Take the NHS out of politics and make it independent like the Bank of England

It doesn’t matter how much money, love and affection Conservative governments shower on the NHS in England, they will never be able to convince most of the British public the health service is safe in their hands.

Sadly, ministers know this, which is why they inevitably go on the defensive when they explain that more money is going into the NHS than at any time in its history, that they are dedicated to making it the best healthcare service in the world, and that they genuinely want the “cradle to grave” NHS to stay in government control and yes, improved.

Whatever Tory politicians say on this is misconstrued, attacked by critics as evidence of back-door privatisation or cutting services to save money. And if ministers do dare to remind people that it was Tony Blair’s Labour government introduced significant amounts of privatisation to the health care system, they are ridiculed.

One health minister, who is no shrinking violet, told me sheepishly that many of his peers have given up fighting this misperception because the belief that the Tories want to destroy the NHS is so embedded in the British psyche that only a lobotomy would remove it.

How depressing is that. This is a terrible, and daft, state of affairs for Britain’s health service – which consumes £100bn of taxpayers money – to be in. The paradox is that NHS England would not be safe in Labour’s hands either: in fact, in the hands of any political party.

For a Corbyn-led Labour government would follow the old socialist mantra that services need only more money to be made to work better, to be paid for with higher taxes. More pertinently, a Labour government would inevitably stifle innovation: perhaps the most important ingredient needed to revitalise the health service.

The idiocy of the political ping-pong game being played out between the parties was brought home again by the churlish reaction to NHS England’s decision this week to postpone all routine operations until the end of the month. The NHS top team – led by Simon Stevens – made the call to relieve some of the pressure of the health services as it copes with winter emergencies.

Yet once again the twitterbugs on the left were out in force claiming the decision was more evidence that the NHS is in “meltdown”; that the NHS is in crisis and can’t cope because of cutbacks and closures et al. That’s rubbish, and they know it.

By all reasonable accounts, NHS England made an eminently sensible decision to postpone non-critical operations: the sort of precautionary measure that any big business or organisation would take if it were caught in an emergency and did not have sufficient resources to cope as well as it wanted. (Many hospitals – like Addenbrookes in Cambridge – are still running to schedule, to date.)

If the tin-eared doomsayers had bothered to listen to Professor Keith Willett, NHS England’s director for acute care, who made the announcement, they would have heard him say that while postponement was not “ideal” the service is nowhere near crisis point.

No one pretends that the NHS is perfect. Nor does anyone pretend that more money would not fix some of the problems in the short-term. In the longer-term, however, there are complex, strategic decisions to take about the depth and nature of care that can be provided ad infinitum to an ageing population with multiple chronic illnesses.There are also big questions to ask about what constitutes an essential NHS service, and where funds could be saved. Only recently the NHS revealed that the cost of cancelled appointments is estimated to be about £1bn a year while half of the £15bn worth of drugs given out on prescription each year are not used by patients.

Then there are also choices to be made about the range of services being offered free such as the recent news that £12m a year was spent last year on anti-dandruff shampoos and indigestion tablets. Really? That could fund an awful lot of vital breast cancer drugs or hip operations.

But there are fantastic challenges – and opportunities too for the future health of the NHS. For the NHS – which is the world’s largest publicly funded healthcare service in the world – is also the world’s biggest and most comprehensive repository of clinical data and medical research, a repository of patient records built up over seventy years.

Finding ways for patients and UK taxpayers – and not tech companies- to benefit from the new commercial applications of NHS data was one of the main issues raised by Sir John Bell, professor of medicine at Oxford University, in his recent government-commissioned life sciences industry review. Sir John pointed out that NHS patient records – used of course with patient consent – are uniquely suited for driving the development of powerful algorithms that could transform healthcare and seed an “entirely new industry” in AI-based diagnostics.

But Sir John also raised the fascinating point that many people have missed the point about AI – that people have believed that the advances in AI have come  from new machine learning. Quite the opposite. He makes the point the value lies in the datasets used to train algorithms on tasks ranging from speech recognition to diagnosing diseases. Quite rightly, he wants the government to review how outside companies are given access to this data, and and examine the ownership of algorithms which are then developed using these records.

This is just the sort of critical health care issue which the government, and all politicians, should be concerned with.

So what should the Conservatives – and all those who care about the NHS and want to see an end to constant ping pong – been doing?

Instead of telling the public they care, they must show they care. They need to do something bold and brave; something out of the ordinary. Just as Charles de Gaulle was the one who took the decision on independence for Algeria and Tony Blair loosened the grip the unions on the Labour party by getting rid of Clause IV, the government should look at ways of depoliticising the NHS by creating a new independent structure in a similar manner to the way Gordon Brown gave independence to the Bank of England.

NHS England is nominally an independent body but it is insufficiently distant from government and needs to be depoliticised and decontaminated of petty party politics.

Imagine if the health secretary, Jeremy Hunt, had a relationship with Simon Stevens similar to that between the Chancellor, Philip Hammond, and the Governor of the Bank of England, Mark Carney? While the Bank’s relations with the Treasury are closely entwined, there is without doubt proper distance that reduces the scope for point-scoring. But the relationship is robust enough to ensure debate, as we saw when Lord King was Governor, and Alistair Darling was Chancellor.Such a newly created body could be owned by the government in perpetuity enshrined through golden shares – or another such structure. In terms of governance, a new NHS advisory board would compromise the usual bevy of independent experts but also cross-party MPs and lay people too. It might need a new name too – the National Wellbeing Service could be a healthy start. Something for Anne Milton, a former nurse and health minister, to chew on if she does takeover from Hunt in the forthcoming reshuffle.