The NHS: A winter of discontent?

The conclusion from Sir Robert Francis that the NHS faces an ‘existential crisis’, for me is justified. Over the last year, it has become increasingly clear that our health service is facing a profound challenge, both in its operation and delivery of vital services. And yet, the recent announcement that the Department of Health misplaced over 500,000 confidential patient records, is fuel for the ever worsening fire. 

This worrying revelation, of which the Shadow Health Secretary branded a ‘cover up’, has reportedly resulted in 173 cases of ‘patient harm’. The figure emerged as the Health Secretary, the Rt Hon. Jeremy Hunt was forced to make a statement in parliament on Monday afternoon to respond to MPs in relation to urgent questions tabled by the Labour Part and the Liberal Democrats. 

This exacerbates the wider issues facing the National Health Service. The blunder comes only weeks after an exclusive report by the BBC highlighted the worsening conditions of hospitals situated around the UK. Alarmingly, it was reported that this winter, the NHS performed at its worst level for over thirteen years. Recent figures, bear this out.  The service has a target of admitting, transferring or discharging 95 percent of patients who come to A&E within four hours of checking in. However, in December 2016 just 86.2 per cent of patients were attended to within four hours, the lowest figure ever recorded for the health service. Furthermore, it is believed that nine out of ten hospitals had an unsafe number of patients during the winter of 2016-17. Yet, the issue has not abated. 

The emergence of these figures, prompted the Health Secretary, after months of silence to voice his views on the factors underpinning the current crisis. Mr Hunt admitted that the current standards of care publicised were ‘completely unacceptable‘. In an interview with the BBC, he stated that it was vital to treat and care for as many people at home and in the community, with an emphasis on social care, to lessen the burden. 

Yet, Jeremy Hunt seemed to criticise the reporting of the issues surrounding the NHS. To an extent, this is understandable as one would be right to note that this is not a situation unique to our health service. Jeremy Hunt stated that ‘all health systems are grappling with similar problems.’  The Health Secretary also questioned the claims that the UK Government is not providing enough funding. In comparison to the health services of both France and Germany, of which reportedly spend more on their health infrastructure, the UK performed better in 14 out of 35 measures.

So, what is it that has sparked the crisis that is engulfing the NHS? Well, for Mr Hunt, it is the ever increasing ageing population that is putting pressure on the infrastructure, with more social care being needed. Yet, Sir Robert Francis (QC) believes that the financial pressure on the NHS- along with high demand- has created a scenario in which a care scandal equal to Mid-Staffordshire (the area he reviewed) was ‘inevitable‘. However, it was announced on March 8th, in the Chancellor’s Spring Budget that £2 billion will be invested into social care. With a financial commitment like this, the issue of a lack of social care could be averted, lessening the impact on the health system. Yet, it has been argued that this cash injection is too little too late. One commentator stated that a large proportion of the sum will be spent on paying the new ‘minimum wage’. Only time will tell. 

The Wanless report acknowledged that NHS under-funding has failed to deliver a system fit for the twentieth century, with areas such as life expectancy and infant mortality making Britain, what the Daily Mail quoted as, “the sick man of Europe”. Figures from the OECD have highlighted that since 1998, the UK spends 6.7 percent of GDP on health care, as opposed to the European average of 7.9%. Despite the comments from Mr Hunt, this is a worrying comparison. The report concluded that an NHS funded through public taxation was the best way to provide fair, efficient and economic health care. This seems, to me, to be a sensible approach to further improving and strengthening the health service. Although the latest Budget pledge for social care is considerably larger, the main focus should be also the heart of the health service. 

A proportion of society has called for increased privatisation, a pragmatic approach, suggested supporting the NHS. But, is this really the way forward? Adopting a neutral approach makes an interesting read of the factors on both sides of the argument. A key argument against stresses that a myriad of different bodies that make up the NHS, especially in terms of contracts to service providers erodes one of the key principles of our health service- free at the point of delivery. Yet, our health service does need help. One argument ‘for’ privatisation has revealed that it gives clinical commissioning groups the opportunity to find better value contracts. This will, in essence, protect the key principle of the NHS being free at the point of delivery and improve the conditions of the service. 

Will the situation with the NHS improve? With the Chancellor’s latest budget announcement, it seems as though the recovery process may start to take-off, but there is still much work to be done. 

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