It’s time to take a break from that wretched Lansley bill,” I told the columnar staff at the weekend. “Find something different for me to write about.”
Hesitantly, the staff drew my attention to an interesting debate among peers about progress over stroke care, a subject dear to my pill-protected cardiovascular system. Good stuff.
But it is hard to escape the bill, even when trying, as the Lords debate on stroke illustrates. No sooner had the column refocused than Ed Miliband dug out Tony Blair’s famous 1997 election war-cry “24 hours to save the NHS” but took the edge off it by writing that we all now have three months to save it from “a free-market free-for-all”. It sounds like a bad case of longer waiting times.
The Guardian reported that even early backers of Andrew Lansley’s reforms (Drs Charles Alessi and Michael Dixon) now think the commissioning board will overwhelm promised GP-power, and ministers got into a tizz over nurse numbers (“you’ve cut them”/“no, we haven’t”/“yes, you have”) - a potentially more significant straw in the wind was Rachel Sylvester’s well-connected column in the Times about the secretary of state’s prospects.
Lansley has used the “pause” (both of them) to alienate even more allies, he should be “taken out and shot”, is the drift of the piece.
Gove-like stealth was a better reform strategy than a big bang bill, Number 10 is now saying. Tell us something new, I hear you murmur. OK. How about offering the job to Alan Milburn (Lord Milburn that would be) with a free hand to sort out the mess.
It’s nonsense of course, what we call “blue sky” thinking, probably from some pointy-headed Steve Hilton type in David Cameron’s back office. But it doesn’t help as the end game starts in the Lords.
Where were we? Stroke care, yes. We’ve come a long way since Mr Lansley suffered a misdiagnosed minor stroke in 1992, so peers agreed after Labour (and Unison’s) Baroness Margaret Wheeler, herself a carer, introduced her debate the other day.
In fact deaths from stroke and heart attacks are 41 per cent down over a decade – further proof that Labour’s extra billions were not “wasted” I’d say – and, though there are still 110,000 strokes and 20,000 minor ones (TIAs) each year in Britain, immediate care (crucial) and rehabilitation treatment are so much better since the national stroke strategy was implemented in the post-Milburn year of 2005. But 300,000 people still live with degrees of stroke disability at a direct cost to the NHS of £3bn a year – double that to wider society.
Peers are old enough to know about stroke, so one looks for tips. For patients who fall and cannot rise until help comes, the Tory educationalist Lord Lingfield recommends Exeter and Plymouth universities’ pioneering IGO (“I Get Off the Floor”) technique. Stroke victim Lord Bill Rodgers (it took two years of therapy to restore his speech, “longer for my confidence”) recommends that children be taught to take pulses to detect irregularities.
Lord Howe, Spaceship Lansley’s rear-gunner, is emollience itself. Ministers are acting on the CQC’s 2010 review to improve stroke networks, iron out variations, build support for those who have left hospital and monitor outcomes better.
But there is no pleasing peers these days. Why has the CQC review team been disbanded and the DH’s own vascular team decayed, asked Wheeler?
And why has Sir Roger Boyle, the departed heart and stroke tsar, not been replaced? Ah, yes, Boyle. He was the one who rampaged publicly against the Lansley reforms and would have been sacked if he was not already going. Hard to get away from that bill.