Views & Reviews Acute Perspective

David Oliver: Grill the politicians live on TV

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h6461 (Published 02 December 2015) Cite this as: BMJ 2015;351:h6461
  1. David Oliver, consultant in geriatrics and acute general medicine, Berkshire
  1. davidoliver372{at}googlemail.com

The US television debates for the Republican presidential candidacy have been strangely compelling, with Donald Trump and Ben Carson’s bizarre pronouncements and a long line-up of egos. Claims and counterclaims are made about candidates’ records in politics or business. Moderators struggle to challenge assertions or aspirations. More heat than light ensues.

UK television election debates are blander, but the party leaders do face some glare. The mass media’s scrutiny of UK party health spokespeople is less effective: specialist health correspondents may fact check grandiose promises or professed achievements, but general political correspondents or newsreaders run the show.

Our health ministers and their shadows are held to account non-stop by health policy think tanks, professional societies, and journals. We see occasional exposés of the reality behind official party lines on the BBC or in Sunday broadsheets. Still, most voters aren’t health policy watchers who follow these niche sources. It’s easy for the NHS commentariat to forget this.

Ministers do give evidence at parliamentary select committees. These can land some bruising blows. But a series of disjointed questions from grandstanding MPs isn’t quite the skilled forensic set-up you’d get from a good barrister or detective closing off your exits one by one. And who watches them?

I propose something more radical. Why not, on live television, have politicians quizzed by a panel of health policy experts and NHS leaders, with enough time for dogged fact checking, graphics on screen, and a studio audience of experienced healthcare staff and patients? If any MPs were brave enough to appear we might see a very different dialogue about historical claims or fantastical promises.

For instance, would Labour’s 2015 manifesto, with its promise to recruit 8000 extra GPs, 20 000 more nurses, and 5000 home care workers,1 have survived expert scrutiny? And all for an additional £2bn in the first two years, when NHS England has requested £8bn, ideally frontloaded, as a minimum.2 3 Or how about the inevitable reorganisation and bypassing of the Five Year Forward View to deliver Labour’s vision for integrated health and social care?

Imagine the Conservatives’ health team being grilled on the disruption and cost of the 2012 Health and Social Care Act,4 the barely credible £22bn savings target for the NHS,5 the lack of credible workforce plans to support a seven day NHS, or the dissonance between their commitments to public health and spending.

Likewise, the Liberal Democrats could be challenged on their complicity in passing Andrew Lansley’s bill and in the damaging cuts to social care funding in coalition.4

It would be a bloodbath, but the fear might lead to the kind of honesty and transparency that Jeremy Hunt says he wants.

Notes

Cite this as: BMJ 2015;351:h6461

Footnotes

  • Competing interests: I have read and understood the BMJ policy on declaration of interests and have no relevant interests to declare.

  • Provenance and peer review: Commissioned; not externally peer reviewed.

  • Follow David on Twitter, @mancunianmedic

References

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