Is NHS Direct the wrong prescription?

As a stern, unbending Tory, I naturally applaud the idea of cutting Government spending. But the cuts need to be made with the keen eye and steady hand of a top surgeon, not by a half-blind madman wielding a scythe.

If you had asked me a year ago whether it was right to scrap the NHS Direct helpline, as the Government plans to do, I would instantly have agreed that it was a huge waste of money, providing cushy jobs for nurses and succour for hypochondriacs.

But that was before I took the huge leap into the unknown of becoming a first-time parent, and faced the endless succession of coughs, rashes, swellings, bumps and abrasions that probably amount to nothing but might just be the herald of that potentially fatal condition you would never forgive yourself for failing to detect.

My wife has found the nurses of NHS Direct invaluable at providing timely advice and reassurance. Her many friends with year-old babies all speak highly of the service, too.

How can it possibly save money to get rid of it, when in most instances the alternative would be a visit to a GP or an A&E Department, at infinitely greater cost to the NHS?

The minister concerned says that the same service can be provided more cost-effectively through the new “111” non-emergency number, now being piloted right here.

And the key, money-saving difference? Apparently fewer qualified nurses manning the phones and more “trained telephone operators”. I am pretty sure that is what they also call those helpful people manning the telecoms and IT helpdesks; the ones who can’t actually answer any question that isn’t on the cards they’ve been given to read out. These provide precisely the same information as the “frequently asked questions” that anyone with half a brain will have read on the website before picking up the phone.

The only value I have found in these services is the entertainment of asking a wholly unexpected question such as “What’s the weather like in Bangalore, then?” and listening to the frantic shuffling of paper at the other end.

Apart from cost, NHS Direct apparently has to go because GPs don’t like it. The Government’s Big Idea is that GPs are the linchpin of the NHS and should basically run everything. Well, Coco the Clown may well be the linchpin of the circus, but that does not mean we should take his advice on how to erect the big top.

And have you actually tried getting to see an NHS GP lately? Once upon a time I had a doctor who knew me and my medical history; now I see a different locum every time I go to the surgery, and usually have to wait a day or more to do that.

My practice has gone down the route of allowing appointments to be booked online, weeks in advance, so that every slot with one of the partners is filled by forward-thinking repeat visitors, rather than patients with chaotically unplanned illnesses.

Many friends face the alternative madness of the 8.30a.m. telephone roulette, with the phone on permanent redial, because appointments can only be booked on the same day.

House calls? You must be joking. My sick neighbour waited most of a day for the out-of-hours service to chauffeur a mainly German-speaking locum all the way from Penrith.

I don’t blame GPs. If someone had offered me a vast pay rise to work 9-5 Monday-Friday instead of being on call 24/7, I would have grabbed it, too. But unless we can recapture something of the spirit of my parents’ Dr Gilchrist from the 1950s, prepared to turn out at all hours and in all weathers to take a look at a sickly child, I would urge the Government to think long and hard before flicking the “off” switch on NHS Direct.

www.blokeinthenorth.com

Originally published in The Journal, Newcastle upon Tyne.

Faltering first steps towards economy

It has been a week of faltering first steps in my household, as one-year-old Charlie discovered that he could let go of the furniture and boldly go across the middle of the room towards the smiling adult with the outstretched arms.

Naturally there have been mishaps along the way, and I have belatedly come to appreciate the origin of that useful phrase “trying to run before you can walk”. Words that spring to mind every time Education Secretary Michael Gove pops up in the media, stuck in the bottom of his hole yet still ferociously digging.

Not that I am without sympathy for those in the Government charged with finding savings in their departmental budgets. It finally dawned on me a couple of weeks ago that I have been living vastly beyond my means for years, and that the only solutions were to increase my income by about 60pc or cut expenditure by a third.

That will be the spending cuts, then, won’t it?

I duly drew up a list of things I could do without, but none has yet got past the family vetting committee. Cancelling my eye-wateringly expensive private health insurance looked like a no-brainer to me, particularly as the small print carefully excludes pretty much any problem I seem likely to develop, but Mrs Hann remains to be convinced. I might go down with blackwater fever right after cancelling my direct debit, and it would be like forgetting to buy a lottery ticket on the day when your usual numbers finally hit the jackpot.

The only foreign holiday I have taken in the last decade was my honeymoon, and I would gladly never take another, but my wife feels the urge to go somewhere reliably sunny in September and even I cannot claim that she is necessarily going to get through a bottle of Soltan in Scarborough towards the end of the summer season.

But tough choices, as they say, are going to have to be made. Memberships of clubs I rarely visit; donations to good causes (and political ones); expensive indulgences like nights at the opera are all in line for the axe. But just looking at my list of potential economies reminds me what a hugely privileged, middle class life I lead.

I may no longer be able to progress, like a mediaeval monarch, between two comfortable homes, but we are some way off worrying about not having a roof over our heads. More of the food shopping may have to come from Iceland and less from Marks & Spencer, but we will not starve (and frankly it would do me no harm if I did, at least for a while).

