In the last decades, and especially in the devolved parts of the UK, the “five Giants” which Beveridge described have been growing. Post code unfairness in treatments and outcomes is a regular matter in the media, and the public have become immune – until they themselves fall victim. Then it’s too late. Dead patients don’t vote, but their families do become cynical and restive… If readers wish to be reminded of the altruism which set up the original NHS read here: In Place of Fear A Free Health Service 1952 Chapter 5 In Place of Fear Neglect, short termism, and denial are the cause. In a media led society this is such a shame, but reflects the poverty of debate on ideological issues.
NHSreality has already commented upon the rationing of hearing aids, and that the delay in proper treatment may be linked to dementia
Andrew Grice for the Independent sums up the current situation and dilemma for the politicians: NHS England is rationing its services – Hammond’s Budget didn’t go far enough – The Budget’s gaping hole was on social care; it is close to collapse and putting ever-increasing pressure on hospitals through bed-blocking, but got no extra cash
A debate about rationing the care provided by the National Health Service will be launched tomorrow, when NHS England begins a conversation about what it can and cannot afford to do.
Although there will not be a hit list of cuts at this stage, the implications will be clear enough: the Government has not provided enough money to meet goals including the 18-week target for elective operations; cancer treatment; mental health; public health and obesity and for a creaking social care system. In short, something’s gotta give.
NHS England’s gloomy prognosis will come at a bad time for the Government. Theresa May has made mental health a personal priority. A green paper soon about expanding help for children will generate some headlines, but without money and staff there will be little or no difference on the frontline until 2021.
Similarly, ministers’ hopes that Budget headlines about a “£2.8bn boost for the NHS” would buy some political credit will prove short-lived when the continuing cash crisis is laid bare. Philip Hammond’s injection was less generous than it looked: £1.6bn for next year, well short of the £4bn a year prescribed by three independent think tanks – the King’s Fund, the Health Foundation and Nuffield Trust…..
…The Local Government Association estimates a £1.3bn funding gap between what care providers need and what councils pay. Although May acknowledged the problem during this year’s election, she got her fingers burnt with her so-called “dementia tax” and the issue has now been kicked into the long grass. We won’t get a green paper until next summer. That is woeful, given the additional pressure the demographic timebomb will put on health and social care.
While the debate over NHS rationing is inevitable, we need a much wider one about the state’s priorities. The 2010 and 2015 elections were followed by a government-wide spending review. There’s no sign of one now – another example of the reduced capacity of a government consumed by Brexit.….