Emily Carver is a broadcaster and commentator.
The NHS needs big ideas. Poor health is not only impacting the lives of those suffering, but it is also costing our country dearly in terms of a depleted workforce and the rising cost of welfare.
We currently have upwards of seven million people waiting for treatment and, despite some recent progress on reducing the number of patients waiting 18 months or longer, there are still roughly 2.5 million people of working age off work due to long-term sickness.
Unsurprisingly, trust is at an all-time low. Recent polling shows only eight per cent of people in England believe the Government has the right policies for the health service, and only nine per cent expect standards in the NHS to improve in the next year.
The NHS will undoubtedly be a deciding factor come the next election, and Rishi Sunak will be acutely aware that most people blame the Conservatives for its failures.
This being so, it’s quite difficult to envisage a scenario in which he can turn around the Party’s fortunes without seeing waiting lists fall dramatically, the threat of strike action cease, and day-to-day interactions with the service drastically improve.
In an ideal world, our politicians would have the bravery to discuss root-and-branch reform (and the public wouldn’t be so closed-minded to such change). But alas, that is not where we find ourselves.
Away from ideological battles around how healthcare should be funded and provided, simple, practical changes are welcome (even when they’re not the most inspiring).
The Prime Minister’s plans announced this week to end the so-called 8am scramble for a GP appointment may well be a “shallow offer”, in the words of Wes Streeting. But if it relieves pressure on GPs (the average practice can receive upwards of 100 calls in the first hour every Monday) and improves patient experience, the proposals are a step in the right direction.
The Government plans to spend £240m improving GP practices, including upgrading phone and online services so that patients can get an answer to their request on the very same day. Receptionists will also be trained as “care navigators”, advising customers towards pharmacies if they are exhibiting symptoms of a common ailment.
To support this, pharmacies will be given the go-ahead to prescribe treatment for common conditions without GP sign-off, including for sore throats, urinary tract infections, and earache. The hope is that, once implemented, these changes will free up millions of GP appointments.
Of course, it is easy to be cynical about these plans. Will patients trust a receptionist to know what’s best for their health? Would patients appreciate being palmed off by a “care navigator” when they want to see a doctor?
And would you want to tell a receptionist about something to do with your intimate health, for example? Many of us will know that receptionists are not always the most discreet!
The questions continue… Will pharmacies even have the capacity to diagnose, particularly when we know hundreds of pharmacies have closed down in the past few years? Do these changes increase the risk patients are given incorrect treatment, and potential illnesses go undiagnosed? Could pharmacists overprescribe antibiotics?
Overall, though, these plans reflect what many people are already doing when it comes to their health.
Online pharmacies are already able to deliver basic drugs and treatments to you swiftly, simply by filling out an online form. Many GPs will also tell you they are already implementing much of what the Prime Minister has announced as new.
Redirecting more patients to pharmacies is thus a sensible move – and something many people are already doing themselves to avoid waiting around to see a doctor.
If effectively implemented, it could also reduce the hundreds of thousands of missed appointments, which cost the NHS millions every year. Expanding the range of services pharmacists can provide (within reason) should also help ease the workload on GP practices, which is so often cited as a reason for low morale and the retention crisis in the profession.
Of course, the Labour Party has been swift to criticise. Others have pointed out that this is a sticking plaster measure to distract away from the real issue: an NHS that is incapable of meeting rising demand and the failure to recruit and retain adequate numbers of GPs.
This assessment is hard to argue with. The Government and NHS leadership must set out urgently how they intend to staff the NHS moving forward.
However, I can’t help but think this big policy announcement may reflect Sunak’s limitations as a leader: where Boris Johnson neglected detail in favour of bold vision, he seems to have the opposite problem.
Sure, focusing on the detail of policy and making small, incremental changes may bolster his credentials as a competent, well-meaning prime minister.
But to win an election (particularly when the Conservatives are so deeply unpopular), he’ll need to convince the public that the future will be better than the present, not only for healthcare, but for the country. A five-point to-do list of pledges that neither excites nor sets the Tories apart from the Opposition will not cut it with a country that has gone through so much in the past few years.
Whilst an emphasis on local healthcare improvements is welcome, it must be accompanied by a vision for the future. What does an NHS under Sunak’s leadership look like in five years’ time? Why should the country be hopeful that things will get better not worse under his leadership?
I’m not sure we know.