NHS spending has more than doubled to £92 billion a year in 2007/8 during prime minister Tony Blair’s decade in office, and the heavy outlay has clearly had an impact.
Waiting times are unrecognisable from the situation a decade ago, and DoH data point to better outcomes in key areas.
However, many GPs believe much of the staggering investment in NHS services has been wasted, and GP leaders say morale is low. So how will history view the Blair decade?
‘In terms of waiting, which was the problem in 1997, there has been real and transformative change,’ Mr Blair told a King’s Fund conference in London last week (GP, 4 May).
Health czars backed the positive legacy Mr Blair hopes to be remembered for. They said that in 1997 patients waited up to two years for heart surgery. The maximum wait today is three months.
Improvements and advances
They highlighted other advances, including fewer premature deaths from circulatory diseases, quicker access to A&E and fewer deaths from cancer.
GPs accept there have been improvements, but do not believe these reflect the funding growth. They feel changes to NHS policies have denied staff time to make the money count.
National Association of Primary Care chairman Dr James Kingsland said: ‘The legacy is an environment in which we might be able to see the NHS flourish.
‘But many things have not even started, and often seem to have recreated what we had before but probably a bit better. We have probably got where we wanted to be, but it’s taken a long time and an incredible amount of money.’
The government ‘threw out the baby with the bathwater’ when it ditched fundholding, Dr Kingsland argued. He said the NHS could have progressed more rapidly to practice-based commissioning by correcting some of the flaws of fundholding.
‘Health authorities were also starting to show they were the right size,’ he said. ‘Engagement with primary care was good, but we stopped all that.’
Single-handed Oldham GP Dr Anita Sharma said changes to the NHS overall were ‘definitely negative’.
‘Workload has increased, despite the loss of out-of-hours,’ she said. ‘With the quality framework there is extra bureaucracy, and so much money has gone down the drain on untested initiatives like Choose and Book.’
Medical Practitioners’ Union president Dr Ron Singer said: ‘Blair should be remembered because he did give a step-up in resources for the NHS. But he then got it completely and utterly wrong by handing a large part of that to the private sector.’
Dr Singer disagreed that anyone could provide services as long as the NHS paid. He said the NHS relied on teamwork, and this could not survive alongside ‘competition and commercial secrecy’.
GPC deputy chairman Dr Laurence Buckman said the NHS had been pleased to see Labour arrive, but goodwill had been ‘squandered’ as money was wasted and services privatised.
Small Practices Association chairman Dr Michael Taylor said continuity of care had been the chief loser under Blair, because of the emphasis on rapid access eroding the link between individual GPs and their patients.
Looking ahead, it seems unlikely that NHS funding will increase at the rate it has under Blair. How it is managed will become increasingly important.
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