NHS must be national

Published: 24 September, 2010

• AT a meeting of Islington LINk  we were asked for our views on the new health White Paper. I stated my belief that the vast majority of the population wishes to retain the NHS, and that as a national service it needs to be run by a national organisation, its Department of Health. Only such a central control of its health services, financed by national taxation and enforcing national standards, is in a position to ensure fair nationwide distribution of health services.

People do not want further infiltration into the NHS by private bodies whose main incentive is profit-making. 

Allowing – in fact, encouraging – hospitals to become foundation trusts permits them financial independence from central control, giving them the right to spend on themselves without regard to the need for financing when this is greater elsewhere. A truly comprehensive picture of the nation’s health provision and needs is lost to the central authority.

Giving patients more choice sounds like a nice gift. But choice about what? GPs can already take into account  exceptional cases where a patient prefers to be referred to a hospital outside his catchment area for good reason.  

To allow more choice, according to mere whim, would make individual hospitals’ estimates of their procurement needs and bed numbers impossible to calculate, so likely to be either inadequate or wastefully excessive.

Furthermore, giving people more choice about local health issues does not empower their democratic say in the organisation of an essential national provision. They may well understand local health needs, but are likely to lack much  knowledge of other areas and their needs. Only a national authority should have the money to provide for the manifold requirements of a national health service, such as training of medical personnel, epidemiological research and conditions of staff recruitment.

I was glad that my summary statement on these lines elicited general applause.
Angela Sinclair-Loutit
Highbury Hill, N5