Without cuts, the NHS is going to bleed out
[dropcap]T[/dropcap]he NHS is not delivering services to patients in time; employees striking over pay and working conditions; waiting lists are too long; mistakes are costing the taxpayer £2.5bn due to shortages of nurses and doctors and there is a £30bn funding black hole expected by 2021. Doom mongering about the NHS is no new phenomenon but recent trends suggest the NHS is at a pivotal juncture and something will have to give.
When Clement Atlee set out his plans for the National Health Service in 1945 I imagine he only had an inkling of the extent it would shape the UK. It has been a cornerstone of post WWII Britain and a pioneering project for welfare states throughout the world.
In many situations we take for granted the access to universal free healthcare provided by the NHS. Compare and contrast with Obamacare in the States, or the problems of receiving adequate healthcare throughout the developing world.
However, the widespread provision of free healthcare outlined in 1945 was a radically different proposition from the situation now. New medical and pharmaceutical breakthroughs seem to be hitting our shelves at a rate of knots. Treatments that were once physicians’ pipe-dreams have become a reality. All great news but everything comes at a cost. Alongside an aging population, we have seen demand for treatment and its cost spiral ever higher at the NHS.
Research shows that NHS funds are expected to run into the red either this year or next. Unlike the last time this occurred, in 2005-2006, the problem will only worsen until we are left facing a £30bn shortage of funding by 2021.
The back drop to this widening NHS budget deficit is that government offices have been slashed in other areas but a “protected” ring-fencing of the NHS budget has remained. It has been shielded from the savagery of government cuts due to its perceived importance to the electorate. The NHS budget has been increasing 0.7% above the rate of inflation over the last few years. Therefore the facts point to only one conclusion: unless the electorate succumbs to higher taxes, quality and quantity of service will be compromised and cuts to staff or the services will be inevitable.
Cutting valuable doctors and nurses appears unthinkable at a time when surgeries are jammed and medical staff regularly work overtime to deal with demands of the British public.
Compromising on healthcare is an unthinkable proposition.
Healthcare should always put quality over quantity with regards to services provided. Which means that the range of services provided for free by the NHS needs to be cut or savings must be made to services already provided.Maybe we should be charged more for less essential services such as dentistry? Should voluntarily obese patients or those who consume too much alcohol have to bear the cost of their actions?
My answer to these questions has to be yes. When we talk about public healthcare there are no easy answers but the NHS should prioritise treatment to those who need it most. There should be a comprehensive review which runs a cost-benefit analysis of NHS services to find out which are essential and which are not. This will not be popular, but the sums must add up. We should look to train more doctors and nurses and encourage the best quality of services for the areas which are most pressing and valuable.
In other areas patients should stump up a higher proportion of the costs or be forced to fund it themselves.
At the end of the day, the aim of the NHS is to provide a universal “basic” level of healthcare to every man, women and child in the United Kingdom. However, in the face of a widening budget deficit we need to re-think the model established in 1948 with the universal, wide provisions of services it provides needs to change. Our idea of “ basic” must narrow, otherwise the situation in hospitals and GPs will continue to deteriorate and strikes will become increasingly more common.
Comments (1)
It’s nice to see that you’ve noticed the crisis in the NHS; it’s a shame you’ve gone for the Mixed Infants level of analysis rather than what might be expected in a university.
First, the aim of the NHS is NOT to provide a universal “basic” level of healthcare to every man, women and child. It provides world-class universal care on the basis of need, not ability to pay. It’s never out of the top three of world health systems in survey after survey. And the great thing is, it happens to be the cheapest way to deliver high quality healthcare to a nation: through a publicly funded, publicly provided, integrated universal health care system – which is the NHS as it should be.
However, since 1990 (first under the Tories then Labour) the NHS has been chopped up and marketised; since 2010 (under the Coalition) it has been privatised. Marketisation drains money from the clinical side of the NHS and pumps it into the “business” side; privatisation shifts that money off to shareholders all over the world. In 2010, satisfaction with the NHS was at an all-time high after Labour (to give it it’s due) repaired years of Tory underfunding. Less than five years later, with “ringfenced” (frozen) budgets as the population grew and billions were spent on privatisation, there’s doubt whether it can make it through another winter.
It seems frightening but the answer is actually quite simple – and it doesn’t mean charging patients with rugby or drink-related injuries because “you brought it on yourself.”
End the internal market and return the NHS to a system that puts patients before profits and you put a tidy £10bn or so back into patient care. Do what’s necessary on taxes and allocate 10% of GDP to healthcare (currently only 9.2% to France’s 11.6%, Germany’s 11.3%, USA’s 17.7%) and that’s another £10bn in the pot. Certainly enough to get the system back on track and back at Number 1.
Yes there are decisions to be made about the NHS but remember that the Baby Boomers bulge will have worked itself through in 20 years. Let “an ageing population” be used as a pretext to end our world-class NHS and it’ll be gone – for good.