NHS reviewed

I am looking at a leaflet informing the public about the creation of the National Health Service, almost 60 years ago. The celebrations for this anniversary begin at the end of this month. There will be a party at Wembley Stadium, a service of celebration at Westminster Abbey, and countrywide events, most of it organised by the Department of Health in Whitehall.

Never underestimate the desire of politicians to lay claim to the NHS. For many years it was a “Labour” achievement, its strongest stick with which to beat the Conservatives. And when the next election comes, the NHS - the fate of the local hospital or GP surgery - will still account for far more votes than any esoteric arguments about 42 days' detention, or EU or climate change treaties.

Labour will suck every piece of political capital it can from the 60th anniversary party. By chance, as I write this, I receive a voicemail from Labour HQ asking whether I plan to write about the anniversary in the next fortnight. “Health ministers are very keen to start laying out where the NHS needs to go in the next few years” and one of them would be very keen to have a few words with me... The debate on polyclinics, the press officer adds, “is one very clear dividing line on modernisation”.

Poor old health service, batted from party to party, from election to election. I turn back to that leaflet from 1948: “Your new National Health Service begins on 5th July. What is it? How do you get it? It will provide you with all medical, dental, and nursing care.” And a very clear dividing line on modernisation in 60 years' time.

All medical, dental, and nursing care... you don't even need to ask the question to know that the NHS could never claim that today. NHS dental care is patchy at best, medical care is heavily rationed, and nursing care, as anyone who has spent time in hospital will tell you, is hit and miss. In part, this is due to greater demands on the health service. Whatever it offers, we want more: more treatments, more consultations, more medicine. More care. Demand has always taken the politicians by surprise: Nye Bevan estimated the initial cost of the NHS at 176 million pounds for 1948-49. Its first full year of operation came in at 437 million.

Today we want the service to meet an ever-expanding definition of health. We want it to make us happy as well as healthy, fertile as well as fit. One day we will expect it to make us beautiful, perhaps even successful too. No wonder it is still struggling on its 90 billion annual budget.

It isn't only the fault of the patients. The officials and the politicians who run the NHS have lost sight of what they are there for. Look at the current campaigns listed on the DoH website: “know your units”, “top tips for top mums” (including “top tips from Patsy Palmer” of EastEnders), and my favourite “Catch it, Bin it, Kill it”, a campaign to encourage the public to practise “correct respiratory and hand hygiene when coughing and sneezing”. The NHS waggles its finger at us, naughty children. Put your hand in front of your nose when you sneeze! It has turned into mum.

When it doesn't admonish, it consults: yesterday the department sent hospitals tens of thousands of surveys to track patient satisfaction with the patient choice programme. And when it doesn't consult, it issues edicts: June 12, 2008 - “The NHS Resilience and Business Continuity Management Guidance 2008: interim strategic national guidance for NHS organisations.” Poor guys. No wonder the best managers in the NHS are the ones who know which Whitehall edicts to file immediately in the bin.

Time after time patients tell the politicians that what they want from the NHS is what the NHS promised at the start: access to high-quality medical care (in clean premises) as and when they need it.

Now the greatest risk to the health of the NHS is approaching: the march of the alternative health industry. This week came the publication of the “Report to Ministers from the Department of Health Steering Group on the Statutory Regulation of Practitioners of Acupuncture, Herbal Medicine, Traditional Chinese Medicine and Other Traditional Medicine Systems Practised in the UK”. Otherwise known as twaddle. What it said is that government should regulate alternative therapies from acupuncture to Ayurveda.

It's the latest step by the alternative health industry, spearheaded by the Prince of Wales, towards official recognition by the NHS. Their problem: doctors see no scientific merit whatsoever in most of the “treatments”. Research by Edzard Ernst, a professor of complementary medicine, has found the majority of alternative therapies to be clinically ineffective, and many dangerous.

Regulate the practitioners - for safety, note, not for efficacy, as that is impossible to prove - and you give them official recognition. From recognition it is but a short hop to demand and then prescription: packet of Prozac, bit of yoga and a bag of dodgy herbs for you, sir. Britons already spend billions on alternative medicine; how much more could they spend when it is public money floating down the colonic canal? Free massages and maharishi ayurveda for all!

