Christabel Hopesmith is right to argue for an accountable and transparent NHS in her letter last week. Whilst Sir Bruce Keogh is pressing ahead with very welcome plans to increase the amount of information available about the performance of individual NHS surgeons, the direction of travel is very different at the corporate level. As the NHS fragments into myriad corporate entities under the marketisation programme initiated by Blair, and now being pursued with vigour by Cameron/Clegg, so it becomes ever more difficult to track how our money is being spent.
We do know that over the last decade there has been a dramatic escalation in pay for the top echelons of staff in NHS “badged” services, that there has been a huge increase in the amount of money being spent on contract negotiation and contract performance monitoring for NHS service delivery and that a lack of past investment in training and facilities has left us today with elevated and onerous charges in respect of agency nursing staff and locums and a crippling burden in paying for the use of PFI hospitals. These additional costs are starving expenditure on the NHS’s core mission, the provision of patient services.
This, of course, is an embarrassing “truth” for Jeremy Hunt and the top brass at NHS England, so the last thing they want is for the details of that truth to be revealed through enhanced accountability and greater transparency at the corporate level. The details would, no doubt, confirm that a return to a publicly funded, publicly accountable, planned and public service delivered NHS should be a top priority for whichever Party wins the General Election next year.