John Prescott phoned up for a chat yesterday, and amid all the this, that and the other we talked about, the subject of NHS Direct came up.
I made mention of the online petition that had been launched to save the service following the announcement (if you can label as an announcement something burbled out by Andrew Lansley on the Bank Holiday) that the coalition planned to scrap it. I pointed out that despite a fairly muted mainstream media response to the story, the petition seeemed to be going well in its aim of getting the 100,000 signatures needed for David Cameron to be be hoist by his own petard of promising a Commons debate on any subject which generated that kind of response.
What I didn’t realise, until the call, was that it was JP and his son David who had launched the petition. You have to hand it to him. He may be an ex-deputy PM, and an ex-MP (Eric Heffer used to say there is nobody more ex than an ex-MP) but he remains indefatigable if there is a good campaign to get going, and has adapted to the new media world better than most politicians a half and even a third his age.
It is to be hoped that when Parliament returns there will be a proper debate on this with or without the petition. Because whilst the Tories may have a mandate to reduce the deficit, they do not have a mandate – on the contrary given how clear Cameron was about his promises on health – to eat into the frontline services the NHS provides.
So the debate becomes whether NHS Direct qualifies as frontline. Like all services, it has supporters and detractors and when I tweeted about it the other day, there were plenty of both to be found. But scrapping it as part of the deficit reduction plan – the unspoken but probably main reason – becomes less credible when you consider that last year it was reckoned to save the NHS substantially more than it cost, by alleviating pressure on other parts of the Service, notably A and E and GPs’ surgeries. And for many people, it IS the frontline, and a very effective first port of call.
The coalition, in so far as it has been forced to argue for this particular cut, hides behind the GPs, saying they want it cut. Well, some might, and they might include doctors’ leaders who see their role as trying to get power and resources to follow the branch of the service they represent. But the only question that matters is whether it is sensible for the NHS as a whole. That is far from proven. Indeed, this decision appears to have been announced with very little forethought at all, which is why it is right that JP and others keep this campaign going so that the arguments can be tested properly in public.
The media continues to give the coalition an easy ride, but there is going to come a point where people start to ask themselves, in pretty large numbers, why things are happening which nobody who voted Tory or Lib Dem wanted or supported at the election. This is one of them.
Both of us are somewhat belated converts to the whole new media scene, and perhaps not quite as technically savvy as appearances might suggest
Very thought-provoking discussion.
Would ‘NHS Direct’ count as front-line services?
For that matter, distance learning courses of any variety, including those at University level, given the number of new schools being not constructed and the number of talented and gifted students able to win university places?
The problem with incorrect triaging procedures in the NHS can be calamitous – look at what happened in certain NHS ‘Foundation Trusts’. I had meningitis, which thankfully was not diagnosed anywhere near NHS Direct. It was more than a simple headache – I ended up spending 6 weeks in a coma.
The opposition has been ‘soft’ on the coalition cuts. Out of all the contenders to put in a response on the IFS study, I thought David Miliband stood out a mile, and I haven’t made up my mind about it all!
Cyberregards to John Prescott.
Your new website is absolutely brilliant – a paradigm of what a dynamic political website should look like. Competition net note.
Best wishes
Dr Shibley Rahman
It seems that by frontline services the coalition means foreign aid!
People should realize that Mr Cameron´s ideological cuts are meant to be permanent. They are not going to be reversed when the books have been balanced.
When the voters understand that eternal austerity awaits them, it will be the beginning of the end for the coalition.
A person can object, or support replacing NHS Direct with the new 111 service (I am dubious about describing that as a cut), but this idea that has been all over Twitter at the weekend that the government lacks a “mandate” to do this confuses me.
Since when have governments actually needed to put something in a manifesto for them to carry it out?
Was the creation of NHS Direct in the Labour manifesto? Was the invasion if Iraq in the manifesto?
We have a system in Parliament where the MPs and government can propose a law – but the only time the words written in the manifesto document are ever part of the debate is if the Lords seeks to block the legislation, which by convention they wont do if it was in the manifesto.
