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Conservative Pledges on Care and Caring
930
Commentary from Westminster Conservative
Pledges on Care and Caring
CONSERVATIVES should have been in little doubt as they began their debate on the Health Service at Bournemouth last week about the widespread dissatisfaction in the country, even among Conservative voters, over the Government’s stewardship of the NHS. A Marplan poll for the Guardian, published as the conference opened, showed that 78% of voters believed the Conservatives had failed to honour their pledge to protect the service. Only on one issue--employment-was there a higher dissatisfaction rating. There was disillusion even among those respondents who still intended to vote Conservative at the next election: in this group, 29% thought the Government had lived up to its promises but 62 % did not. Gallup, in the Daily Telegraph (a newspaper rather more in evidence at Bournemouth than the Guardian), had an equally dismaying story to tell. 80% of respondents thought the Government was too eager to cut health, education, and other services. Like most resolutions at Conservative conferences, the one from Darlington that was selected for debate at Bournemouth was guaranteed not to give the leadership too much trouble. It welcomed the Government’s record provision of resources for the NHS but asserted that spending alone was not the answer to health problems, and urged the Government to step up its value-for-money campaign to get taxpayers’ cash efficiently translated into patient care. Councillor Mrs Heather Scott, who moved it, put herself firmly in the camp of those who blamed squandering at local level rather than tight-fistedness at the top. The only cuts in the service, Mrs Scott declared, were the ones made by its surgeons. If people believed otherwise, that was in large part because of the successful propaganda campaign that had been waged against the Government. Family practitioner committees and community health councils had fallen into the hands of Labour, and the media were only too willing to seize their chance to spread the word. But three of the speeches that followed did manage to bring some sense of the outside world’s apprehension into the Bournemouth hall. Dr Andrew Hardie drew on his experience in East Birmingham-one of the twenty worst funded areas in the country, he claimed-to argue that, while the service advanced in some areas, it was crumbling in others. His own hospital was on red alert (emergency admissions only) one or two days each week, and this was in the relatively easy months of August and September. What was going to happen when the cold weather came? People were not going to vote Conservative if they were constantly told that everything was marvellous when they could see waiting-lists stretching half way round the hospital grounds. Councillor Brenda Constable, a senior nurse tutor from Cannock and Burntwood, also in the West Midlands, echoed earlier condemnation of constant anti-Government but accepted that many people were unconvinced that the NHS was safe in Conservative hands. She sounded almost as distressed about cuts in nursing at ward level as some speakers at the Labour conference had been. And she was cheered when she added: "Beware, my friends. You have lost your matrons and with them the
propaganda
character of our hospitals. Do you wish to lose your ward sisters? If they go, we are taking one more step towards an impersonal service". And a third West Midlands speaker, Dawn Price, who is chairman of the Bromsgrove and Redditch Health Authority, having congratulated the Government on building fine new hospitals, went on to argue that a point could sometimes be reached where further savings became impossible. If funds had to be pulled back to cover a wages award that had exceeded expectations, the public perceived this as a cut. She was sharp, though, with opponents of RAWP: "I do sympathise" she said "with those who find themselves in the position which those of us north of the Watford Gap have had to contend with for many years". The reply to this debate by the Social Services Secretary, Mr Norman Fowler, was a conference triumph, ending in one of those standing ovations that did not have to be prompted by the platform. In a speech that used the word "care" no fewer than twenty-four times, he delighted his audience with a comprehensive tour of the Government’s health service achievements in general and its hospital building programme in particular, producing a computer print-out of projects in progress so long that the foot of it fell below the platform and into the flower arrangements. But remarkable though the record was, he was, he insisted, still not satisfied. There would be action on waiting-lists. Every health authority would have to tell him by the end of the month how long its lists were, and why. Then he would see to it that times were cut. More: with the help of Sir Roy Griffiths, the new number two in the NHS Management Board, he intended to reduce the time it took to get to a consultant in the first place. Mr Fowler went on to produce a series of pledges to increase the throughput of specific courses of treatment. Bypass operations had tripled since 1978 to around 10 000; by 1990, that figure would reach 17 000 a year. Hip operations, up from 28 000 in 1978 to 38 000 now, should reach close to 50 000 in 1990. Cataract operations, up from 35 000 to 55 000, should hit at least 70 000. All that would mean freedom and independence for the elderly. For women, there would be call-and-recall systems for cervical cancer in every health district within two years. There would be targets for children, too-to increase the rate of bone marrow transplants, and to ensure that by the end of 1988 no mentally handicapped child receiving long-term care would be required to live in a large mental handicap hospital. In a close-of-conference speech that was also peppered with references to care and caring, the Prime Minister recalled her own recent visits to five hospitals, declaring that "everywhere patients were loud in their praise of the treatment they received from the doctors and nurses whose skill we all admire". The Government’s commitment to the Health Service, she declared, was "second to none". The assembled representatives cheered her, as they had done Norman Fowler, with a fervour which suggested that, in their judgment, the cloud of unpopularity now hanging over the Government’s health service record would soon be swept away. No harm in that, perhaps, in the sense that building party morale is what these conferences are for. But Marplan’s disgruntled 78% will not be so readily convinced. Mr Fowler and colleagues are going to have to show some very impressive progress on the ground, and very soon, if the health issue is not to prove a serious liability for them at the next election.
