Happy New Year? The pressures on the NHS will only increase in 2016

Kailash Chand in The Guardian 4th January 2015 reports: Happy New Year? The pressures on the NHS will only increase in 2016 – If the health service is to survive, it needs to be properly funded, adequately staffed, and with patients and clinicians in charge

As we look ahead to 2016 it is clear that the pressures on the NHS will, if anything, increase unless the government takes urgent action. Jeremy Hunt’s manifesto pledge of more GPs is a complete fantasy and the prime minister’s seven-day NHS project is a political gimmick. The government has made empty promise after empty promise about how it plans to recruit an additional 5,000 GPs by 2020, yet it doesn’t face up to the reality that there aren’t enough entering the profession. A BMA survey showing that a third of GPs plan to retire within five years suggests the problem is only going to get worse.

It is not just primary care that faces an uphill struggle in 2016. In England, there are NHS trusts facing a record deficit of £1.6bn, which will manifest itself in longer waits for patients, cancelled operations and more pressure on staff and resources.

The NHS continues to face unprecedented pressures such as soaring demand and a crisis in recruitment and retention. The pressures are now spreading to other parts of the system. Once in hospital, doctors are finding it difficult to discharge patients because the support services in the community needed for the most vulnerable are not available. Waits for diagnostic tests are lengthening and the key cancer targets have not been met for some time. The cuts to social care are not only devastating for the lives of vulnerable older people, but are having a knock-on effect on the NHS.

The government says that it has made a start towards fixing the problems in the NHS with the extra £8bn a year it has promised by the end of this parliament. But while on the one hand it gives, with another it takes away with its plan to use so-called efficiency savings to find the additional £22bn the NHS needs.

The number of over 65s is expected to increase by 50% in the next 20 years, and the number of people with obesity continues to climb. Remarkable advances in healthcare mean people are living longer and survival rates for diseases such as cancer are improving. This means more people are living with lifelong conditions, such as diabetes, and have complex medical needs. Unless we find a sustainable way of dealing with an unprecedented rise in demand, the health service will not be able to cope. It is galling that the government has stopped short of any real measures to tackle the amount of sugar in our food or the amount of alcohol people are consuming, while at the same time cynically cutting £200m from the public health budget.

The NHS, struggling with long-term conditions and an ageing population, is being swept on a tide of demand it cannot control or predict, nor is equipped to deal with. Mental health services, which are already struggling under the strain of demand, inadequate funding and incompetent commissioning decisions, will not achieve the parity with health, at least in my lifetime.

The Health and Social Care Act 2012, and its focus on competition, privatisation and marketisation, has brought the NHS to its knees. The NHS family has been treated in a stepmotherly fashion by this administration. Junior doctors, consultants and GPs are in dispute with government about their new contracts. Emotions are running high and it is in the interest of no one for there to be industrial action, but when doctors’ backs are up against a cold wall, anything can happen.

If the NHS is to survive, we need to get back to basics – a health service that is properly funded, adequately staffed, with patients and clinicians in the driving seat. Healthcare which is public, integrated – not a two tier, part-privatised health market. It’s not too late to turn things around, but if we don’t act now it soon will be. Until 2012, the NHS was the most efficient healthcare service in the world, delivering the best value for money and the highest quality of patient care. Now the health of the NHS itself seems to require critical care. As austerity bites further, it is likely to require palliative care unless the public reacts to awaken the politicians.

There are some positives, however. Despite the increasing workload pressures impacting on the NHS, dedicated staff continue to work around the clock to provide patients with world-class care. When junior doctors took a stand against the government’s ill-advised attempts to force upon them a new contract – one that would be unsafe for patients, unfair for doctors and unsustainable for the NHS – the rest of the profession stood with them in a show of solidarity that spread from the ward to social media. And the power of the media and public sympathy for the NHS just simply hit astronomic levels with the Christmas number one hit by the NHS Choir, a group of dedicated doctors, nurses and other health professionals, helped no doubt by pop icon Justin Bieber’s tweet. He told the public to “do the right thing”. I advise Jeremy Hunt and David Cameron to take a leaf from his book. Do the right thing for the NHS.

NHSreality feels strongly about the smell of the politics and language of health – it’s all a load of s…t

 

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This entry was posted in A Personal View, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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