So please everyone drop this rather bizarre argument that you need a mandate to pass a law and get back to debating the pros/cons of the decision itself.
Normally I would agree that the phrase ‘no mandate to do so’ is over-used, particularly as we are have a coalition government that no-one, technically, voted for. However all major parties said they were commited to protecting frontline NHS services. If NHS direct is deemed to be frontline then they do not have a mandate to do make this cut.
Hubby and I have long been of the opinion that this government knows it isnt going to last and so have decided to take a slash and burn policy on public spending so that when the coalition does indeed fall apart they will be able to blame each other for the mess that the public sector is in and promise all sorts of increases should they be elected.Very clever idea as we then all heave a huge sigh of relief that the bad times are over and there can be only good times ahead
Alastair the link in your blog is incorrect it should be – http://www.savenhsdirect.co.uk/ – without the full stop after the uk.
I used NHS Direct last week. I’d fallen off my bike and bruised my ribs and after a few days of the pain not going away I thought I should go and get it seen. NHS Direct pointed me towards the appropriate service saving time and money for my GP.
I increasingly think that the cuts agenda isn’t being driven by an economic rationale but by a spiteful political one, identifying those programmes established by Labour to be targetted first.
At the moment, with all of the proposed changes to the NHS, a statement from Liam Donaldson rings in my ears. He was being interviewed about Swine Flu, just as the first cases of the disease were being diagnosed and there was considerable concern about what would be the extent of the pandemic. I remember him saying that the WHO had declared that the NHS was very well prepared, even if the pandemic proved to be very severe, and that our pandemic plan was one of the best in the world. He went on to describe how that strength stemmed from the strong central control that the NHS provides. That strong center the Tories/Libs are about to destroy in both health and education. It is tragic.
And it is for these reasons that the ONLY question that really matters in the leadership election is who will make the most electable PM. And only David Miliband ticks that box. So much is at stake in the next few weeks. I really hope and pray that the Labour party members use their heads as much as their hearts when ticking those boxes in the next few weeks.
Alastair – I’m sure I will find the petition, but how about a link to it at the end of your blog?
http://www.savenhsdirect24.co.uk lets raise awareness, post your experinces via the guestbook
I was horrified when I heard about the decision to scrap NHS Direct; it’s a lifeline in so many cases and the decision is thoughtless heartless and basically stupid. It would be better to stop the NHS buying in management consultancy; over the last year they’ve frittered £300m
I shall go sign the online petition good – on JP and his son. and good on you AC for writing on the subject.
By mandate i would assume,at least in my book anyway,a clear majority of seats something this government doesnt have
For once I am completely behind you, Alistair. NHS Direct is the most sensible idea anyone has had for the NHS and to scrap it would be criminal. I hope the Lib Dems who support this will come to their senses or hang their heads in shame.
How the hell is it not frontline????
It is the first port of call for many, many people. Their website is a thing of genius for mums like me with very young kids. Back to swine flu again. NHS direct was, to start with, everyones first point of contact. When demand got too great was there not another phone line started?? The reason being that NHS Direct needed to get back to being part of the day to day NHS frontline. I’m dying to see Cameron and Lansley squim as they try and tell us that was never the case and redefine the meaning of a frontline service. The goalposts are going to have to be moved quite some distance methinks.
I am not a fan of NHS Direct having used the service several times. I am concerned that the cost of the service is the same as a visit to a GP. This seems strange to me as a helpline using technology should not cost so much. Further, it is a myth to think that nurses are expert at diagnosing which is somehow being used as an argument differentiating the 111 and NHS Direct service. The same technology is used by trained and untrained staff. NHS Direct is not wholly serviced by trained staff and this too has been forgotten.
No one has pointed up that NHS Direct was to be replaced by a cheaper service in the labour party manifesto. Noone has pointed up the huge number of NHS Websites – I am interested in health and use them all. Each NHS Quango has a site (dozens exist), County Health Trusts, local PCTs, Kings Fund, and the best website of them all Dr Foster. NHS Direct offers the same diagnostic service online as other NHS sites. In all when we need to cut out unnecessary expenditure and provide a service cheaper we should aim to do so.
