Toby on Tuesday 

'Bureaucratic Displacement'

 

Just as Channel 4 is screening its four part series, “NHS: £2 billion a Week & Counting”, allow me to introduce you to Dr. Max Gammon. Now Dr. Gammon is a long-standing UKIP activist who has fought Council seats in London’s East End. He is also a senior doctor who has devoted much of his life to studying our NHS. As long ago as 1976, he wrote his seminal work “Health and Security: Report on the public provision for medical care in the United Kingdom.” This created the concept of Gammon’s Law, which he described as his “Theory of Bureaucratic Displacement.” He wrote, “in a bureaucratic system increase in expenditure will be matched by a fall in production…such systems will act like ‘black holes’ in the economic universe, simultaneously swelling in resources and shrinking in terms of emitted production.” In other words, new investment tends to find its way to administration and not to patient care. Since 1976, Gammon’s Law has gone global, embraced by Milton Friedman and healthcare systems from Australia to Saudi Arabia. The challenge for a UKIP Government will be to ensure that scarce resources find their way back from administration into patient care and somehow to reverse Gammon’s Law.

Currently, the NHS costs around £110 billion a year to run, a figure that is growing rapidly. It is the World’s fifth biggest employer with over 10,000 GP practices and 2,000 hospitals serving a population that is both ageing and increasing remorselessly. Here in Thirsk and Malton, the challenge is especially acute, as administrators draw resources from rural areas, with their strong traditions of holistic personal care, towards vast health centres and hospitals in urban areas like York and Middlesbrough. If elected in May, I see the preservation and continuation of medical services close at hand as a complete priority. As one farmer has told me, “If my animal falls sick, the vet is always close by. If I fall sick, that’s no longer the case.”

Now it is often said that the NHS has become our national religion. UKIP is happy to be a full member of this faith, but we must still be clear headed about how the system works. While NHS spending currently represents some 6% of GNP, because of increasing demands, actual expenditure per head of population is falling fast. The three old parties are all proposing to lower expenditure per head over the coming five years, from some £1,950 a year now to around £1,825 for the Conservatives, £1,850 for the LibDems and £1,875 for Labour (Source: The Nuffield Trust). Interestingly, it is only UKIP, with its commitment to finding a further £3 billion a year in NHS investment that will keep spending per head closer to its current levels. This will be a critical number as Polling Day approaches.
This extra spending will become available from funds released by our quitting the EU and reductions in middle management – again, we must never, ever forget Gammon’s Law when new resources become available. And the first principle that the NHS must remain free at the point of delivery and time of need for all UK residents will remain sacrosanct. I have received a good many emails from constituents calling for additional expenditure on cancer treatments and I can safely say, yes, cancer care is precisely where such new investment is needed, not least because directly or indirectly we are all touched by cancer at some stage in our lives.

Now, PFI (Private Finance Initiative) contracts are a classic area where Gammon’s Law applies, with vast expenditure on initiatives that could not be further removed from patient care. A UKIP Government will stop further use of PFI’s in the NHS and will encourage local authorities to buy out their PFI contracts entirely where this is affordable. And we’ll ensure that the NHS is exempted from the Transatlantic Trade and Investment Partnership, so that aggressive global corporations have no rights of access to the NHS. The risk to our tradition of holistic care would simply be too great. For the same reason, UKIP opposes the sale of NHS data, including patient data, to third parties.

UKIP will also oppose any plans to charge patients for visiting their GP and will ensure that GPs’ surgeries are open on at least one evening a week, where demand exists. We will also ensure that visitors to the UK have NHS-approved private health insurance as a condition of entry to our country, while migrants will need to have paid National Insurance Contributions for five years before having rights of access to the NHS. This will help end the scandal of health tourism and save the NHS some £2 billion a year. Of this saving, £200 million will be allocated to the ending of hospital car parking charges, a matter that goes to the root of holistic patient support. Likewise, UKIP will ensure that foreign health service professionals coming to work in the UK are properly qualified and can speak English to a standard acceptable to the profession. And UKIP will amend working time rules to give trainee doctors, surgeons and medics the proper environment to train and practise. Properly resourced registered nurses and matrons with real powers will replace administrators in a revitalised NHS. There will be a duty on all NHS staff to report low standards of care.

And UKIP will replace Monitor and the Care Quality Commission with elected county health boards to be more responsive scrutineers of local health services. These will be able to inspect health services and take evidence from whistle-blowers. And finally, as the pressures on the NHS grow inexorably, the days of NHS-funded cosmetic surgery must finally give way to more urgent treatments such as cancer care. Behind all these reforms is the passionate wish to concentrate spending on the needs of the patient, not of the administrator. Dr. Max Gammon is not only an NHS visionary and UKIP activist, but also a committed Christian. It is in this spirit that he has approached the future of the NHS. If it is now to be our national religion, let’s focus on healing the sick, and not submit to the demands of assorted bureaucratic jobsworths who stand in the way of a revived NHS!

Until next Tuesday!
Toby