Opinion: Are Starmer's reforms really necessary for NHS?

I'm always suspicious about politicians wanting to reform the NHS. It usually means the largest organisation in the country enjoys yet another round of musical chairs which ends up with everyone doing the same thing but with a different title in an organisation with a new name!

The last big reform we had was brought in by the Conservative-led coalition in 2010. They inherited a relatively well-funded NHS with falling waiting lists.

Within a couple of years funding was slipping, all the attention seemed to be focussed on Andrew Lansley's reforms and the waiting lists started creeping up - and then accelerated rapidly.

Today the NHS is facing really difficult times - particularly its emergency services. I know the government likes to blame covid and its aftermath, but the fact is that is only one element. 

The problems were clear long before the first lockdown was declared in March 2020.

The fact is now the NHS needs more resources and two recovery plans - one to deal with the immediate crisis and one to look at long-term changes to ensure enough doctors, nurses, midwives, physios, radiologists  etc are trained and recruited.

But I'm not sure it needs a root and branch reform that seems to be suggested by Sir Keir and Mr Streeting.

There are certainly bureaucratic issues that need to be addressed to make life easier for patients.

Why can I order a repeat prescription on the NHS App, but not book an appointment at the surgery? I can book an appointment on another app - which then turns up on the NHS App.

My hospital appointments don't appear on the app, I have to rely on the letters I get from the department and write them down on my calendar.

It's not a great problem - but a bit more joined up thinking might help.

As a layman the proposal that GPs should be salaried and employed by the NHS looks like a good idea.

The idea that they are, in effect, small business owners running their own organisation with a fee from the NHS feels like a bit of a throwback to the days of Dr Finlay!

Just because you're a brilliant GP doesn't make you a brilliant business manager (or HR professional looking for the perfect practice manager!).

But the idea that the whole structure of the organisation should be changed so people can self-refer themselves to specialists doesn't seem entirely appropriate - you really do need a GP to be able to triage a potential problem to know which specialist to refer to.

And I do hope that any changes don't resort to the doctors and nurses good, health administrators bad narrative that some seem to adopt.

The fact is you need administrators - be they receptionists, computer inputters, those who draw up staff rotas - to free up the doctors and nurses to get on with their jobs!

And one last point. We know the NHS is facing the toughest of times - but for many who rely on it for regular treatment it really is business as usual.

The may be challenges at the A&E department at Ipswich Hospital, but planned treatment is continuing with few problems for patients. (Image: Simon Parker)

On the day Ipswich Hospital's accident and emergency department was really straining at the start of the month I was down at the other end of the building having some of my regular treatment.

The staff there were as cheerful and efficient as ever. You wouldn't have known there was any crisis in the NHS.

A couple of days later a relative went in for an ophthalmic consultation - again handled very efficiently. It really is business as usual for the non-urgent treatment.

That is a very important message. Yes the NHS is struggling with emergency work - but for those who rely on it, it is still providing a superb service.

And those thinking they can make it better need to think very long and hard before embarking on yet another round of reforms.