It is time for a proper debate about the future of our NHS

August 23, 2016 10:50 AM

For some, the National Health Service is more than just a healthcare system - it is a sacred cow moulded in our national identity. As a consequence there is precious little debate about how it functions or how it is funded.

And the lack of such debate and consequential reform lets down the patients who need treatment but also the taxpayers who pay for the substandard service we have come to expect.

And the Guardian reported today that the government’s pledge to create a seven-day NHS could be unworkable due to the existing lack of staffing and funding despite receiving extra money from the Parliament every year. It seems that no matter how much taxpayers’ money is thrown at the problem, there appears to be little prospect of any long-term resolution.

To get a full sense of the growing crisis in the NHS, just read two weeks’ worth of headlines:

  • 43% of health boards provide no specialised mental health care for mothers –thousands of new mothers with untreated post-natal depression can mount to a cost of £10k per woman. (Daily Mail)
  • Patients could be denied treatment that gives hope of longer survival. (The Times)  
  • New cancer treatments are not being made available, lagging behind other western countries as the NHS is failing to negotiate better drug prices (Telegraph)
  • Bed blocking pushes hospitals to ‘breaking point’- more than 6,000 elderly people are trapped needlessly in hospital beds each month as nursing homes, families and social services fail to provide adequate care, costing £6bn to the NHS. (The Times)
  • Statins are the latest thing to be ‘rationed’ due to desperation (Telegraph)
  • The Patients Association warns average waits for 5 common procedures at the highest levels since began compiling figures 6 years ago. (Patients Association UK)
  • A Patients Association report shows that thousands of patients had surgery cancelled on the day that they had been due to take place last year (Telegraph)
  • Increasing numbers of patients will be left to endure “crippling pain” as rationing spreads across the NHS, one of Britain’s most senior surgeons has warned. (Telegraph)
  • Crisis-hit hospital trust may close Grantham A&E at night: Hospital bosses could shut an accident and emergency department at night in order to combat a staffing crisis (BBC)
  • NHS failure on medicine prices costs public £125m. NHS officials waved through medicine price rises of up to 600% with no questions asked. Alert on drug prices came two years ago, includes a 1000% rise in cost of eye drops. (The Times)

Long waiting times, appointment cancellations, closure of existing services, lack of provision for new treatments, staff shortages, hike in medicine prices, cost of bureaucracy… the list goes on and it’s grim reading.

The consistent theme is that there is of either rationing or queuing. Given that everything ‘free at the point of use’ this is hardly a surprise – there is no incentive not to consume.

Without serious structural reforms, continued pressure on our healthcare system is inevitable, and the wider economic and social consequences of this should be clear to anyone. So there needs to be much more open debate about how we fund our healthcare system.

Looking at the French or Dutch style insurance system which have genuine competition, choice and superior outcomes for patients while also providing universal coverage may be a useful start.

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