Having been privileged to officially open a wonderful new NHS heath centre on the Harrow Road last Friday (Health @ The Stowe), I could not avoid pondering the question of how we have allowed what is generally a success story in the NHS to turn into something of a public relations disaster. How can a near threefold increase in spending on the NHS, producing, amongst other things, 29,000 extra doctors, 66,000 more nurses, 380,000 fewer people on waiting lists and a near eradication of long waits for treatment, have turned into a daily media diet of ‘cuts’?

Of course, there are some obvious explanations. The delivery of health care is being re-shaped across the developed world, as new drugs and new technologies advance treatment in ways thought impossible only a few years ago. Hospitals still have, and always will have, a central role to play, but increasingly at the most traumatic and specialist end of the spectrum, so the shape and size of hospital provision is changing. Yes the changes in the way services are delivered can be challenging for communities, especially when there is also a background noise about financial pressures. Are these pressures real in themselves? Well, yes and no. Some local health trusts are in difficulties- Kensington and Chelsea Primary Care Trust, for example, found itself in serious trouble last year- but this was due to weak financial management rather than a shortage of money. Substantial and well-merited increases in pay and staffing levels in the NHS and new contracts for GPs and hospital consultations have accounted for the larger part of the extra spending, but this does mean that resources elsewhere in the service are not unlimited. Meanwhile, decisions by the National Institute of Clinical Excellence on which drugs to approve for NHS use will perhaps always generate controversy, as NICE seeks to determine the efficacy of new treatments upon which so many people’s hopes will lie. Inevitably, any decision to withhold approval will cause fierce disappointment in some quarters, but yet it is surely essential that someone makes a judgement as to what, out of the torrent of new drugs and treatments, represents good value for money? Finally, in a service which deals with tens of millions of people each year, there will always been mistakes and instances of bad practice, all of which entirely warrant exposure, yet which may also distort public perception of the NHS as a whole.

Perhaps expectations will always outstrip the capacity of a universal service to deliver, because we all understandably want the chance to benefit from whatever health care will minimise pain and suffering; prolong life and aid rehabilitation- and every day seems to bring new opportunities to do so. Yet I still think our aspirations for the future should not lead us to ignore what is being and has been achieved in the recent past. Whether this be in the form of bricks and mortar- as in the fantastic new ‘Health at the Stowe’ centre, or the quite dramatic reductions in waiting times for both in-patient and out-patient treatment at St Mary’s, or the big increases in local NHS staffing levels (400 more qualified nurses, 94 extra consultants)- the success stories greatly outweigh the negatives. To ignore the problems and the challenges we face in delivering improved public services would be a dereliction of duty. To focus on them to the exclusion of all that is good and improving risks pandering to the corrosive ‘nothing works’ cynicism so favoured by reactionaries everywhere.