Reader TTS

Jeremy Corbyn always meant the National Health Service to be centre-stage in this election. Now it has happened — but not in the way he intended. The Tories, who have never quite lived down

the reputation they acquired in 1948, when they and the doctors initially opposed Nye Bevan’s vision, invariably protest a little too much that “the NHS is safe in our hands”. But never mind

the Tories: is the NHS safe in Labour’s hands? On Wednesday Andrew Neil’s forensic interrogation of Jonathan Ashworth, Labour’s Shadow Health Secretary, exposed a yawning gap between him

and John McDonnell, the Shadow Chancellor. The latter’s promise of a four-day week did not, Ashworth assured Neil, apply to NHS staff. As far as the million or so people who work for

Britain’s largest employer, such reductions in working hours were only a long-term aspiration. “There’s not a four-day week coming in the NHS,” he declared. Oh yes, there is, said McDonnell

a couple of hours later. Standing on a stage next to Ashworth, the man to whom a Labour government would entrust the nation’s finances insisted that NHS staff would also enjoy the 32-hour

week he is dangling in front of other hard-working families. “That will mean recruiting more staff because we can afford to,” he added. Back to Ashworth, who later repeated to the BBC that

“quite obviously a four-day week in the NHS at the moment is not realistic”. The man who aspires to fill Bevan’s shoes is desperate to spend the additional £6 billion allocated to the NHS

under Labour’s plans on improving waiting times, mental health services and other improvements. But giving existing staff a day off would gobble up all that cash and more. As for recruiting

additional doctors and nurses: there are already more than 100,000 vacancies and many staff are already working overtime merely to keep the core services going. Ashworth knows that our

antiquated health service is struggling even to keep pace with a population that is growing at both the beginning and end of life, with a baby boom at the same time as an ageing population.

There is simply no spare capacity to indulge the fantasy of “a better work-life balance” for staff, as long as patients are obliged to fight their way through a byzantine system to get the

diagnoses and treatments to which they are entitled. Paying NHS staff more to do less, may be a vote winner for those who work in hospitals, but it is a recipe for chaos and misery for the

public who use them. In many ways the NHS is a microcosm of the problems that beset Britain as a whole. Its top-down bureaucracy and its low productivity, its use of old technology and its

failure to train enough medical staff are familiar in other parts of the economy. At its best, the NHS is world-class; too often, however, patients come up against an ugly mixture of

arrogance and incompetence, especially in dealing with hospital management. The novelist Tibor Fischer recently wrote about his father’s appalling experience here in TheArticle. His is not

the only family of modest means to have despaired of the NHS and turned to private medicine. As long as the Labour Party clings to its mantra that the NHS is the envy of the world, it will

not face up to the structural flaws that have led to the UK enduring markedly worse outcomes in cancer, for example, than other comparable countries. NHS reforms have a bad name, partly

because of Labour’s aversion to collaboration with the private sector. But reform is still needed. So is more and better health education to improve lifestyles, plus joined-up government to

address dementia and other incurable ailments of old age. The NHS is not some fragile ornament to be protected, but an instrument that must be fit for purpose. A party that cannot even

decide whether it is to be run for the benefit of the staff or for the patients does not deserve to be entrusted with adapting and expanding its capacities to meet the nation’s evolving

health care needs. The internal politics of the Labour Party would ensure that, once in office, the ideological priorities of John McDonnell, not the practical ones of Jonathan Ashworth,

would prevail. Is the NHS safe in Labour’s hands? As things stand, the answer has to be: no.