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Why Labour's plans for hospital league tables simply won't work
2024-11-15 00:00:00.0     每日快报-政治     原网页

       

       Wes Streeting (Image: Getty)

       Labour has a deep-rooted belief that it is the only party that can be truly trusted with the National Health Service.

       This is partly because it founded the NHS in 1945. A historic achievement, no doubt.

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       But can Labour, now headed by Sir Keir Starmer, really claim to be the party of the NHS?

       Not at all, judging by its latest wheeze to improve performance.

       New Health Secretary Wes Streeting wants to publicly name and shame failing hospitals in league tables.

       And he wants to sack NHS managers if they cannot improve patient care and take control of finances.

       This, he claims, will drive up standards, reduce chronic backlogs and free up beds.

       Unsurprisingly, his masterplan has been met with widespread condemnation and fury.

       Simply put, it won’t work.

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       Those are the words of doctors, nurses and hospital trusts who say it will be divisive and lower staff morale.

       The Royal College of Nursing’s executive director for England, Patricia Marquis, said we should not be tolerating poor management but that “scapegoating” trust leaders for underinvestment and systemic failures is not the solution.

       “NHS staff must not be pitted against one another,” she said.

       Thea Stien, chief executive for think tank the Nuffield Trust, warned that “naming and shaming” NHS trusts can make it harder to recruit staff.

       Frontline medics said the plan would backfire without reform elsewhere.

       Dr Nick Murch, president of the Society for Acute Medicine, said failing hospitals could become “stuck in a vicious cycle” unless social care was significantly improved, with some hospitals and vulnerable elderly patients impacted by issues such as delayed discharges.

       Although some medics believed league tables could encourage a sense of competition among trusts and a determination to outdo rivals, more doctors appeared to oppose the plans.

       The move comes after former Labour health secretary Alan Milburn was appointed as a non-executive director for the Department of Health and Social Care.

       During Mr Milburn’s time as health secretary, league tables were also brought into the NHS.

       It wasn’t a new idea then either. Tony Blair’s Labour government nicked the blueprint from the Tories, who had tried it in 1990.

       On both occasions, it failed to work.

       Former Conservative health secretary Stephen Dorrell was unequivocal in his belief that the plan is doomed to failure.

       “What we were promised was new ideas, not reheated 35-year-old ideas,” he told Times Radio earlier this week.

       Now a Lib Dem, Mr Dorrell said his successor’s plan is "borderline insulting”.

       To resolve the problems, he said, you need to resolve the problems of social care and primary care in the wider healthcare system.

       “The idea that the health service needs another round of league tables and it’ll all be okay I think is borderline insulting,” he said.

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       Dr Steve Taylor, from the frontline lobbying group Doctors’ Association UK, said: “We’ve been here before, haven’t we? And there’s no evidence that having league tables improved patient care.”

       NHS England will carry out a “no holds barred” review of NHS performance across England with the results made public in league tables which are regularly updated.

       Under government plans, the best NHS performers will be given greater spending control to help modernise their buildings, equipment and technology.

       The DHSC said there is currently little incentive for trusts to run budget surpluses as NHS trusts are unable to benefit from them, but that will now change, with top-performing trusts given more cash.

       Mr Streeting has already announced that failing NHS managers will be denied pay rises if they do not improve patient care or get their finances in order.

       A new pay framework for very senior managers will be published before April next year, with those who do well given financial rewards.

       And then we come to the question of money, billions of pounds of it to be more precise.

       What will happen to the additional £22billion allotted to the NHS in Labour’s first Budget? Will it transform the service – and reduce the NHS England waiting list – or disappear into the abyss”

       More than half the tax rises announced went to topping up day-to-day spending in the NHS. Yet despite Labour repeatedly prompting that there would be no cash without reform, there were no new requirements or productivity improvements attached to the additional funds.

       But will these changes really ensure every penny of extra investment into the NHS is well spent?

       The latest findings from the Institute for Fiscal Studies show that the NHS is still doing less than it did pre-pandemic, despite a huge boost in resources.

       So simply pouring money in isn’t the answer. Cracking down on failing hospitals isn’t the answer.

       Reform and investing in the whole package is the answer.

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       Tackling the UK's primary healthcare problem - GPs, community pharmacies, dental services and eye health services - not to mention the social care crisis must be done too.

       Gimmicks like league tables will do nothing to take the NHS off life-support.

       


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