- The Guardian,
- Tuesday June 6 2000
Tony Blair yesterday swept back to work after his informal paternity leave and set about dragging the NHS towards a modernisation agenda that will deliver better healthcare in return for the promised billions in extra funding.
He chaired a meeting of health ministers from Whitehall and the devolved assemblies - including Sinn Fein's Bairbre du Brun - to trade "best practice" ideas for a better NHS.
Ministers were quick to embrace a system of closer partnership between health and social service authorities for the better treatment of the elderly, which Northern Ireland has pioneered.
The prime minister also marked his return to Labour's increasingly election-oriented agenda by indicating that, although inefficiency and unjustified privilege in health and education will remain vital targets in the government's sights, ministers will use more conciliatory language.
Mr Blair will use a speech to a Women's Institute audience tomorrow to defend Labour's insistence, loudly trumpeted by Gordon Brown, that elite universities such as Oxford and Cambridge still have much to do to become true meritocracies for talent from all social groups. But he will also assure voters that "talk of class war is complete rubbish", according to his spokesman, Alastair Campbell.
Alan Milburn, the health secretary, marked the emollient tone when he declared yesterday that he had no quarrel with consultants, only with the poor practices of some. It came too late to prevent senior doctors complaining that they were being made whipping boys for wider NHS failures.
Back at No 10, Mr Blair chaired what was described as a successful, wide-ranging two-hour session with health ministers from Cardiff, Edinburgh and Belfast as well as Whitehall's own team and Downing Street experts.
Ministers are convinced that part of the battle they want to win within the NHS is to persuade most hospitals and GPs to adopt the habits of the best around the country. Last night officials singled out four areas for immediate cooperation:
•Avoidable "bed-blocking" in hospitals to prevent inefficiency, patient distress and early readmission of elderly patients to hospital after they have been sent home too soon;
•Better exchange of information during winter flu crises;
•A drive to end wildly varying performances in different health areas;
•Next month's promised national plan for health, which will foster Mr Milburn's "four Is" - more information, intervention where hospitals are failing, better inspection, and incentives for staff to do better.
The fruits of yesterday's talks should emerge quickly. Mr Milburn told the health summit that Britain was "under-doctored and under-nursed" and that progressive consultants supported efforts to raise the skills and status of nurses.
Today he will back plans to cut waiting times at accident and emergency departments by referring minor cases to new nurse-led injury clinics. Instead of waiting for hours while doctors handle critical cases, patients would get quick treatment.
Mr Milburn will publish the proposal at a conference in London where he will admit that the NHS has suffered years of undercapacity, underfunding and understaffing.
"But in many cases, variation in performance has little to do with lack of money and resources and everything to do with lack of modernisation," he will say. "For too long the Labour party thought that underfunding was the sole problem. It is radical ideas and radical reform that are needed."
That is a crucial admission: that medical habits must also be modernised.
"We need a cultural change to break through the old demarcation barriers between doctors, nurses and physiotherapists," Mr Milburn will say.
