Today Tony Blair will defend his record on the NHS. The great improvements he uses to justify his record will actually be the usual farrago of lies and misrepresentations.
Consider for example the "thousands of new nurses" recruited.
I spoke to my friend who runs a key nursing department for a mid - sized NHS Trust. She told me "A few years ago we had to fight to get a new nursing position allocated. Now there are many positions allocated but the recruitment process is so long winded and bureaucratic most applicants have lost interest by the time we can make them an offer. When we get turned down we have to go through the whole loop again. I have just filled a position after two years trying to recruit."
Blair will proclaim as another great advance the empowerment of patients through choice.
Patients are not empowered by choice of course because we are not equipped with the medical knowledge to make the choices. We rely on the advice of NHS professionals. Given a real choice I think most of us would prefer that advice to come from doctors and nurses rather than accounting professionals.
Improvements in efficiency wil be backed up with the usual barrage of statistics but has efficiency really improved or is it just more smoke and mirrors. Do you improve service provision by hamstringing the service providers? Check out this screwball accountancy.
An NHS unit that overspends its budget in a financial year will have its budget for the following year cut by the amount it has overspent. Nobody looks for causes of the overspend, a surge in demand maybe, or repairs to property and replacement of equipment. Only the bottom line is looked at.
The introduction of an internal market in the NHS by the Thatcher government was a disaster but that has been exacerbated by the introduction of privatisation by stealth and Labours ingrained control freakery.
When the lunatics were running the asylum things were bad but they are ten times worse now the bean counters are in charge.