Challenging the Prime Minister

Written by Vincent Cable MP and published in The Informer on Thu 24th Mar 2005

I had the unusual good fortune, this month, to be drawn to question the Prime Minister in parliament for two successive weeks. I took the opportunity to ask about the NHS. Why can senior hospital managers be sacked for failing to balance their books but not for tolerating poor hygiene or a bad record of clinical negligence? Why are cuts being made in some frontline services - like mental health provision - while money is spent recruiting new managers on high salaries?

The verdict residents give me on local health services is very mixed. Positively, a lot of money has been spent rebuilding the West Middlesex and improving its services, especially emergencies, though too many mistakes are made and patient satisfaction remains low. Teddington is now a popular local success story having faced the risk of closure a decade ago. Kingston has excellent new facilities for A&E and maternity - though some adverse reports on cleanliness. Some important services like cancer screening are more accessible and more accurate. Ancient practises are slowly being transformed by IT. Absurd macho working hours by junior doctors are being curbed. Clinicians are better paid, but are under more pressure and face arbitrary targets which can compromise medical judgements.

When the NHS was founded it was hoped that as the population became healthier demand and costs would fall. The opposite has happened. People live longer, bringing the medical conditions of old age. Affluence brings obesity and associated diseases; also more stress and mental illness. Our expectations of treatment and care have grown.

Overall, the NHS has undeniably improved since I became an MP eight years ago; but patient satisfaction has not kept pace. A conscientious MP has to strike a difficult balance: to acknowledge the genuine improvements, while fighting for more.