Are there new signs of life in the NHS?
Daily Express, 3rd December 2003

A few months ago I went to my GP because I had a dodgy knee. I had had it for a while, but I have always taken the view that there is no point troubling the overstretched National Health Service unless you absolutely have to. It had got worse, though, so I felt I had no choice.

My doctor checked me out, wrote me a referral note and suggested I "pop along" for an X-ray at my local hospital, University College in central London. My heart sank. Not there, surely? This was where my wife had our first baby 10 years ago – overworked and demoralised staff doing their best in shabby conditions where patients are (or at least were) asked to clean out their own baths.

My only other experience of the place was a couple of years ago when our second child received a gash in her head. We raced down to accident and emergency, waited more than an hour in despair, my anger restrained by notices warning against abusive behaviour against staff.

So this time, having written off the rest of the day, cancelled all my meetings, I went home from the GP's, picked up the bumper novel I was reading and trudged off to UCH. I consoled myself that, whatever else, I would have time to finish the last few hundred pages of the book.

What happened next was remarkable. The X-ray department was almost empty. A receptionist took down my details, and I settled into a chair to read. Within five minutes I had been called. Instead of a consultation, it was straight in … and ten minutes later it was straight out again, not quite with a "have a nice day", but almost.

Lucky? Certainly. A fluke? Who knows? I make no scientific claims, but intriguingly when I recounted this tale to colleagues and acquaintances in recent weeks, several had similar stories to tell. I am told the same goes for the Express editorial meeting when my piece was mooted. Sure, many people have had contrary experiences, but these have in the past – rightly or wrongly – been regarded as the norm.

Along the way to UCH I walked past the gleaming new blocks for the hospital will soon open. On my route to the bus each the morning I walk past the construction site at Great Ormond Street hospital for children – a beacon of good practice in antiquated conditions. New buildings do not necessarily make for good treatment, but they do improve morale. They also improve hygiene – one of the worst indictments of the NHS. While governments like to change systems (this one has juggled with the health service at least as much as its predecessor) often it is the small things that make the biggest difference for patients, such as peeling wallpaper and dirty floors.

In recent weeks, John Reid, the Health Secretary, has greeted two reports, claiming that they demonstrate consistent improvement. The first came from an independent think-tank, the Nuffield Trust, the second was the six-monthly report by the Chief Executive of the NHS. These pointed to most, but not all, waiting lists decreasing, and a particular rise in patients being treatment outside hospital – in GPs' surgeries and outpatients' clinics.

The trouble with reports, however, is that you pays your money you take your choice. There seem to be just as many surveys that give a different picture. People have rightly become wary of statistics, especially official ones. NHS doctors and managers have complained that priorities have been skewed by the need to meet particular targets.

No, what matters for the public, the future of the NHS and this government is our own individual experiences.

Gordon Brown, the Chancellor, has promised health spending will rise from £65 billion in 2002 to £87 billion in 2006 – a staggering increase. Next week, in his pre-budget report, he will have to admit that the figures are looking more precarious. The government will have to borrow more to sustain the spending.

If that spending is not seen to be making a difference, then all bets will be off about the kind of health service we will have in a decade or so. The Conservatives will seize on any failure to push their vision of more private health, although as Reid pointed out this week private insurance schemes require more managers and pen-pushers than the NHS.

For Tony Blair, it is a nerve-wracking wait. Public perceptions, and certainly media perceptions, often lag behind reality. Perhaps it is in our nature only to blame politicians, not to give them credit when improvements are made. The billions of pounds of extra investment have not just to make a difference – they have to be seen to be making a difference.


This article first appeared in the Daily Express and may not be reproduced without permission.