Charlotte Leslie

For years, Secretaries of State for Health have studiously ignored one of the most corrosive regulations to the NHS: the European Working Time Directive. Although the EU is not supposed to have any remit over health, this 'health and safety' directive limits junior doctors' hours to an average of 48 hours per week, with added ECJ judgements imposing compulsory immediate compensatory rest time should hours be breached – and 'on-call' time classed as work, even if the doctor is fast asleep. This rigid imposition is neither healthy, nor safe; with junior doctors complaining that it has led them to do illicit work to get sufficient hours of training in, unpaid, less supervised, resulting in them being more tired and less trained.

If politics was science, you would call Wales the ‘control’ group, for public service reform. Here is a country where Labour are the only game in town and a socialist philosophy which places a monopolistic state provider at the centre of health care and education reigns supreme – yes, even more supreme than the pupils and patients this system is designed to serve. In fact, in devolved Wales, Labour are running the public services as Ed Milliband would like to see them; a Labourite utopia of State supremacy, with none of the so-called evils of alternative providers getting in the way of the tight grip of the State. So how is this socialist utopia going, then? If a recent Question Time from Newport is anything to go by, not so good.

When T.S Eliot spoke of the folly of trying to ‘Devise systems so perfect, that nobody will need to be good’, he effectively described a distinction between the left – who instinctively turn to systems to get things done, and the right – who tend to believe in focusing on individuals, people, and their values. In a world where the centre-ground has become over-crowded with political parties all frantically claiming it, and a rainbow array of party hues (Blue Labour, Red Tories), this is a distinction that still makes some sense. In fewer areas is this distinction seen more clearly than how we think of our public services. Whether we think of them as the people who work in them on the front line, or the systems they work in.

As the Mid-Staffs tragedy unfurls, it becomes more and more apparent that contrary to the insistence of former Labour Ministers and Prime Ministers, this was not an isolated case, but an appalling example of problems evident throughout the NHS. Indeed, back in 2008, the then Labour Government received reports from respected international health consultants warning of a culture of fear and compliance within the NHS; a place where the emphasis was on 'hitting the targets, but missing the point' and patient safety came second to presenting a set of statistics suitable for dispatch-box delivery.