‘protect the nhs by making it independent of government’ | nursing times

I began nursing in 1986 and, in all that time, not one person has asked me to completely reorganise the NHS. I’m not bitter obviously. It clearly isn’t my turn yet. But when it is, you’ll

all be getting a foot spa. I know what you are thinking: “Actually, Mark, some of us don’t want a foot spa, we’d prefer clinical supervision or parking spaces or holiday discounts”. That’s

fine because, all of a sudden, we’re talking about how best to invest in nurse wellbeing and wondering what to do with the money I put aside for half a million foot spas. The other thing I

would do on the first day, even before we’ve had tea, would be to make the NHS independent of government. A bit like the Bank of England – let the State be responsible for the health

service, but unable to meddle in it. It has long seemed to me that, regardless of the political preferences of government, the NHS is perceived primarily as a problem to be solved rather

than an institution to be protected. As long as it is tied into ever-changing government policies and the unending electioneering that precedes them, it presents as a kind of kids’ chemistry

set – something to use for experimentation before tea. Having said that, I just need to quickly and seamlessly do something I don’t think I have done before – agree with a government

proposal. The current NHS reform plan, which essentially seeks to undo the ideologically driven health and social care reforms of 2012 seems to be an acknowledgement of the need to protect

the health service from the whims of the marketplace. > "Any attempt to reduce the free-market assault is a good thing" The Lansley bill made things harder and worse. In the

same way that the word ‘freedom’ is used to dress up deregulation so, in the case of Lansley, was the term ‘decentralisation’ used to disguise ‘carve up’. It brought more red tape, drew

funding away from services and hampered attempts to establish national standards of care. Any attempt to reduce the free-market assault is a good thing and the proposed reforms address key

issues around integrated care, workforce planning and meaningful accountability. So there; I am sort of agreeing with Matt Hancock. Or, to be more accurate, I am not completely and totally

disagreeing with him, as is the norm. However, two fundamental problems remain. The first I refer to at the beginning: not the bit about foot spas but the fact that the NHS will remain so

close to government that it won’t be able to stop itself from fiddling with it again next year or the year after, or whenever the current prime minister returns to his natural role as

daytime game show host and someone else feels the need to leave their mark on history. Make the NHS independent of government; put it behind the metaphorical baby gate so those pudgy, clumsy

hands can’t keep breaking it. Take the politics out of healthcare. The second problem is: who trusts that the current regime has a driving desire to do what is best for a national health

service? Granted, it has seen the difference in effectiveness between the vaccination programme (let the NHS do that) and Test and Trace (pay someone who worked in telesales to sort that

out), which might be chastening – but is that enough? We’ve had austerity, pay freezes and disinvestment, all rooted in a fundamental discomfort with the purpose, soul and functioning of

healthcare in the UK. Is the government really likely to change so profoundly? Probably not. But I’m trying to work on my cynicism, so I’ll cross my fingers and try to notice an opportunity

when I see one.