My Lords, I add my thanks to the noble Lord, Lord Turnberg, for putting this debate on the table. In dealing with this question, I consulted the army of doctors, specialists and carers who enable me to be here today and to function. I asked them, as well as my colleagues in the department of health economics where I used to work, what kind of solutions they thought would deal with the problems that we face.
The general response was the suggestion that is already on the table—that you cannot have good health without having good preventive care at the very beginning, without having good food at schools, without having timetable slots for gym sessions and exercises, or without enabling the next generation to grow up healthy. The problem with the NHS is that people like me are now surviving and are costing a great deal. I am constantly in a variety of hospitals, being pumped and tested and put together. We are expensive—but I hope that we render some services.
On the other hand, what is absolutely required, more than care, is preventive measures. Also, my colleagues from health economics pointed out to me that, in terms of state funding, the NHS has been improving faster than the input to it, year after year since 2010. Essentially, efficiency is increasing; unfortunately, the burden that is put on that efficiency is increasing faster.
We cannot deal with that by looking at the National Health Service simply in terms of health and medication. We absolutely need to prevent people rushing to the NHS because their GPs are overstretched and they cannot get easy access to them—calling an ambulance ensures that they do get access to the NHS, whereas getting themselves to the GP is often costly and time-consuming and involves a great deal of waiting. So what is needed is to enable patients to have better access to GPs.
I do not think that that is served by having round-the-clock services in hospitals. I had dinner with a group of GPs last night. Many of them said to me, “It doesn’t matter whether you get your hernia removed on a Monday or a Saturday”. Hospitals perform a great many functions that do not need to be provided on a seven-day basis. We need to be able to separate what needs doing now, how we do it, and, particularly, how we secure the next generation’s health.