The year 2020 will go down in history as the year in which the United Kingdom civil service in all its parts and guises came under the spell of Twilight of the Gods. The myth of administrative capacity has been hugely damaging to the essence of the National Health Service and the Public Health where coal face workers have been sacrificed by a lack of competence in Management and a chaotic response from Government Leadership.
The opportunity is to do what Beveridge wanted but Bevan could not create. Provide a non political economically independent health and care fund by payment from employees and employers alike over a seven year initial period, building in effect a sovereign wealth fund that would gradually take over functions of capital expenditure and operational cost allowing general taxation to be removed from the funding of what has become an over mighty unimpressive inflexible juggernaut that relies totally on the clinical workforce who were sacrificed many times over in futile attempts to stem the spread of infection and treat the suffering of patients.
The current political, economical and social mix of control cannot arbitrate a pandemic and the structures in place allied to missing co-ordinating structures were agonising to perceive. There are many solutions that can be offered but constant changes to healthcare provision since the 1930’s
have yet to prove satisfactory.
The current models do not provide answers to what to do with the elderly, what to do with the chronic sick, what to do in casualty and acute medicine and how to avoid rationing. Cradle to grave is a slogan, but personal responsibility for an insurance payment by all adults over the age of 18 through a national fund has never been tried but might be the only be remedy.