Events of the last couple of weeks can leave nobody in much doubt that the NHS is struggling this winter. But does this signal the death of the NHS, as the tabloid press is spinning it, or is it just a temporary blip as the government would have us believe?
The answer lies, as always, somewhere between the two but I believe that a perfect storm is brewing. We require urgent and decisive action or we will see the end of the NHS as we know it before the end of the next parliament – regardless of who wins in May.
The NHS is part of the fabric of our nation and the vast majority of the public have not yet accepted the message that its future is really under threat. After all it is among the most efficient and effective healthcare systems in the world. How could we possible let it go?
This series of 3 blogs is written for the large section of the public who to date have had relatively little information about the issues, but it should also be of interest to those with a greater depth of knowledge. I hope to persuade you that there is a clear and present danger. I you disagree with me on any point please leave a comment at the end. If you think I am wrong you must say so. If you agree you should share the links.
In the first of three linked articles I will outline 10 significant threats to the service. In the second I will suggest where we are heading if no action is taken. The final blog will cover what I think we could do to improve things and give you an opportunity to share your ideas.
Reasons to be fearful
- An aging population – We are all living longer. The average life expectancy goes up every year. Sadly much of this extra life time is spend in declining health so our need for health services increases even more.
- The obesity epidemic – Obesity rates are rising rapidly. Currently 25% of us are obese and this is expected to rise to 50% by 2050. Obesity is associated with high blood pressure, heart disease, diabetes, stroke, arthritis cancer and depression plus many other conditions which require health care.
- Increasing public expectations – There is an almost limitless amount of potential demand for health services. People can chose to treat themselves or ask for help from a variety of services ranging from pharmacists to hospital consultants. More are choosing to ask for help and are likely to choose the highest qualified. This is particularly noticeable in patients who are coming to the end of their lives. In the past it was often considered most appropriate for GPs to treat them at home. Indeed this may be the kindest approach in many instances. Nowadays it is increasingly common for people nearing the end of their lives to be sent to hospital for care.
- Struggling social services – social care budgets have been cut by up to 40% over the last few years despite the increasing needs of an aging population. When social care fails people turn to the NHS in times of need. Hospitals are always open and will fill with people who really don’t need health care have reached a crisis and have nowhere else to turn.
- New and expensive therapies – Cancer drugs, proton beam scalpels and robotic surgery all hit the headlines but every day hundreds of new treatments are launched which are slightly better and significantly more expensive that the old ones. The public expect access to the best but it creates huge healthcare cost inflation.
- Fixed or shrinking budgets – Whatever the government says, real NHS budgets have been falling since 2012 and are forecast to continue to do so.
- A negative press – the NHS frequently gets undeserved negative press coverage. I have written about this elsewhere. Suffice to say that it could undermine its reputation in the eyes of the public, which will make it harder to obtain the political support for necessary reforms.
- Poor staff morale and recruitment – increasing work in the face of decreasing cash and a hostile press make it harder to recruit. We now rely heavily on staff trained overseas, but this valuable resource will not keep us going forever.
- Privatisation – changes in the law (TTIP and the Health and Social Care act) that will encourage private companies to take over part of the NHS are coming into force. Private companies will inevitably cherry pick the easy and profitable parts of the service, putting the remaining section under increased pressure.
- Lack of political will. The NHS is a problem for all political parties. It requires investment and reform. No party seems to have the appetite to make the difficult decisions about tax and public consultation that are so desperately needed. Letting it fail will get them off the hook. As we approach another election the main parties will expend a lot of energy talking about the NHS while becoming increasing incapable of taking any meaningful action. This at a time when the service will be under most pressure and likely to need decisive management.
So I hope that you are convinced there are difficult times ahead. If nothing is done there is a danger we will drift into a more fragmented hybrid public/private service with insurance top ups and will lose the core values of the NHS. Care will be less efficient, inequitable and being ill will become a financial as well as a physical problem for many. More of this on part 2 of this series.
If you agree with these points then please share this post with others. If you disagree then say so in the comments box below.
Part two in this series of three and be found here.