Unhealthy headlines and Mid Staff failings bring calls for heads to roll, but much in the NHS is better and we must do the same
Any doubts I might have had about leaving the formidable Sir David Nicholson in charge of the NHS despite his spotty record in response to the unfolding scandal at Mid Staffs NHS Trust (MPs are quizzing him that) were dispelled by Tuesday morning's headlines. "Failings in the NHS cost 30,000 lives a year," thunders the Times.
The Mail and Telegraph, both campaigning to get Nicholson as if he had personally strangled the 1,200 suspected victims of NHS failings in Mid Staffs, are just as bad. "Billions in extra cash fail to stop the rot in NHS," roars the Telegraph. This is untrue – I put it no stronger – as readers will find if they get to the end of the offending articles. These newspapers and their foreign-based owners are enemies of the NHS and what it stands for.
The Guardian's headlines – hurrah - get it right. "Britons have less chance of healthy life, major study finds" is the strap above Sarah Boseley's page one summary. Not likely to be headline of the week, but it has the merit of accuracy. Inside the headline on Boseley's piece hits the right nail. "Smoking, diet, alcohol and drugs: where it all went wrong."
In other words, the chief culprit for Britain's modest fall down the international league table of advanced industrial states – from 10th in 1990 to 14th in 2010 – in terms of health outcomes and disease is not the NHS, but you and me. Unlike Spain, Italy and Australia, the three sunny countries which came top, we smoke and drink too much, eat bad food and take insufficient exercise. Some of us abuse drugs.
That's hardly a secret, is it? We've all known that for years and so have the Spaniards, Italians and Greeks (they do well despite their acute economic gloom) who host us during the summer holiday season. The NHS has its problems – Mid Staffs embodies some of them and Denis Campbell again highlights productivity and financial issues here – but key indicators like deaths from heart disease (down 41%), stroke (down 28%) etc are much better.
Plenty in the NHS is better, we know that too, the money did help and most hospitals are better for it. We're all living 4.2 years longer after all. Just so, we also know – or should – that 2012's other big care scandal/expose was in the private sector, at Winterbourne View where staff also behaved callously and worse.
Yes, we can blame the owners of the care home for staff conditions and low pay (some patients were paying up to £3,000 per week) just as we can blame those in charge of the NHS – Nicholson or ministers, Labour and Tory – for Mid Staffs. But it wasn't David Nicholson who left patients thirsty or hungry in their own piss or Jeremy Hunt/Andy Burnham who connived to cover up deaths caused by careless treatment.
As with the banking system, the phone-hacking scandal, burglary or anything else there's a limit to the extent to which we can blame the failings of regulators – a fall-back position which Tory politicians (more than Labour, I think) are often too keen to embrace when it suits an ideological position. In the end the people who actually did these dreadful things are the people who did them and hold prime responsibility.
That's true of the drive to emphasise prevention of ill-health too, it's chiefly down to us, to you and me. Most of us have some bad habits and know we do. We live in a society which encourages many of them – via advertising, the excessive use of sugars and fats in food (sweeties by the supermarket checkout for the kids), via substance abuse (including that bottle of wine you finished last night) and sedentary lifestyles.
Whereas 100 years ago public health was about decent drinking water and proper drains and hospitals struggled to cope with basic infections, nowadays it's much more about lifestyle choices – as the British contributors to today's World Health Organisation (WHO) report told Sarah Boseley and anyone else prepared to listen.
It's what Labour policy sought to improve when it offered to pay for fat customers gym tickets or bribe hopeless young mums to get their babies jabs. Ministers were mocked by the usual Fleet Street suspects for doing so. It's what Andrew Lansley wanted to achieve when he devolved public health to local level, integrating health and social care via health and wellbeing boards – part of the terrifying top-down (copyright D Cameron) changes which Nicholson is there to keep off the rocks. GPs must do better too – and in my experience are better than 10 years ago.
Later on Tuesday Jeremy Hunt, still finding his feet in Lansley's job, is making a speech on how we must try better, NHS and individuals, if we are to save those 30,000 avoidable deaths a year of which the headlines spoke, I hope he has the courage to stress the responsibility of the individual rather than dump on the NHS as the tabloids will want him to do.
He might also ponder whether his party's instinct for the voluntarist approach to those tricky issues of pricing, advertising and health warnings for damaging food, drink and tobacco is inadequate to the challenge society faces. Lansley struck me as too trusting of powerful industry lobbies with promises they don't keep.
It's not easy how to balance liberty and paternalistic intervention in a free society. The Mail shows that every day by denouncing the nanny state on one page and condemning the government for exposing its readers to risk – risk of a psychopath ("Freed to Kill By Police Blunders") on Tuesday's front page.
The consequences are there in A&E most nights of the week, wrecked or damaged lives which cost the NHS millions to repair each year (and I haven't even mentioned the knife fights yet). We're not doing enough and we can no longer afford the bill for failure. Unless, that is, ministers have decided that unhealthy Britons will save more on the pension bill.
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