NHS funding: there’s not enough money to cure all our ills



David Cameron: over-promising on health

David Cameron knows that the Tory treatment of the NHS is one of the issues that is toxic for his party. It was no surprise then that during the General Election campaign he went out of his way to neutralise it.

Cameron is not afraid to use his personal life story to cement his political credentials, and he makes much of the support the NHS gave him and his family during the fatal illness of their young son. No doubt he is sincere when he talks of the help they were given.

Whether he was wise to promise more significant investment in the NHS during the forthcoming parliament is another matter all together. No matter what resource is poured into the NHS, it will not be sufficient to meet its needs. Its hunger knows no end.

With his party returned with a majority, Cameron will have no choice but to implement his promises in England and Wales, and what happens there will have a knock-one effect in the rest of the United Kingdom.

Responsibility for health is devolved to the regional parliaments and assemblies, but what happens at Westminster feeds through. It certainly sets the tone for the debate about the health service, how we fund it, and how it meets our expectations.

Much of the focus is on things the NHS doesn’t do that well – managing accident and emergency, coping with ‘new’ pressures such as diabetes and dementia, and the refusal of the National Institute for Clinical Excellence to allow the use of expensive new drugs and treatments that may prolong life.

In our national life, the NHS is sacrosanct.

Such is the reverence for the NHS, that we have the spectacle of a Tory prime minister outdoing Labour in stating his passion for the service. Gone are the days when the Tories worshipped BUPA and private health care. Only the Royals now feel safe being seen to go private.

We all want an NHS that is bigger, better and cures all ills. Such is the orthodoxy of this message, that it is taboo to suggest otherwise.

Like the little boy who pointed out the nakedness of his emperor, I’d like to suggest that we think again about our expectations of the health service.

Why should it be protected when other areas of public spending are being cut? Why should it be given what amounts to a blank cheque – £8 billion from Cameron during the campaign – when some of the poorest in our community are being forced to endure the indignity of food banks? Why should we spend billions buying back months of our lives, rather than focusing on how we can die with dignity?

I have no difficulty with us investing in research for cures to life-limiting ailments; but that energy would be best directed at finding cures for diseases which afflict the poorest in the world (HIV-Aids, Malaria, and TB among many others) rather than those caused by affluence. In 2013 6.3 million children under five died – the vast majority of them of treatable diseases in developing countries. Almost one in 10 died as a result of diarrhoea. Where’s the morality in that?

Our attitude to health care is another example of the self-centred bubble we have created for ourselves. I know it sounds harsh, I wince as I write this, but there comes a point when we must say enough is enough. At an individual level, that’s cruel. I know I cannot lose sight of the fact that the people I am talking about here are dearly loved: mothers, fathers, brothers, sisters, children.

But we have a moral obligation to take a wider view.

The sanctity of human life sits rightly at the heart of the moral and ethical principles that underpin our society – but even those most opposed to abortion and euthanasia recognise that death is an intrinsic part of what makes us human.

As the good book says: “To every thing there is a season, and a time to every purpose under heaven: a time to be born, and a time to die; a time to plant, and a time to pluck up that which is planted.”

But in our post-Christian world we have made life a commodity, and forgotten the value of death.

We have done some marvellous things in the cause of science – vaccines, antibiotics, retroviral drugs – but in our insatiable demand for progress we are in danger of creating a zombie generation. People whose lives are measured by the phrase “never mind the quality feel the width”. (I declare an interest here, I am old enough to be heading there sometime soon.)

Frankenstein would have been proud of what we have created. Yes, by all means let’s have a debate about how the NHS can better meet our needs. But let us start talking about the morality of how we deal with health – on a global, not just a national or local scale; and let us face up to our mortality and embrace it.

* A version of this article appeared in The Irish News on May 8 2015