70 Years On: Protect Our NHS
Last week the National Health Service celebrated its 70th birthday to much fanfare and celebration. The NHS has been described as one of the greatest social achievements of the 20th century with its promise to care for the British people from cradle to grave. But all is not well.
All the key indicators within the NHS have worsened, with waiting lists reaching 10-year highs. A shortage of doctors, nurses, beds and care packages for elderly patients means that black alerts, trolleys in corridors and dangerous safety levels for patients are at a peak. NHS England has cancelled tens of thousands of hospital operations, which is creating the biggest backlog in the health service’s history.
A&E services are in a permanent state of chaos. What was once confined to winter is now an all-year-round occurrence. Despite the former Health Secretary Jeremy Hunt’s boasts, mental health services are still woefully underfunded. There has been a closure of more than 4,000 mental health beds since 2012. Social care services are in a state of paralysis.
The £2bn pledged in the budget to reverse £5bn of cuts to social care funding is nothing more than a sticking plaster. Funding reductions for local authorities - in some places reductions are as high as 40% - have undermined the viability of many local authority social care services across England. This has resulted in more patients arriving at A&E and more patients trapped in hospital as the necessary social care support needed to ensure their safe discharge is no longer there.
GP services are also in a perilous state. Billions of pounds of health service funding have passed to non-NHS providers under the Tories. That sum will continue to grow.
The NHS is withering away, and if things carry on as they are, then in the future people will be denied the care they once had under the NHS and have to pay more for health services.
The way forward is clear: the next labour Government should introduce the NHS Reinstatement Bill at the first Queen’s speech, abolish the Health and Social Care Act 2012 that fragmented care and push the NHS towards a market-driven, “out-for-tender” mentality where care is provided by the lowest bidder. Reversing this costly and inefficient market bureaucracy alone will save significant sums. Above all, the secretary of state’s duty to provide an NHS throughout England must be reinstated, as in Scotland and Wales.
In principle I support the integration of health and social care and closer collaboration between NHS services and clinicians. But I am fiercely critical of some of the ways NHS England is attempting to deliver this integration (primarily the Sustainability and Transformation Partnership and the Accountable Care Organisation) due to concerns around their accountability, engagement, and the requirements placed on them to deliver significant financial savings by rationing of the health care.
The internal market and existing legislation on competition within the NHS are not compatible with integration, and need to be removed before integrated models of care can be successful.
We must restore the principle of fairness through the national terms and conditions of service for doctors and all NHS staff. It is imperative that we restore trust between the professionals, patients and politicians. Above all, we must allow professional standards to thrive since these are the basis of public and patient trust. And, the NHS must move from a disease and treatment model of care to one of prevention, by promoting a healthy diet and lifestyle.
The founding principles and values of the NHS have stood the test of time. How can we ensure it survives another 70 years? The answer lies in the political will, public support, and the dedication of the NHS family, who work to deliver a service true to the founding ideals of Bevan’s dream.
Labour’s health team, headed by Jonathan Ashworth, should formulate the policies to fight for those ideals – for comprehensiveness, universality, access based on need and not on ability to pay, for a service that is free at the point of use, for mutuality in which the public accepts that priority should be given to those most in need.
Keep markets for profit out of health care delivery! Any adulteration of these principles threatens to cause fragmentation of the NHS with the certainty that never again will such a health service be created. Protecting and pledging to save the NHS from private vultures would be the best birthday present the NHS could have received.
Dr Kailash Chand OBE is a GP, Honorary Vice Preident of the BMA, and an NHS campaigner.