Thank goodness Tom harris offers a reasoned opinion on the change. It restores my faith somewhat.
Many thanks to you and JP for giving this campaign real energy. I don’t think we actually know the value of NHS Direct yet – I am confident that if we can keep developing it then over time it will prove to be a very important strategic component of the NHS portfolio of services. What is important is that it continues to pay its way while those added value benefits are being explored and developed. So this is exactly the wrong time to downsize it (through the 111 pilots) to an IT centric call-handling service.
I am sorry to use such cold business oriented language on a political question about which people feel so passionately. However it is nearly twenty years since business consultants like Michael Hammer and Gary Hamel started talking about reorganising complex processes around the casework paradigm that lies at the heart of much of general practice and NHS Direct. Since then there has been much theorizing and very little practical knowledge on what is effective as opposed to what is efficient. NHS Direct and its Nurse led model in the public service is for the first time giving us that knowledge. Don’t choke it in its infancy.
By the way your new website is superb – many congratulations to Provokateur.
Agree all power to Prezza’s elbow. If only others from the Blair era, notably Mandelson, could show similar commitment and sense. I am a David Miliband supporter and if anyone thinks MAndelson’s intervention today helps David, they are mistaken. It helps nobody and nothin but MAndy and his ego which I thought had enough stroking from all the attention his book got. He likes to talk about his knowledge of Labour history. Could he remind himself who said to whom that a period of silence would be welcome, and take it from me on behalf, I am sure, of many Labour members
Er…’scuse me, Mr Campbell, but how can the coalition have an electoral mandate when it didn’t stand for election? It was the people who put first put together this coalition, not the politicians. My guess is that the people knew what they were doing too, hence the widespread satisfaction with our ‘People’s Government’. The people seem to have desired an ad hoc mandate and that’s what they’ve got. Speaking as a Liberal Conservative and former centre right Liberal, I love this coalition, among many other reasons, because it’s restoring our civil liberties. Having spent 13 years worrying myself sick about the constant erosion of them, with respect, by your government, and the transformation of our country into what seemed to so many of us to be a police state, I am overjoyed about their restoration.
I’ll tell you a secret, I believe this is the first time I’ve posted on here, or if I have posted here previously it was once in a blue moon. The reason for that is that you and Tony Blair and Gordon Brown scared the daylights out of me. But you don’t scare me any longer. I don’t expect you to understand that, but it’s true.
Appalling. Absolutely appalling, The Tory + Lib Dem spin machine has gone into overdrive however – and using their media chums to spin this in their favour.
Reading Lib Dem blogs like the Orange Book loving “Liberal Democrat Voice”, you would believe that NHS Direct accounts for 90% of all deaths worldwide – and replacing it with a Call Centre full of minimum-wage collecting administrators will solve all of the planet’s health problems at a stroke.
These are indeed strange times for this soon to be miserable country.
SIGN THE PETITION
Am sure NHS Direct provides a very valuable service but am reminded of a comment a few years back by a doctor working in A & E at the Whittington in North London. He said they called it “NHS Indirect” – because the telephone advisers were so concerned to err on the side of caution, they told far more callers than necessary to go straight to A & E.
(Makes one wonder if the coalition’s proposed 111 service intends to save money by telling sick callers they’re perfectly okay and should get back to work! )
This was in the Labour manifesto and now Labour is opposing it! Opposition for opposition’s sake. No wonder people got sick of you lot. Meanwhile the coalition is getting on cleaning up the mess you left behind.
If we needed evidence that this government is not at all interested in evidence based policy, this is it. In five days we have gone from the announcement of a trial reported as ‘The (111) government service will not initially replace NHS Direct, but may do so in the longer term if successful’ (BBC News 23/8/10) to the announcement of the abolition of NHS Direct.
The media has to be more honest. It should have been reported as a straightforward cost cutting measure, that the government is not interested in the consequences, and that they didn’t think we had a right to know about it before the election. After all, we might have thought ‘call me Dave’ was still in the nasty party.
And it was NHS Direct who ran the Pandemic Flu Service anyway both online and the phone service but most people aren’t aware of it.