Health care trussed

LIKE recurring nightmares, three images have kept invading my head these past few days.
David Cameron, curiously airbrushed on an election poster, urging us to trust him with the NHS.
David Cameron, wearing his serious and caring face, in conversation last year with executives of the Woodland Trust.
And Kaa, the wicked snake of the Jungle Book movie, eyes becoming huge hypnotic spirals as he hisses: “Trusssssst me!”
Trust Cameron and co with the NHS? Whatever made anyone think that was a good idea?
Sure, the Tories have ring-fenced the NHS budget, making it about the only thing in the country (apart from bankers’ bonuses) not facing crippling cuts. Apart from the demand to make £20billion of “efficiency savings” over the next four years, which sounds to me like another name for cuts.
However, it’s not just the amount of money you spend, but what you do with it that counts.
Cameron has put the NHS in the hands of the obsessional Andrew Lansley. A man whose zealous drive to “reform” is every bit as dangerous as any swingeing programme of cuts.
Rather than saving, Lansley is set on spending huge sums on what the government excitedly describes as the biggest reform of the NHS since it was set up. And he wants it all done in two years.
This is a shatteringly swift pace of change for such a huge and complex organisation. But it’s not just too far, too fast. Lansley’s driving hard in the wrong direction.
His watchwords – as with most 1980s-raised Tory ideologues – are “choice” and “competition”.
But it’s not choice that patients need. It’s quality of care, available when and where it’s needed.
And that cannot be best provided by competition among profit-seeking companies.
It is probably true that the NHS – like almost every aspect of British society over the last 25 years – has become over-run by managers. But that is at least as true of private enterprise as it is of government departments.
Taking decision-making out of the hands of Primary Care Trusts and handing it to GPs won’t reduce the paperwork.
It will simply put more of it on your local doctors’ desk, giving them even less time to do what they were trained to do. Which is practise medicine, not push paper, balance budgets and write cheques.
It’s like the breakneck drive towards turning schools into “academies”.
In that case, unpaid school governors will find themselves doing much of the work which until now has been done by paid local-authority professionals.
Unless they choose to “buy back” those services. Which is undoubtedly what hard-pressed GPs will end up doing, by clubbing together to employ the managers sacked by the defunct PCTs.
With both schools and hospital services, local democracy is under attack.
Duty of care replaced by duty to make money.
As one of my friends put it: “I find it very interesting that the entire NHS budget is being handed to GPs, who aren’t actually employed by the NHS, so vast amounts of public money is being passed into the private sector.”
Very interesting indeed.

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WOODLAND is wonderful. There can be little better for the soul (if you believe in such things) than a walk in the woods.
There can scarcely be a better way of getting in touch with wildlife, or with the changing of the seasons.
The calendar may still say it’s winter but this last couple of weeks almost every tree has been budding, every bird turning amorous. The woods – especially ancient, deciduous woods – are the place really to experience it.
Our forests are the heart of our island nation, Robin Hood our essential mythical hero.
Yet already woodland covers a much smaller proportion of Britain than it does mainland Europe. So we should be concerned – hugely concerned – by any threat to what remains.
Like the threat by a supposedly cuddly, caring, green-tinged government to flog off our national forests.
All of them. From Kielder in the north to the New Forest in the south; the Forest of Dean to Epping Forest. And, yes, Sherwood Forest itself, what’s left of it.
The Woodland Trust, leading defender of British woods, has until recently been rather cosy with Cameron. Now it is campaigning for “ancient woods to be treated as a special case” in the Forestry Commission sell-off.
And for “closure of loopholes in protection for all ancient woods, to guarantee their public access and wildlife value, no matter who owns them”.
Which is good, but not good enough. Because who owns them matters.
Once they are in the private hands of a few super-rich Tory landowners, what is to prevent the forests being turned over to housing, holiday camps or golf courses, for profit? Which is, after all, the prime motive in Cameron’s world.
Especially with the government planning to relax planning regulations.
If, like me, you care about our forests, join me in registering a slightly stronger protest: “Save our forests – don’t sell them off to the highest bidder”.
That’s the wording of a petition at 38degrees.org.uk