Carstairs: Political football?

Cohorts, loyal followers and valued others, I have a gut feeling that our NHS is going to shoot up to the very top of the agenda in coming weeks and months - and let's hope years too, for it needs to get its house in order.

The question of whether Prime Minister Brown is, as claimed by his detractors, or is not kicking our beloved and beleaguered national healthcare system around like a 'political football' we will come onto in a moment.

But first, some food for thought: Britain's public sector healthcare provision is at best mediocre, according to the latest European health system index issued by Health Consumer Powerhouse early in October.

Of 29 countries to be assessed, Britain - whose NHS has been said to be the envy of Europe and which has, by some senior people at EU-level, been referred to as a 'benchmark' - crossed the line in 17th position; just three better than Slovenia.

Hmm. We have slipped too, down the rankings from earlier in the year and are apparently struggling to keep up with our western European neighbours.

The seemingly more successful Bismarckian way (based on competition between insurance bodies), takes the lion's share at the top of the table. First is Austria, followed by the Netherlands, France, Switzerland and Germany.

Yet, Britain was also beaten hands down by some newer and much poorer Member States, such as Estonia and Cyprus. First they hammered us in the Eurovision Song Contest and now they've bettered us at mending broken people. If this keeps up, soon we won't have to worry about an immigration policy at all.

What are we particularly bad at in the NHS? Long waiting times, patchy/regional healthcare provision, low rates of five-year cancer survival and the relative likelihood of catching a nasty, such as MRSA, while lying in hospital. What are we not so bad at? Patients' rights, apparently ñ and ironically. I mean, do we not have a 'right' - given everything, including the NHS funding boost in recent years ñ to receive some of the best care in Europe? Do we not have a 'right' to be placed somewhere free from murderous bugs during our enforced and uncomfortable convalescence? Do we not have a 'right', if we're unfortunate to require treatment for a cancer, to hope to live as long as we might in any other rich, advanced, leading, western nation?

A few weeks ago I was eating luncheon with a GP, who told me that he would never rely solely on the NHS for medical treatment. "Dear fellow no, I'm private", he uttered somewhat forlornly, "as are all my colleagues. You ask any doctor and I'll bet you your pudding they'll have the best private healthcare cover."

So, to the point: Gordon Brown is reportedly considering an election to check on his popularity ñ by the time you read this, he may have already made a decision - and it seems that the NHS will be a significant driver in pushing those swinging voters in the right, that is 'left', direction. Lo and behold then, the government nips out a swift interim report on the plans of leading cancer surgeon and health minister Lord Darzi to make NHS services in England much better. Fine timing that, what?

Floppy-haired, Henley-dweller Boris and his ex-Eton, ex-Oxford mate Dave's party has been cynical about this, calling the report 'cobbled together', while the Mingster's bunch have pointed to the possibility of it being just a "political stunt ahead of a possible general election."

Putting aside the political fencing, surely the question of the moment is simply thus: how can the NHS deliver better healthcare than it does currently? Come on, someone must know. Maybe you do. If you can answer this question in 150 words or less, please send an email to editor@pmlive.com and put 'Letters' in the subject line. If we get enough, I'll showcase the most interesting in November. Go on, be the one.