DAVID MCKIE
Commentary from Westminster Conservative
Pledges on Care and Caring
CONSERVATIVES should have been in little doubt as they began their debate on the Health Service at Bournemouth last week about the widespread dissatisfaction in the country, even among Conservative voters, over the Government’s stewardship of the NHS. A Marplan poll for the Guardian, published as the conference opened, showed that 78% of voters believed the Conservatives had failed to honour their pledge to protect the service. Only on one issue--employment-was there a higher dissatisfaction rating. There was disillusion even among those respondents who still intended to vote Conservative at the next election: in this group, 29% thought the Government had lived up to its promises but 62 % did not. Gallup, in the Daily Telegraph (a newspaper rather more in evidence at Bournemouth than the Guardian), had an equally dismaying story to tell. 80% of respondents thought the Government was too eager to cut health, education, and other services. Like most resolutions at Conservative conferences, the one from Darlington that was selected for debate at Bournemouth was guaranteed not to give the leadership too much trouble. It welcomed the Government’s record provision of resources for the NHS but asserted that spending alone was not the answer to health problems, and urged the Government to step up its value-for-money campaign to get taxpayers’ cash efficiently translated into patient care. Councillor Mrs Heather Scott, who moved it, put herself firmly in the camp of those who blamed squandering at local level rather than tight-fistedness at the top. The only cuts in the service, Mrs Scott declared, were the ones made by its surgeons. If people believed otherwise, that was in large part because of the successful propaganda campaign that had been waged against the Government. Family practitioner committees and community health councils had fallen into the hands of Labour, and the media were only too willing to seize their chance to spread the word. But three of the speeches that followed did manage to bring some sense of the outside world’s apprehension into the Bournemouth hall. Dr Andrew Hardie drew on his experience in East Birmingham-one of the twenty worst funded areas in the country, he claimed-to argue that, while the service advanced in some areas, it was crumbling in others. His own hospital was on red alert (emergency admissions only) one or two days each week, and this was in the relatively easy months of August and September. What was going to happen when the cold weather came? People were not going to vote Conservative if they were constantly told that everything was marvellous when they could see waiting-lists stretching half way round the hospital grounds. Councillor Brenda Constable, a senior nurse tutor from Cannock and Burntwood, also in the West Midlands, echoed earlier condemnation of constant anti-Government but accepted that many people were unconvinced that the NHS was safe in Conservative hands. She sounded almost as distressed about cuts in nursing at ward level as some speakers at the Labour conference had been. And she was cheered when she added: "Beware, my friends. You have lost your matrons and with them the
propaganda
character of our hospitals. Do you wish to lose your ward sisters? If they go, we are taking one more step towards an impersonal service". And a third West Midlands speaker, Dawn Price, who is chairman of the Bromsgrove and Redditch Health Authority, having congratulated the Government on building fine new hospitals, went on to argue that a point could sometimes be reached where further savings became impossible. If funds had to be pulled back to cover a wages award that had exceeded expectations, the public perceived this as a cut. She was sharp, though, with opponents of RAWP: "I do sympathise" she said "with those who find themselves in the position which those of us north of the Watford Gap have had to contend with for many years". The reply to this debate by the Social Services Secretary, Mr Norman Fowler, was a conference triumph, ending in one of those standing ovations that did not have to be prompted by the platform. In a speech that used the word "care" no fewer than twenty-four times, he delighted his audience with a comprehensive tour of the Government’s health service achievements in general and its hospital building programme in particular, producing a computer print-out of projects in progress so long that the foot of it fell below the platform and into the flower arrangements. But remarkable though the record was, he was, he insisted, still not satisfied. There would be action on waiting-lists. Every health authority would have to tell him by the end of the month how long its lists were, and why. Then he would see to it that times were cut. More: with the help of Sir Roy Griffiths, the new number two in the NHS Management Board, he intended to reduce the time it took to get to a consultant in the first place. Mr Fowler went on to produce a series of pledges to increase the throughput of specific courses of treatment. Bypass operations had tripled since 1978 to around 10 000; by 1990, that figure would reach 17 000 a year. Hip operations, up from 28 000 in 1978 to 38 000 now, should reach close to 50 000 in 1990. Cataract operations, up from 35 000 to 55 000, should hit at least 70 000. All that would mean freedom and independence for the elderly. For women, there would be call-and-recall systems for cervical cancer in every health district within two years. There would be targets for children, too-to increase the rate of bone marrow transplants, and to ensure that by the end of 1988 no mentally handicapped child receiving long-term care would be required to live in a large mental handicap hospital. In a close-of-conference speech that was also peppered with references to care and caring, the Prime Minister recalled her own recent visits to five hospitals, declaring that "everywhere patients were loud in their praise of the treatment they received from the doctors and nurses whose skill we all admire". The Government’s commitment to the Health Service, she declared, was "second to none". The assembled representatives cheered her, as they had done Norman Fowler, with a fervour which suggested that, in their judgment, the cloud of unpopularity now hanging over the Government’s health service record would soon be swept away. No harm in that, perhaps, in the sense that building party morale is what these conferences are for. But Marplan’s disgruntled 78% will not be so readily convinced. Mr Fowler and colleagues are going to have to show some very impressive progress on the ground, and very soon, if the health issue is not to prove a serious liability for them at the next election.
DAVID MCKIE