Dieting is a dreadful prospect, but becomes curiously enjoyable once you have started, as you become obsessively focused on shedding the pounds and feel the benefit of not carrying all that surplus weight around with you. With luck, economising will prove equally addictive. I am just hopelessly out of practice, having been lucky enough to remain reasonably prosperous since the early 1980s.

Never rich, though; never saving for the future; in fact, never really giving a thought about tomorrow. Could there have been a worse preparation for late-life parenthood?

I did notice, in my years as a trustee trying to raise funds for musical charities, that the genuinely wealthy were often pathologically mean. This, I have finally realised, is their secret.

So this week I finally embark on my first unsteady steps to slash spending, just like a proper toff. I hope that anyone trying to touch me for a few quid in the coming months will note that my sudden close-fistedness is not the result of suddenly acquiring a fortune: quite the opposite. With lottery tickets also on my list of cuts, contracting blackwater fever seems a much more likely prospect.

www.blokeinthenorth.com

Originally published in The Journal, Newcastle upon Tyne.

2010: the dawn of reality

So far we have faced up to our appalling financial crisis like those cartoon characters that keep running long after they have passed over the edge of the cliff. But soon grim reality must surely dawn, and we will all plummet downwards amid a resounding crash of tax rises and spending cuts.

Before that we are doomed to months of relentless point-scoring in the run-up to the General Election, as each party seeks to demonstrate that things would be even worse under the other lot. Then, whoever wins, we will face the shock revelation that things are far worse than expected, and that drastic emergency action must be taken.

For this reason, the General Election of 2010 will surely be like that of 1992; one not to win. Our electoral system almost guarantees that the winning party will have been backed by only a minority of the electorate, so at least most of us will be able to derive some grim satisfaction from watching the new Government rapidly sink to record depths of unpopularity. Personally I would like nothing more than to consign him to the book of Great British Failures; but, for poetic justice, surely that poisoned chalice has got to be Gordon’s?

Originally published in The Journal, Newcastle upon Tyne.

Savage cuts - and even worse in store?

So, electors of Britain, how would you like your spending cuts? Bold, savage or draconian? What, you were hoping for the usual pre-election promises of more cash for schools ‘n’ hospitals, the faint hope of a high speed rail link in your lifetime, and the even dimmer one of a dual carriageway A1?

Forget it. It isn’t going to happen. Not at the coming election anyway.

No, it looks like your only choice is going to be deciding which party would do the best job of wielding the axe. Which, as Paul Linford was suggesting on Saturday, should hand an advantage to the Tories because they have a reputation for that sort of thing.

An unjustified reputation, as it happens, since Mrs Thatcher actually presided over an increase in the proportion of GDP absorbed by the British State, and record increases in health and welfare spending. But at least we all knew that, in her heart, she wanted to rein things back. That surely needs to be the default setting of anyone aspiring to govern the country. We have tried the alternative of the surprisingly open-handed Scotsman who wanted to spray our cash around like a drunk with a fire extinguisher at a crazy foam party, and we have seen precisely where that got us. In the proverbial, in case you had not noticed.

I can think of no better illustration of the madness of the current regime than the fact that yesterday I sent off the £250 voucher graciously sent to me to open a Child Trust Fund account. Apparently if the little fellow makes it to his seventh birthday they will send me the same again. Only they won’t, with any luck, because it will be one of the egregious wastes of public money that whoever wins the next election will abolish. Along with my £20 per week child benefit and the tax credits paid to couples living on what sound like perfectly comfortable incomes to me.

The Government needs to recognise that most of us can look after ourselves, thanks, and want nothing more than to be left alone. In particular, we have no desire to fork out yet more in tax to pay for bright sparks to dream up ever more complicated schemes to “help” us, which require thick, glossy brochures and well-staffed call centres to explain what on earth they are about.

We can also do without all their efforts to protect us from miniscule risks of harm through their ever-expanding web of databases, surveillance and checks.

I would pledge my vote today to anyone who guaranteed that they would scrap ID cards, the NHS IT scheme and the 2012 Olympics, withdraw from Afghanistan, allow a free and unbiased vote on our continued membership of the European Union, and focus welfare spending on those in genuine need. So, sadly, there is not going to be any candidate in 2010 that I really want to vote for, and many more of us are going to be in the same boat. Thus turnout continues to diminish and politicians keep wringing their hands wondering where they are going wrong.

And why 2010, incidentally? Why not now? According to the conspiracy theorists, because Lord Mandelson is on a mission to prop up Gordon Brown until the Irish have been brow-beaten into rethinking their opposition to the Lisbon Treaty, the new European Constitution is enacted and Tony Blair installed as President, calculating that “Dave” Cameron will lack the bottle to give the British people a referendum on the subject when he is faced with this fait accompli.

I am not normally a believer in conspiracy theories, but this one seems more plausible than most. Could all the talk of vicious spending cuts and tax increases simply be a ploy by the political class to take our minds off something even worse?

www.blokeinthenorth.com

Originally published in The Journal, Newcastle upon Tyne.