Clock ticking on NHS timetable of recovery

WHO do we believe when it comes to assessing New Labour's record on health since Tony Blair swept to power five years ago?

Do we accept the endless drip-drip-drip of media stories about grannies on trolleys and bodies in storerooms?

Do we accept the Tory criticisms that New Labour is all bluster without substance of making serious reforms?

Do we accept that waiting lists are getting shorter, but they are also getting wider?

Or do we concentrate on the fact that after three years of standstill, in the past couple of years NHS spending has been growing at more than six per cent in real terms a year - double the average of the last Conservative administration.

Or the fact that - rather belatedly - Chancellor Gordon Brown recently committed the Government to spending an extra £40bn on the NHS over the next five years.

Visit the Labour Party's Internet website and you will see a long list of figures under the heading, Achievements.

Apart from the extra 31,000 nurses, 7,000 more doctors and almost 10,000 scientific, therapeutic and technical staff hired since 1997, there are also 68 major hospitals being built at a cost of £7bn.

Then there's the small matter of more than 700,000 more NHS-funded operations a year since 1997, with waiting lists down by more than 100,000.

Who do we believe? Professor Alan Maynard, of York University, is better placed than most to comment on Labour's record in Government. He has been studying the health service for a quarter of a century and is one of the UK's leading experts on the NHS. He also chairs the York District Hospital NHS Trust board.

"The NHS has been run extremely frugally, with rundown facilities, for 30 years," he says. "We could have turned the tap on in the early 1990s but we chose not to. We chose to have relatively poorly-funded health services we could moan aboutand we are very good at that."

And so, in 1997, Labour's manifesto commitments were few and far between.

"Blair made the decision that Labour would win electoral support on health whatever, so they said very little," says Prof Maynard.

They promised only to increase funding in real terms year on year, to cut £100m from bureaucracy and put the money into patient care and to reduce waiting times for cancer patients. As polling day approached, though, these pledges developed into the slogan "24 hours to save the NHS" - a slogan which subsequently played into the hands of their detractors.

"Some of the things they have done since 1997 are good," says Prof Maynard. "Certainly, the fact that they have been able to squeeze out more activity from a highly constrained system is impressive."

But the increased pace of treatment within the system is at a cost.

"There is no doubt the pressure on the service is absolutely stupendous," he says. "The politicians are very anxious to achieve the targets they have set, but you can't invent doctors, nurses and hospital beds in sufficient numbers to really affect capacity really quickly."

And, even with Mr Brown's millions promising to flood into the NHS, Prof Maynard wonders whether the Government will be able to make sufficient progress towards achieving its long-term targets before the next election.

Tony Blair and Health Secretary Alan Milburn ask the public to "bear with us", but unless ordinary voters believe that the NHS has improved, there could be an immense political price to pay.

Part of the reason for Prof Maynard's doubt is the tight grip Labour keeps on the NHS.

"I think there is a real risk there will be problems because their style of management is very centralised," he says.

"They have this rhetoric of decentralisation to Primary Care Trusts, but in fact it is all central dictats. The system is being managed very hard from the centre with the regional offices as the local policemen and the new strategic health authorities as even more local policemen."

Prof Maynard believes the media has a responsibility to be more balanced about problems in the NHS - and for ordinary citizens to be more level-headed about scare stories.

"I am sure horror stories can always be found, but to draw conclu-sions from them is not representative of what is going on," he adds.

He points out that about 7,000 Americans die every year from medication errors, twice as many as the number that died in New York on September 11 - "but which issues gets the most coverage?"

He says that, although most people support Mr Brown's higher taxes to increase NHS spending, the public will also have higher expectations.

One of those facing those higher expectations is Dr Jim Hall, a heart specialist at the James Cook University Hospital, Middlesbrough. For the past year he has been chairman of the Northern and Yorkshire regional task force charged with expanding heart facilities.

Dr Hall is reluctant to get involved in party politics, but he does recognise progress.

"When you look back over five years you can see there have been big changes. If you look back to ten years ago, then there has been a huge increase in activity.

"My gut feeling is that increases in rates of heart surgery at our hospital is up by about 30 per cent over the past five years," says Dr Hall.

So far as angioplasty is concerned, a minimally invasive procedure to unblock arteries, the numbers at South Tees have more than doubled. Angiography, a diagnostic procedure to measure arterial blockages, has increased by about 25 per cent, the specialist adds.

Next March, Dr Hall's expanded heart unit is due to open. It will carry out 1,800 bypass operations every year - compared to the current level of 1,200 per year.

"I believe we are making some progress. I think patients are getting a better deal now than they were before," says Dr Hall.

"When I became a consultant in 1993, the issues were still there about resources, but the debate has moved on and it is now about time scales and how we can make things happen," he says. "I welcome that greater sophistication."

The Government also gets a pat on the back from an unlikely quarter - North Yorkshire health campaigner Graham Maloney, who has in the past used harsh words about the current administration.

Mr Maloney, who has been campaigning on health issues since 1993 and in recent years has been an advisor to the victims of disgraced North Yorkshire gynaecologist Richard Neale, says: "Since Labour got in, we have advanced tenfold in improving the situation for patients who complain about under-performing doctors.

"While the Neale group would still prefer a full public inquiry into the scandal, at least we have got a private inquiry from Labour."

Dr Liam Fox, the Conservative Shadow Health Secretary, is unsurprisingly dismissive about Labour's record.

He points out the Labour did not come to office, or be re-elected, promising "some" improvement. Mr Blair said there were "24 hours to save the NHS", but that has now been diluted into his vague promise that it will be "basically fixed by 2010", he says.

The Tories point to the loss of 50,000 care home beds, a bed-blocking crisis in hospitals, record cancelled operations, record hospital infection rates, record re-admissions rates among the elderly and "clinical distortions" caused by waiting list policy.

Another promise, free nursing care, turned out not to be free but capped at £110 a week, adds Dr Fox.

The Tories also point to an increase in bureaucracy in the NHS - there are now 1.15 administrators for every NHS bed - while bed numbers have shrunk by 12,000.

Perhaps the problem for New Labour is that the past masters of spin find it difficult to convince voters that their achievements are real after all.