If laughter is the best medicine Dr Phil Hammond just might be the ideal cure-all… but Happy Birthday NHS tour also covers serious side

REPLACE hospital beds with bunk beds – bed crisis sorted!

That’s one of the suggestions Dr Phil Hammond has had on his stand-up comedy tour Happy Birthday NHS, on which he asks his audience for their ideas on how to improve the health service.

The wonderful NHS turned 70 this year after being launched in 1948 by Health Minister Aneurin Bevan, its chief architect who based it on three core principles: that it meet the needs of everyone, that it be free at the point of delivery and that it be based on clinical need, not ability to pay.

“Another suggestion that really made me laugh, and I thought it was serious, was that a nurse’s uniform can cost more than £100, but you can buy one in Ann Summers for £19.99 and it’s wipe-clean!” laughs Dr Phil, a BBC radio presenter and regular on TV shows such as Have I Got News For You.

“I talk about the history of the NHS and my passion for it but I’ve been doing NHS-related shows since 1990 when I was a junior doctor in a double act.

“I’ve done a few shows so far, and it’s a combination of celebrating the joys of the NHS, some of its history, how it’s changed in the 30-odd years I’ve worked in it and looking at ways of improving it for the future.

“My favourite suggestion so far is that all Cabinet members and their families have to be treated in the worst-performing hospital in the country.

“There was another great one that people who shelter their money in tax havens can still call an ambulance but it has to come from the Cayman Islands!

“And how about all political pledges have to be legally binding even if they’re written on the side of a bus!

“But then you get actually quite serious ones, and what I’ve noticed is people don’t mind a bit of serious.

“One was a chap who said there should be mandatory safe-staffing levels, what you have on an aeroplane you should have in an intensive care unit.

“There needs to be the right number of staff to keep it safe but there’s no legal requirement.”

I suppose the first question for Dr Phil really should be is the NHS worth saving?

“It is but it’s not simple,” says the man who qualified as a doctor in 1987 and worked as a GP for more than 20 years.

“It’s definitely worth saving for its ethos, the idea that we put our money into the centre and we pull it out according to need so that nobody goes without and everybody gets the treatment they need.

“That’s absolutely safe, most people would unite around that.

“But most people now realise it needs more money and more staffing, though there are disagreements on how you should raise that money.

“Just comparing ourselves to Germany, since the year 2000 if we’d put the same proportion of our GDP into healthcare as they have, we’d have put an extra £260 billion into the NHS.

“It’s very hard to reverse that sort of starvation over a long period time so, yes, the Tories are putting a little bit more in but it’s not nearly enough.

“There’s also an issue of self-responsibility. We do know how we lead our lives has a big impact on our health.

“Some people are destined to be unhealthy but most of us could probably do a few things to take the pressure off ourselves and off the NHS.

“I think we need to move a bit more towards self-care and self-responsibility but not so far that we say, ‘If you get sick it’s your fault.’

“The vital components of health start with connection – unless you feel connected to a particular group of people, it dramatically affects all other aspects of health so rekindling communities is vital to rekindling our health and taking the pressure off the NHS.

“So yes it’s worth saving but we have to do more than just put more money in, we have to do things on the ground to improve our health but more importantly to improve the health of others around us who are struggling, particularly older people living on their own.

“That ethos that Nye Bevan had that we’re all in this together is really important.”

Asking his audience how they would improve the NHS was supposed to produce “The People’s Plan” but Dr Phil’s had to rethink that part of the show.

“I’ve been giving my view for years and I thought, ‘Wouldn’t it be interesting to go around the country and pick up a people’s plan which I could then publish?’,” he says.

“But having done a few events one of the commonest suggestions was ‘Dr Phil for Health Secretary’ which I hadn’t really considered and didn’t really want to do!

“But then I thought, ‘Well, if I’ve got to do that then I’ve got to become an MP first so Jacob Rees-Mogg, I’ll have a crack at him in my constituency of North-East Somerset.’

“I tweeted that and was immediately taken off air by the BBC. They said I could be broadcasting to my constituents and even if there isn’t an election for another two years, I had to come off immediately so it’s all gone a bit wrong!

“So while the original idea was to get a people’s plan, I think now it will become my manifesto if I do eventually stand. Though I did say that if Labour decide they really want to have a crack at Jacob Rees-Mogg as they may well do, I will stand aside because there’s no point splitting the vote.”

Dr Phil experienced the sharp end as a GP but we’re now seeing more and more people using the A&E as their doctor’s surgery.

“I don’t always blame them – sometimes you just can’t get access to a GP so who else are you going to go to?” he says.

“In England, they keep trialling apps where you see a GP on a mobile phone but the trouble there is a GP gets about £140 for an entire year for looking after a patient, it’s peanuts, you can’t insure your hamster for that.

“But these companies come in and cherry-pick the fitter, younger people who want to see their GP on a mobile because they don’t have complex medical problems, but when they take the £140 from those patients, it means the GPs are left with the more complex patients with less resource to look after them.

“Most healthcare is now looking after people who are getting older with complex diseases, but it relies on the fitter people being able to subsidise that.

“Technology can help, it can make sure the right notes are in the right place and that we get our blood results on time, but you can’t replace that human aspect of it.

“And that’s what needs most support at the moment because the stress levels in NHS staff are often worse than their patients, we’re killing the staff through work-related stress.

“The NHS needs to be properly managed and I think managers get a raw deal at times.

“But the problem is ‘continuous re-disorganisation’. Whenever we have a change of government, they throw out the previous health reforms and try something else, even if the other lot had actually had a good idea.

“This means the managers can’t make sense of anything and it’s worse in England where you have competitive tendering which siphons off billions, whereas Scotland and Wales very sensibly turned their back on that.

“I think when the Tories say they love the NHS they mean they’d love it off the public finances and want to outsource.

“But in 20 years of writing for Private Eye the one thing I’ve learned is that outsourcing is rarely the answer, particularly in healthcare, which is really complex and not about a simple profit motive or bottom line.

“The disastrous Health and Social Care Act meant the Health Secretary only has to promote universal healthcare rather than provide it and now because of that a lot of community contracts are going out to tender.

“This means the likes of Virgin pop along and over-promise, which splinters care, and they can’t make a profit out of it so they either cut back services or hand back the contracts and it’s just a huge mess.

“I think public services should largely be publicly provided, though not entirely, we’ve never been able to provide all the psychiatric care we need on the NHS for example.

“Which is something to bear in mind considering the fact trying to fix the NHS could send you mad.”

For further information, visit www.drphilhammond.com