OH dear. Who remembers when BBC's Panorama occasionally did serious investigative work? John Sweeney’s exposé of the Scientology cult? Or the revelations of football’s dirty secrets?
Unfortunately, Panorama: The Perfect Storm*, this week’s film about the NHS in Liverpool owed more to the techniques of Hammer Horror than to File on 4. It was a triumph of style over substance and what there was of substance was misleading. Or worse.
Style: An entire hour was accompanied by a scary sound track ratcheting up the tension ever more. When’s the shower scene coming? we asked. The voice-over sounded like David Morrissey doing a deodorant commercial after several pints and a night of karaoke. Mysterious cars turned onto rain-swept city streets at dawn. Gormley’s iron men were shrouded in gloom and battered by the waves. Lots of documentary footage showing Liverpool’s slums in the bad old days. And lots of contemporary, grainy footage of the North End showing not much has changed.
It contained every possible cliché about Liverpool but omitted to include the obvious truths.
GrimSubstance: The theme was that the demands on health and care services are increasing. People are living longer. More people are developing long-term conditions. More are obese. More are living alone. More are being admitted to accident and emergency departments. Finance and existing systems are finding it ever harder to cope. Hospitals are expensive to build and run. Social care budgets are slashed.
Liverpool’s answer? The Healthy Liverpool initiative, advocated by NHS Liverpool Clinical Commissioning Group, and the focus of the programme and which, campaigners fighting to keep the NHS public agree, is an example of a health service that always puts people first. So far, so good.
Real life patient stories were heart-rending and affecting. Committed doctors and nurses continue to do wonders in surgeries, in the community and in hospitals. Who could not be moved by the examples?
The programme went along with the Tory narrative about NHS finance. What it didn’t say was... 'it is the politicians, not the doctors and patients, who are culpable for the mess the NHS is in'
But what did they prove? That Liverpool is a desperately poor city. And that its health and social care services are invaluable.
So how can a healthy living campaign cope with budgets and resources that are being slashed and fragmented? Easy! Take money off the hospitals and promote "self care", or give it to “care in the community”. Really?
Are we really so sanguine that we can care adequately for the elderly and infirm by ourselves? People end up in A&E because patients in hospital are usually safer than those living alone at home and failing to cope. If all the necessary community services were established, cost-effective and of high quality, that might be OK. But their existence is patchy and threatened - and can certainly not manage while at the same time GP and hospital budgets are slashed.
How can schemes like Healthy Liverpool get into full swing and cope when, as one North West GP, Dr David Wrigley, later remarked in his own overview, what many of his patients are facing is being “left ‘stuck’ in hospital or struggling on at home in worsening health, hit by 40 percent cuts to the home support they used to receive from care assistants and social workers.” It was Dr Wrigley, who co-wrote the recent book 'NHS for Sale', and who first labelled Monday's Panorama show “the perfect wasted opportunity.”
GrimmerWe know from Liverpool Mayor Joe Anderson that Liverpool has suffered a 58 percent cut in funding in real terms since 2010/11. He has said: “The financial challenges we face are unprecedented and many tough choices lie ahead.” And Liverpool’s divisional manager for commissioning for adult services and health, says that “when councils are under the financial impact we’ve been under in Liverpool (£156m reduction over three years) then we naturally focus on how we ensure we meet our statutory duties. This has resulted in the withdrawal of some key preventive services.”
Of course everyone believes in the integration of health and social care; but not its use as a smokescreen for cuts and privatisation.
Errors and omissions: The programme went along with the Tory narrative about NHS finance. What it didn’t say was (to quote Dr Wrigley) “it is the politicians, not the doctors and patients, who are culpable for the mess the NHS is in. It’s the politicians who have overseen falling NHS expenditure…and across the board cuts of 10 percent to the money hospitals receive for treating us.”
No scrutiny of the "DevoManc" proposal which would see Manchester councillors take control of NHS services in a metro-mayor deal.
Nor did Panorama expose the Tories’ English NHS “market” that wastes an estimated £10bn a year or more on bureaucracy.
Nor the Private Finance Initiative (PFI) scandal, even though Liverpool is still using this to build hospitals.
No mention of the billions wasted on agency workers or the way politicians have treated the NHS workforce, slashing training (whilst increasing the workload and reducing pay).
And nothing about a halving in the number of hospital beds in the last 30 years, and a level of healthcare spend lower than just about anywhere in the developed world (despite the NHS being the world’s BEST health system before the Tories reappeared from the sludge).
It cost £640 million in 2014 alone for management consultants to draw up further care in the community plans which, even Panorama admitted, were untested. Of course we can always sell off hospital land to make up the shortfall.
Meanwhile, Professor Wendy Savage, president of the campaign group Keep Our NHS Public, says: “We hear a lot about the increasing demand on the NHS caused by the elderly but today people are much fitter than 20 years ago and older people contribute a lot to the community. We need public health which has teeth to prevent companies marketing unhealthy food and drinks. We need understanding within government of how each department can contribute to health and we need to have a real living wage to reduce poverty which causes ill health.”
Much easier to blame patients for the failings of politicians, and persuade us that we simply can't afford a comprehensive health service. But then again the BBC Charter Renewal is coming up…. Cue scary music.
*Watch BBC1's Panorama, The Perfect Storm here
