How responsive is New Labour? In the NHS, much is made of the government's intention to improve information to patients and the public. But what happens in practice if you want to challenge current policy? At a conference on June 9 last year, I heard Frank Dobson, the then secretary of state for health, describe our wonderful NHS as free at the point of use for those in need. Unable to catch the chair's eye to challenge Dobson on the spot, I subsequently wrote to him on June 22 pointing out that what he said was untrue for many of the oldest and frailest citizens. They do not receive free health care if they have the misfortune to land up in a nursing home and have assets over £16,000. How could the Labour government justify this discrimination, which offends the founding principles of the NHS?
There was no answer. A repeat letter on August 29 met the same fate. On September 9, I rang his personal assistant. She would ring back. She didn't. I rang again on September 20, and on September 29 a letter arrived saying: "In view of the volume of correspondence that the minister receives day by day, it is not generally possible for him to deal personally with letters received from the general public." The rest of the letter reiterated the present situation but did not address my original point that the policy was unfair and against the statutory requirement (in the 1946 act) that the NHS provide free health care at the point of need.
My next letter made this clear. Again there was no answer. I rang on November 9. From this conversation it appeared that ministers can receive at least 70,000 letters a year. These are forwarded, after a slight delay, to a correspondence unit. The person to whom I spoke had 100 letters on her desk requiring answers. She sounded fed up. Naturally, she and her colleagues can only give standard replies. Speaking to her supervisor, I established that, in her opinion, the only way to get at the minister is through your MP. Accordingly, I did this on November 23.
His office helpfully sent me a copy of the parliamentary debate on long-term care and funding, which occurred in early December.
But still the original point lay unanswered. I suggested that the local MP pursue the minister further. That was on January 11 - and nothing has been heard since.
So what lessons can be learnt? First, it is obviously pointless writing to a minister. The next approach might be - in this case because it is about health policy - to use the community health council, but there is little evidence that the CHC will be able to access the minister's in-tray any more than the average citizen.
Age Concern is conducting a campaign, the Debate of the Age, which includes this issue but also covers many other aspects of discrimination against elderly people. It is probably unhelpful to their greater agenda to push one point only. It is clear from the increase in the number of phone-in programmes that many citizens have a beef they want to get off their chest.
If you get on to Radio 4's Any Answers or You and Yours you will have your two minutes of airtime, but will this make any difference? Similarly, letters to the paper may make you feel better, but, as there is little comeback, it is also frustrating.
There is an injustice here and, in a democracy, it should be possible for any citizen to register his or her concern. But it is clear that this requires skill. The matter must first be seen as important by more people than yourself and then ways have to be found to maintain the issue in the public consciousness. This is the reason for not giving up but using every opportunity to reiterate the issue.
Finally, there must be some possibility that something can be done, as banging on regardless quickly loses allies. This particular matter requires government commitment.
At last, there is some evidence that the pressure is getting to the government and they cannot indefinitely disregard the recommendations of the commission on long-term care.
But do not waste your time writing to politicians. Maintaining the accountability of our government to us citizens requires much more than a first class stamp.
• Andrew Wall is a former health service manager.
