service — which means that they are much more likely to discriminate between providers both on cost and reported quality of the surgeon. With these incentives in place, the LASIK procedure has been reported to have fallen in cost by over 30 percent during the last decade.
Even more importantly, the quality of the procedure has improved dramatically in that period as providers competed to deliver the most efficacious treatment. According to Erik Gross, an expert in the field of LASIK technology,
'Early procedures were not LASIK at all, but uncomfortable surface ablations with no astigmatism correction. Subsequent generations of the procedure increased the treatable range, added correction for astigmatism, correction for hyperopia, the lasikflap to increase stability and comfort, accuracy and safety features, and finally moved to true custom wavefront analysis and correction.'"
Brilliant, isn't it?
And so sad it won't happen here – not, at least, for a very long time.
"It seems the NHS needs to get it's priorities in order."
Absolutely!
"...a victim of what my family has come to call 'means-testing by voice'."
The educated, law-abiding middle-classes. The minority you CAN discrminate against!
"LASIK eye surgery is an example of what happens when a free market emerges in healthcare."
That's astounding! Why can't more politicians see this?
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