The National Health Service is facing a personnel and capacity crisis closely linked to a crisis in social assistance. “We have a diagnosis; the Government must now move to treat these conditions. Not doing so should be seen as an ideological choice, rather than because of a fundamental and innate impossibility of treatment.”
30 GEN –
England’s National Health Service has turned 75 and is not in good health. Patients with a suspected heart attack wait five times longer for an ambulance than the target wait of 18 minutes. In 2022, 347,707 patients spent more than 12 hours in the emergency department waiting for a bed, four times the number in the previous 10 years combined. Excess deaths in 2022 were the highest in 50 years. A record number of NHS employees leave.
This is certified by an editorial published in the The Lancet. “Unfortunately, things are likely to get worse before they get better. For the first time in NHS history, both nurses and ambulance staff will go on strike on 6 February unless an agreement is reached on wages. Even junior doctors will vote whether to go on strike or not. This is undoubtedly the most dangerous moment for the nas since its inception”.
It then explains how, although the symptoms have been present since at least 2015, “they have been misdiagnosed and not treated”. These include “underinvestment, staff shortages and running the system at full capacity have been exacerbated by profound staff demoralisation and burnout, increased demand for services and the winter surge in Covid and flu. Population health has been neglected, as have slowing life expectancy and a struggling social welfare system.
In the debate on possible solutions to the situation that has arisen, dal Lancet, there are several “useless distractions”. Firstly, “the government’s inclination is to believe that the current NHS model is unsustainable and needs radical change, with copayments and increased user subsidies. This view is deeply wrong. With the right approach, the NHS is sustainable and must maintain the principle of providing free care when needed, which is the foundation of a just society Secondly, that the NHS has a productivity problem; that it is not doing enough with what it gets This is tantamount to misunderstanding the purpose of healthcare, which is not a factory for the sick, judged by crude metrics of efficiency, but a service based on care, compassion, and quality. more for comparatively less is dangerous and obviously harmful”.
Thirdly, the challenges facing the NHS can be solved by tapping into a stronger private health sector. The UK private sector workforce is mostly drawn from the same workforce that makes up the public sector. Stealing from one to prop up the other and, at the same time, fatally fragmenting the health service makes no sense. Fourth, the proposal of a Royal Commission or a cross-party consensus is unlikely to be helpful. is facing a personnel and capacity crisis closely linked to a crisis in social care. We have a diagnosis; the Government must now move to address these conditions. Not doing so should be seen as an ideological choice, rather than because of a fundamental and innate intractability”.
There are two possible short-term remedies. “Firstly, the Government must recognize that the NHS is in crisis and requires unprecedented and urgent action. Secondly, it must deliver a message of value to NHS staff, in the form of a compromise on an agreement payroll and non-financial commitments, such as tackling pension reforms, improving basic working conditions and delivering on the promised workforce plan.In turn, the NHS must accept that, for whatever reason, it has a cultural problem. Racism, sexism, bullying, harassment and conflict are rife. A toxic work culture is an often cited reason for leaving the NHS and negatively impacts patient care.”
In the longer term, however, “investment in public health and prevention must be increased as the main way to reduce demand for the NHS. The government must abandon short-term cash injections and use tax-based funding to obtain increases sustained and predictable funds. In this way, capacity and resilience can be built from the ground up in the system, with investment in staff, buildings and technology. The NHS needs to improve the speed of development and diffusion of innovation and the adoption of new working models must not be blocked by the traditional view of roles and responsibilities Anything is better than the current welfare model, which monetizes vulnerability, enriches a few suppliers and leaves more than a quarter of staff of social assistance in conditions of poverty”.
“Negligent NHS care has brought the NHS to its knees. But contrary to rumors, there are some quick fixes. Last but not least, value and encourage NHS staff, who have responsibility to protect the nation’s health in an unprecedented economic crisis that is deepening inequality and pushing thousands into poverty and precariousness,” the analysis concludes.
January 30, 2023
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