John Lister, London Health Emergency, looks at the crisis in the NHS.
Having taken over the Tory Government's NHS spending limits, Labour ministers are now confronted by the consequences. The latest figures show that the total waiting hospital treatment has climbed to an all-time record (1.26 million by the end of December) and that the queue has been growing at a massive 4,000 a week in the final quarter of 1997. Numbers waiting over a year for treatment have more than trebled in 12 months from 22,000 to 68,000. Another 820 patients joined this line of long-waiters each week in the last three months of 1997.
Even more dramatic has been the rise in numbers waiting over 18 months for treatment, which had been pushed down to just 123 nationally by the Tories in December 1996, but which has rocketed almost eight-fold to 974 a year later. These figures tell a much more significant story than a broken Labour electoral promise. Rather than waiting lists being cut by 100,000, they have increased by 100,000. They show a hospital system that is bogged down by a massive financial crisis, and in many areas reduced to an emergencies-only service for much of the year.
Despite the handout of an extra £300m to relieve "winter pressures" and ease blockages in the system, and despite the absence of severe winter weather or the sort of flu epidemic which routinely causes problems for hospital services, the system is clearly unable to cope. Many of the beds freed up by discharging elderly patients to nursing homes have immediately filled again with frail elderly patients.
Tory policies of slashing back numbers of front-line hospital beds have left little scope to manage elective as well as emergency services. But there is no sign of a rethink: instead the financial regime is getting tighter. At the end of last year the NHS Finance Director Colin Reeves admitted that the combined deficits of Trusts and Health Authorities added up to over £460 million. Labour ministers are insisting that these deficits must be cleared by £190m by April, and the remaining £250m by April 1999.
Draconian cuts are being proposed by health chiefs across the country for the coming financial year. With little flexibility on treating emergencies, the bulk of these cuts hit "elective" (waiting list) care. Many managers have freely admitted that a consequence will be to boost waiting lists, and in many cases breach the Patients Charter standard of a maximum 18-month wait. Hospital bosses are warning of queues stretching out past the millennium. In some cases health authorities have gone further and opted to "ration" services, effectively excluding lists of treatments from the NHS, forcing patients to pay privately or do without. Health Secretary Frank Dobson, however, continues vainly whistling in the dark, claiming that the NHS had "coped better than ever with winter pressures".
It doesn't have to be like this. There is no economic crisis. Gordon Brown is sat on a growing cash surplus. An injection of new money to fund the reopening of front-line beds would enable immediate progress in clearing the waiting list. If Labour leaves it too long, the extra numbers added to the list will make it impossible to claw back to the levels left behind by the Tories.
Conference: A Rescue Plan for the NHS, Saturday March 14th, 12 noon, ULU, Malet St., London WC1. Called by Welfare State Network. £4/£8. Speakers include Tony Benn, Jeremy Corbyn, Dr Alyson Pollock, Geoff Martin (London UNISON), John Lister (London Health Emergency). Details 0171-639 5068.
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