When I mentioned to someone close to me that I was going to blog about the NHS, I was advised DON’T as I did not know enough to speak authoritatively on the subject, which of course is true. But the point of my writing a blog is to raise issues I care about that have some bearing on my work as a community activist. When it comes to the NHS, this happens to be true too. Rather than talk nonsense and delve into areas beyond my comprehension, I will instead offer some personal reflections and, just as importantly, ask questions, for in my experience doing this often helps get to the bottom of a matter.

The NHS is a subject that has caught the attention and imagination of politicians. One feels each new administration has ideas that differ from the previous one as to what needs to be done. While one might get some sense of the ideological struggles that take place, it is not always easy to discern what improvements have been made. Since starting my community worker career at the turn of the millennium , I have lived through a number of re-organisations, which don’t appear to have achieved much and has only added to confusion when trying to talk to the right people and, more importantly, making a difference when it comes to peoples’ health.

I don’t want to take sides politically, although I look forward to hearing from politicians from all parties concerning their ideas and commitments as to how they will deal with the NHS crisis, if indeed there is one, although without great expectation. I suspect, just as a few years ago education was one of the key election issue, this time around it will be health, so it is well to be forearmed. A recent political speech that did impress me was that by 91 year old Harry Smith at the Labour Party conference just gone. He related a number of incidents of needless suffering and death, prior to the Second World War, which might have been avoided if there was a free NHS service (a point that my late mother also made). It is why he was grateful for the setting up the NHS just after the war and his fear that the good work might be undone and we revert back to the bad old days. I sense a not too dissimilar scenario in many other countries and realise why people in the UK are proud of the NHS.

Personally, I have had a mostly positive experience of the NHS, but there are many who haven’t. Besides possible significant efficiency savings in the NHS, and I await the analysis and proposed solutions, there is the issue of escalating costs and the complaint that the NHS is not fit for purpose. The debate that will be and is taking place will no doubt revolve round how/whether to improve some/all of the services and whether more public money can be spent to improve the service or the service has to be cut back or privatised, and people made to pay and, if more money is to be spent, where will it come from, given that in many other areas public money has been reduced because of the current economic and financial situation.

For those who have read my earlier blog posts will know that two of my NHS “campaign” issues are for there to be a permanent health centre for my own area, St. Lukes Ward Southend, and better mental health services for the homeless. My frustration is that despite banging on many doors, over a long period, and supporting others who have done so, progress has been painfully slow. The doors banged on appear to have been the right ones, although given all the reorganisations who knows for sure if these were. Despite what seemed cast iron cases when argued at the time, those messages were largely ignored. There remains a lack of leadership, appropriate response and accountability, which beggars belief.

Prior to that, I was involved in setting up the Growing Together project, which helped people with mental health issues. While we had help from various statutory bodies, that from the NHS was minimal and my experience then was similar to what it is now. While I am mindful that there are service user led groups, which I am often invited to join, designed to make service commissioners and providers more accountable and responsive to public opinion, without demeaning the efforts of those who are involved, I wonder, based on past experience, how effective these are.

Similar concerns apply to many places elsewhere in the NHS, including the recently reported challenge that my own local (Southend) hospital faces – on one hand to deliver the excellent services which we all hope will be the case and on the other coming to terms with being in significant debt and having to cut costs. There are issues like doctor and nurse training (there is a grave shortage of British trained medical professionals), the relationship with social care and the social needs that add to the burden of the NHS, whether and how services are to be paid for, the use of the private sector and many more points that need to be raised. That discussion does need to happen but it will have to wait for a future post.

Meanwhile, I await developments. No doubt a lot more will come to light in the months to come, especially in the lead up to the 2015 General Election. I look forward to wading in, not just as an intellectual exercise but mindful of the 1942 Beveridge report that contained the words: “medical treatment covering all requirements will be provided for all citizens by a national health service” and with it the hope that the NHS service, begun 1948, will be fit for purpose and serve those in need, whatever their station in life.