Alistair Burt, Health Minister, resigned this week. It's important news. It's not because of a scandal, nor (as he joked) because resignations are contagious. He's just stepping down. Hardly worthy of headlines compared to the Brexit story, the leadership contests or the Chilcot enquiry, is it? Well actually, yes.
A minor minister's resignation might not appear to be big news, but whilst we're distracted by the headlines it is these minor players and their under-the-radar policy moves that reveal a stark insight into where our public services are heading. And the prognosis is bad.
During Alistair Burt's short stay at the Department of Health since 2015, he has pushed to cap pharmacy spending, equating to a £170m cut for pharmacy services (like flu jabs). The knock-on effects from a pharmacy cap will effect everyone and seriously damage the NHS. Bad policymakers are seldom caught red-handed like this, but everyone's too busy reading Chilcot to notice Burt leaving in the wake of a million signature petition against his legacy.
The pharmacy cuts sprang from DoH plans to stealthily cut NHS spending by cutting around the famously ring-fenced portions of the NHS budget. They discovered that pharmacies are the only access point to publicly-supported healthcare that is more numerous in the UK's most deprived neighbourhoods than affluent ones. Burt proposed a plan to reduce the density of these so-called "cluster pharmacies". The cuts will reduce the number of UK pharmacies by about 20-24%, the bulk of them in the UK's poorest communities. This is not a "one nation" Conservative policy. It's also going to backfire on the DoH and the next Health Minister if the cuts go ahead as planned.
Research conducted by the Quadrangle Research Group for the National Pharmacy Association puts this cut into context. There are three main points to note:
Firstly, this proposal disproportionally hits the UK's poorest neighbourhoods. The UK's poorest 10% of neighbourhoods will lose 22% of their pharmacies, whereas the 10% most affluent will lose only 1%. Scale that up and the poorest 50% of the country will bear three times more closures than the 50% better off. Pharmacies rank as the top healthcare provider for minor ailments like ear ache, constipation and sore throats, and are used heavily for advice on using medicines by mothers and female OAPs. So this cut removes an important service from the poorest mums and grannies in the country more than any other demographic group.
Secondly, the pharmacies most likely to close are small, independent chains (British SMEs, not big tax-avoiding offshore corporations like Boots). This policy targets one of the few categories of small business that survives in deprived areas more than affluent ones, removing an important tax revenue source from weakest local economies with the highest levels of unemployment.
Thirdly, the NPA research showed that respondents named their nearest GP, A&E or NHS Walk-in Centre as the place they were most likely to visit if their nearest pharmacy closed. On a nationwide basis, this will put at least 1 million more people through struggling NHS services every week. When you combine that patient increase with the fact GPs are retiring three times faster than new GPs are being recruited and the high attrition rates for A&E doctors, that sudden rise in NHS patients will cost the nation significantly more than the £170m it saves.
Burt's legacy will reduce healthcare provision in the areas with the lowest life expectancies in the UK, close SMEs in the UK's weakest local economies, and force more people into NHS services where they are struggling the most. It is a national health crisis in the making.
It is a policy that illustrates precisely how the current administration is, through bad planning, disproportionally loading the pain of austerity onto our poorest communities. It's also a policy that will eventually increase everyone's waiting times to see the GP or receive emergency care. 52 million more NHS visits per year? Does that sound like a sensible plan to anyone? No wonder Burt is resigning.
Yet there is barely a ripple of comment in the political press. There is still a chance, albeit very slim, that the cuts could be voted down in Parliament, but this seemingly minor policy is unlikely to get much of a hearing in the wake of the Brexit upheaval, if there's time to debate it at all.
Let's hope Burt's legacy gets a bit more news attention than his resignation did, before you need to see the doctor...