Reflecting on the Darzi report, editor Jaimie Kaffash argues that the Government must tackle societal problems first if there is any hope of NHS reform
The last week has been dominated by Lord Darzi’s report into the NHS. He may not be the most popular person among GPs, and we’ve certainly been snarky about him on these pages. But in fairness to the peer, it was actually a very good report.
It laid out the truth of the state of the NHS, and correctly pinpointed the lack of funding in general practice. Obviously, there was a huge political angle to this – he was a minister in the previous Labour government and was of course more than happy to give the Conservatives a good kicking. It’s no surprise that his terms of reference seem to be the past 14 years.
Of course, the Government accepted this report. It was happy to emphasise the state of the NHS left by the Tories.
The theme I found most interesting was his focus on not just underinvestment in the NHS, but austerity as a whole. At the very top of his report, he correctly stated: ‘Many of the social determinants of health – such as poor quality housing, low income, insecure employment – have moved in the wrong direction over the past 15 years with the result that the NHS has faced rising demand for healthcare from a society in distress.’
Without blowing my own trumpet, this is a point I’ve made over and over again. Personally I feel that we cannot improve the NHS – and especially general practice – until we sort out the societal problems. And that basically means extra funding.
But there is a huge element of cognitive dissonance going on. In the very same week Lord Darzi published his report, the big story was about the Government means testing fuel allowance for elderly people. Of all the ways we can stop the NHS having to take on societal problems, I would suggest elderly people having to go to hospital with preventable hypothermia is up there in the top spot.
And, this obviously followed the chancellor’s many statements that suggest an extension of austerity.
It seems to me that the new Government’s first priority has been to blame the previous government for everything that’s going wrong (which is fair). But, they still seem to be continuing all the previous government’s policies.
Now, there has of course been one huge win. The Government has struck a deal with the junior doctors – although if I was to be uncharitable, this seemed like an open goal. Yet there is no suggestion they are addressing the systemic and structural problems within the NHS and society.
My advice to the Government would be to actually read Lord Darzi’s report. I agree that the NHS needs to reform – the days of trusts being bailed out on a whim, while general practice has to feed off the scraps have to be over.
Secondary care cannot improve until general practice is given the funding it needs. But I would also add that general practice will continue to struggle and face overdemand for as long as savings are made for societal problems. Apparently, there was a report this week that said the very same thing.
Jaimie Kaffash is editor of Pulse. Follow him on X @jkaffash or email him at [email protected]
Lord Darzi lost his plot with polyclinics debacle & Jaimie you are both out of date as Professor Michael Marmot has been saying things about poor social conditions @ poor health for years!
What Darzi should have said was increasing GP workforce as a major objective as we get more graduates from medical schools & hold on to them!!!
It shouldn’t escape one’s attention that Darzi actually led the vote against the Rea amendment, thus voting to pass the Tories’ HSCB 2012. The Darzi report disingenuously states – occasionally close to verbatim – what Health Foundation, NHS campaigners and others have been banging on about for 14 years. Labour was remarkably silent all the while. I remain uncomfortable that Darzi’s cadre are mollifying the masses whilst carrying on regardless with industry-led plans from 2000’s; including PFI, APMS, Palantir ‘global’ population health, PAs, private outsourcing, wild-west tech, and Griffiths management. No signals to suggest an end to NHS (or other) austerity, no “tough decisions” to actually provide the up-front major investment which imo is the only real solution to redress some balance, and to ensure that that investment is ploughed into the NHS and not private enterprise. Mandelson, Blair, Darzi, Milburn et al are absolutely wedded (both financially and ideologically) to private sector interests and the ‘global health’ industry. They enabled and promoted the privatisation project, which is now I hope clearly evident. It was a mistake which they won’t own or own up to. I fear that the Darzi report is merely a softsoap for very little to change. Why else are these enablers still in charge?
Nick Mann, I can’t stop agreeing with you! Well said. Sad that the Labour party has also been captured by neoliberal con-artistry. The capital:GDP ratio is reaching highs last seen in the 1800s (and increasing), but centrist Govts still lack the nerve to tax private capital justly in order to properly fund the common wealth of the youthful public sector good. It is affordable, we just change the fictional (ie man-made, not laws of nature) fiscal, debt and accounting rules.
It’s what Streeting, Reeves and Starmer aren’t saying that bothers me. Do we have to wait till Budget day?
Who is Nick Mann? Put him in charge.