We must resist the drift to conservatism and support the case for radical changes in NHS hospitals
As a political stream that sees itself as radical, one problem for the left is that in some areas of political change its first instinct is to conserve the status quo. For example, the left’s initial politics when it comes to the NHS is to conserve it as it is and define all change as in some way ‘reactionary’ or, even worse, as ‘cuts’.
Medicine is one of the faster-changing aspects of our 21st century society. As a leftwing progressive, it is difficult to see any of the major advances in healthcare as anything but unremittingly beneficial for individuals and society alike.
In 2006, the progress that had been made in treating the disease meant the majority of people who had cancer in the UK survived for five years after contracting it. In 2010 my 70-year-old friend left hospital the next day after a knee replacement. Ten years earlier, his other knee operation meant he stayed in hospital for 10 days. This drop in the length of stay is partly caused by the changes in anaesthetic over the last 20 years.
Both of these medical advances are progress for our society. But the political problem is these two changes in medicine – and so very many others – are making the way in which we organise our NHS hospitals obsolete.
If the length of stay after operations falls to one-third of what it was
20 years ago, why do we need so many beds in the hospital? The answer is we don’t. If patients can have their chemotherapy in their own home, why do we need so many outpatient departments in NHS hospitals? The answer is we don’t.
But if someone suggests closing four wards in the local district general hospital or diminishing cancer care in the hospital, what will the progressive stance be? It is quite possible that it will be against these changes because they are ‘cutting’ the hospital.
The title and the argument in our new pamphlet, The Hospital is Dead, Long Live the Hospital, try to challenge what appears to be a dilemma between the necessity for change and the politics of conservatism that resist change in our hospitals.
Over the next 20 years every single NHS hospital is going to have to change very radically, most of them several times. At its conservative worst the left can try and resist that and end up stopping medical progress getting to the very population we claim to serve.
Alternatively, it can recognise that in every location where NHS healthcare is delivered at the moment, some form of healthcare will be needed in the future. But to keep up with medicine it will be different and will develop a different offer to the public. It will not be possible to help bring about these improvements by conserving the status quo.
Paul Corrigan was a health adviser to the Labour government. The Hospital is Dead, Long Live the Hospital: Sustainable English NHS Hospitals in the Modern World by Paul Corrigan and Caroline Mitchell is published by Reform
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