NHS NEEDS A ‘ROYAL COMMISSION’ TO PROVIDE A PATHWAY FOR SUSTAINABILITY!

The NHS will be celebrating 70th Anniversary of the NHS in 2018. The state funded service was founded out of a noble ideal that good healthcare should be available to all, regardless of wealth.  The NHS has always been a ‘poisoned chalice’ yet a unique public service, envy of the world. The service provision is in need of a thorough and comprehensive review that can reflect upon its historical experience and provide a pathway to adopt the new advances in science and technology while embracing the integration of the private sector to meet the growing demands on the NHS. Buddhdev Pandya MBE says, “My preference would be for establishing a ‘Royal Commission’ more appropriate since it would provide a more cohesive approach”. Thought of the Day  15th January 2018  Buddhdev Pandya MBE

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ecently, The Secretary of State for Health The Rt Hon Jeremy Hunt MP has called for adoption of a ten-year strategy for the health service. This is a welcomed approached since temporary solutions based on ‘knee-jerk’ reactions successive governments have seemed to have added more confusion and failed in providing any sustainable resolution for improvement in the quality of patient care over the years.

The NHS will be celebrating 70th Anniversary of the NHS in 2018. The state funded service was founded out of the noble ideals that good healthcare should be available to all, regardless of wealth.  The NHS has always been a ‘poisoned chalice’, yet a unique public service and an envy of the world.

Many recent reports have highlighted the need to take steps to avoid valuable resources being wasted to ensure better use for improving patient care. There is a common thread through the mismanagement of human resources as well as processes; both requiring innovative and lateral thinking.

There are serious concerns over the current delegated responsibilities through the NHS Trusts for their ability to plan and delivery services, capable to meeting the needs of the changing environment. Many aspects of the functional capacity of these bodies are under question for lacking sensitivity in efficiently recognising and tackling troubled hot-spots and influencing processes to bring about long term amicable solution.

The NHS has also inherited a new dynamic of the contract culture since the integration of the Private Sector (Public and Private Sectors Partnerships). It has compounded challenges in many respects, involving monitoring processes and integration of services and related models. It has incubated a culture of uncertainty and fear among the workforce as they fear significant reduction of influence in planning services in their own areas of working. It has impacted on the moral of the front-line workers with its total accumulative effect of creating mismatches in service planning with the availability of the resources and, for that matter balancing the demands with availability of resources. 

Many of the shortcoming have been inherited over decades as various governments have often tried sort term or popularity measures. There was a significant absence of any coherent long-term view on the level of resources or changes in services required. The NHS is also likely to be a major public debate point

in the coming years. While I agree that the NHS may need further funds given the demands on the services, my thought is that merely pouring in funds may not be an ideal solution given the complexity of challenges. The fear is genuine that most possible increases are likely to be swelled up in bureaucracy where the clinicians are not in the driving seat! 

The NHS is now facing shortages of specialist staff, GPs and other front-line workers. It confirms that workforce requirement needs to be a part of long term strategy, particularly when it is highly dependent on the migrant workers. It involves education, training, recruitment, retention and career progression and better harmonisation between these elements.

What requires is comprehensive and thorough review encompassing the past seven decades of service as much as to consider the impact of the new advance technology, integration of the private sector in relation to the growing demands on the NHS. There may be a case for reflecting on the service delivery structures, regulatory and monitoring regimes for improving accountability and transparency across the NHS. 

My preference would be for establishing a ‘Royal Commission’ with more appropriate terms of reference to provide a more cohesive approach.  It would help converge focus in identifying more productive avenues based on wider input from the critics and political opponents as well as the frontline professionals. At least, their grievances, suggestions and recommendations would find a more structured path way to register concerns. There is a value in allowing engagement of all the stake holders in converging on an exercise to bring about some commons consensus of views on many aspects for suggesting improvement and possible reshaping of the NHS.

A Royal Commission is a major form of an ad-hoc formal public inquiry into a defined issue and available to the government to inquire into various issues. Commissions report findings in an advice and recommendations from are not legally binding but can form bases for a potential green paper for developing necessary legislation or amendments.

Perhaps, we all need to form a view and bring this to the attention our Members of Parliament and the Secretary of State for Health for their considerations. ¨       

Author contact:   buddhdevp@gmail.com

Buddhdev Pandya MBE Buddhdev Pandya is a publisher and political columnist. He is Director of Promotion for a national doctors organisation. He is managing Editor of ‘The Physician’ a medical journal and a magazine for doctors. He was chief editor of an award winning of an ethnic paper. He served as Director of Corporate affairs, Director Policy and Promotion British Association of Physicians of Indian Origin which he helped to established. He was a member of the legal team that mounted judicial review in areas of immigration rules and disproportionate CSA exam results affecting trainee GPs. He has also headed Policy Unit and Capacity Building initiative for Confederation of Indian Organizations. Buddhdev started his career in electronics and went on to become Director of many Racial Equality Councils funded by the Commission for Racial Equality for promoting equality and good community relations. He also helped brief for Employment, Social Policy and Immigration Unit funded by the Home Office and took part in many formal and informal inquiries.  He has served as a Board Member of on a Health Authority, Family Practitioners Committee, Community Health Council, Probation Committee and Police Community Liaison Committee. He has established an Indian Community Centre, Asian Elderly and Women Centers and a Mental Health Care in the Community project. He was actively involved in many awareness campaigns which included; Asian Mother & Baby, Sickle Cell and Thalassemia, Diabetes, Stroke, ID Cards, Forced Marriages. He passionately believes that time has come to undertake. He advocates constituting a ‘Royal Commission’ to provide comprehensive review the structure of the national health service (NHS) and make recommendations for making the services more compatible for coping with the changing needs and integrating the advances in medical science and technology for improving patient care.