Blog 2023 Malcolm Blair-Robinson

Never mind the detail. The principle is the issue and the principle is right. The NHS has become a process, not a facility. Its function is to treat every patient as an individual, just as any human life is unique, and not only put them right when their health fails, but also to keep them healthy. This can only be done if every person has an individual doctor in charge of them and guiding all their treatment programmes.

This does not happen now. Patients are detached from their GP as soon as they go to hospital as an outpatient or an inpatient. Here they are herded about like a commodity dealt in at a market. What happens to them is as much determined by process and targets as it is by need. Their need.

The exception to this is a serious and life threatening emergency following a trauma, an individual accident or a large scale disaster. Then the normal rules are suspended, clinics abandoned, intensive care mobilised and targets ignored. All the skills and knowledge inherent in the many branches of the medical and nursing professions, flow undiluted to the needy. Miracles are common.

This is the standard that has to apply across the board. Working through GPs can do this. We do not accept  sub- standard airlines, where passenger suffering and mortality is higher than the average. All have to operate to the very highest standard. So ought all parts of the NHS as all times. The culture of take or leave it because it is free and do as you are told because we know best must end.

This is not primarily a reform of logistics. It is a reform of attitude.

The intervention by Bob Ainsworth is timely. The current legal framework is a complete failure and has created exactly the kind of criminal economy which existed in the U.S. during the years of Prohibition, worth £billions annually.  Moreover drug use is more or less out of control and illegal substances can be obtained in every town and neighbourhood and most secondary schools including the private sector and all prisons. If you add all the other criminal activities of which drugs are the capital source, there are many more £billions in play.

The harm to the innocent who become addicted is alarming. The time has come, after no less then fifty years of failure of the current approach, to do something radically different. Bob Ainsworth proposes regulation and control, making the substances legal if sold by licenced authorities. The activity of the drug dealers would continue to be illegal, but they would be priced off the streets anyway. It is time for politicians and the government to show courage, follow Mr Ainsworth’s lead and come up with a plan. If the tabloids shriek, let them. On this they need to grow up.