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NHS too often politicians’ train set

At the roadside, monitoring the traffic speed with a couple of local stalwarts, we fell to discussing this column.
No question, the NHS and Social Care should be front and centre, they said.

Not to have a go at a government with 13 years under its belt nor to berate the six different people who have been Secretary of State since 2010. No, the discussion centred on solutions.
The Department for Health and Social Care has a policy, funding and oversight role in the end-to-end of all of this but it does not directly run either the NHS or Social Care.
In fact, it doesn’t directly manage anything much. It works through 28 partners – agencies and other public bodies. As Bishop Berkeley would have asked, how can we tell it is there at all?
The important point for the politicians, though, is that as the largest enterprise in Western Europe, the NHS is the biggest and best train set with which they get to play. It has so many moving parts, so much scale, so much newsworthiness.
They only get to play with it for a couple of years or so on average and therefore have to dive in early to make any career-supporting difference. They rarely get to see their changes come to fruition, properly embed, drive the newness they want because they time out. Hence, too, the intensification of the usual left/right rhubarb as any kind of election approaches.
An organisation of more than a million people has its budget set externally and is subject to the ever-changing whims, fancies and priorities of politicians. Ouch. No wonder the system is challenged.

What would happen if we took the NHS out of the political realm? One could fantasise about how but conceptually all parties could come together and commit to durable aims and a long-term plan. Crikey…a PLAN.
Wow, an organisation that people want to work for, be motivated by, share in the success of…and a spotlight on the carvers out of juicy bits for private gain, on the forgotten and unfashionable parts of the service such as child mental health and illumination of the true motivations of some of those manic street preachers in the Unions.
There are other areas, not least Environment, Energy and Food Security that could similarly benefit.
To get partisan politics out of the equation, though, the political system would need to deliver a striving for agreement not a continual push for difference.
A decent, honest and fair proportional electoral system would help a great deal. Time we faced up to how our factional, winner takes all, see-saw system is the root cause of many societal and economic problems and especially the besetting sin of short-termism. Time for change.

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