And imagine the bonanza in work for the Whitehall bureaucracy, as the British Association of Accredited Ayurvedic Practitioners grapple for dominance over the Maharishi Ayurveda Physicians' Association (none of these is made up). Question 10 of the consultation document preceding Monday's report read: “Would it be possible for the herbal medicine traditions of Kampo and Tibetan herbal medicine to be individually represented on Council?”

The Government responded on Monday - with a three-month consultation. So join in. Write to the Health Minister Ben Bradshaw at Richmond House, 79 Whitehall, SW1A 2NS. Write, on behalf of the NHS: “What I want for my 60th birthday is... the chance to provide medical, dental, and nursing care to all. And absolutely nothing else.”

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Australia: Not enough medical staff to use badly-needed donated organs!

Dying Queenslanders desperate for transplants are missing out because the state's leading hospital is giving donated organs to interstate patients. At least twice this year interstate surgical teams have flown to Brisbane to retrieve organs turned away by Prince Charles Hospital. The fiasco has been blamed on staff shortages and surgeons with "large egos and voluminous hip pockets".

Queensland Health has confirmed organs donated by Queenslanders were being sent interstate because of the "unavailability of transplant service surgical staff with the appropriate specialised skills at the time of the offer". It refused to reveal whether anyone on the heart or lung waiting list had died after organs had been sent interstate. Under the national donor scheme, organs which become available in a state are meant to be offered to residents in that state first. In Queensland, two people are waiting for hearts, eight for lungs and two for heart/lung/liver transplants.

The stunning revelations have been exposed by Professor Russell Strong, the first surgeon to perform a liver transplant in Australia and medical director of Queensland Health's Queenslanders Donate. In a strongly worded letter to Queensland Health acting director-general Andrew Wilson, he argued Queenslanders had a better chance of a transplant if they lived interstate. "I wish to draw your attention to a situation that must be regarded as unacceptable and with the potential for severe repercussions," Professor Strong said in the April letter, obtained by The Courier-Mail.

He argued the hospital should be stripped of its transplant services. "It is highlighted by two events in the past three weeks (where) two young healthy males were involved in motor vehicle accidents, received traumatic brain injuries and became multi-organ donors," he wrote. "In the first case, the heart and lungs were offered to The Prince Charles Hospital (TPCH), were accepted for heart/lung bloc and two names given for a cross match. Within half an hour, TPCH rang back declining the organs due to a lack of surgeons to remove the organs and perform the transplant surgery. "The organs were offered interstate and an interstate team came to Queensland to retrieve the organs. "

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Australian ambulance inquiry to hear of 'bullying and intimidation'

Bureaucracy stifles paramedics who try to blow the whistle

An inquiry into the NSW Ambulance Service is expected to hear evidence of deep-rooted problems of intimidation and bullying. But the parliamentary inquiry, due to start in less than three weeks, could suffer the same fate as previous investigations, with paramedics too afraid to speak publicly, fearing retribution from their superiors. Nurses recently gave evidence behind closed doors, during the Royal North Shore Hospital and NSW Public Hospitals inquiries, scared they would later suffer harassment from management. Almost all the submissions lodged by ambulance officers are either anonymous or cannot be published.

Upper House MP Robyn Parker, who is overseeing the inquiry, said there were already common problems evident from ambos who have submitted evidence. "Anecdotally we can see there is a high suicide rate among ambulance officers," she told The Daily Telegraph. "It also appears management are using rosters and the transfer system to bully officers. I will be probing the department on both those (issues) on the first day." Low morale is plaguing the service, which has been the subject of internal and governmental investigations.

Ms Parker said: "The officers need a place where they can air their grievances and I will be demanding answers from the (health) department. "But this will also be putting the Government on notice and hopefully they will act."

The Daily Telegraph recently reported the overstretched service was relying on firefighters to respond to medical emergencies. Trucks are equipped with trauma kits and defibrilators attending to patients when ambulance crews do not cover the area. One ambulance officer said some Sydney suburbs were completely without emergency medical coverage. "Many areas in Sydney are inadequately covered by ANSW due to a deficit of stations," the submission said. "In the areas known to me there are three suburbs Carlingford, Berowra and Galston, that are at best 15 minutes from an ambulance. For a first-world country in the 21st century, that's embarrassing."

Another anonymous worker said inexperienced junior staff were attending jobs unsupervised. "I cannot remember the last shift I worked where we stayed wholly in our station area," the submission said. "We constantly move resources and become stretched to the limit and some areas end up with no coverage. The fact the NSW Fire Brigade is covering ambulance jobs is testimony to this."

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