Does the National Health Service have a sell-by date?

Before the NHS, Britons were required to pay their own way. If you were lucky enough to be in work you would be entitled to health insurance, although it would not extend to your dependents. Therefore, if you were from a middle or lower class family and your wife or children were ill, there was little you could do but hope for the best. Though free treatment was sometimes available from teaching or charity hospitals, it was not guaranteed. 

It wasn’t until 1947 that Labour health secretary, Aneurin Bevan, bucked the trend and implemented the National Health Service Act. Under this act, all services were to be free at the point of care, financed from central taxation and everyone would be eligible, including temporary residents and UK visitors. 

No one can dispute that in its heyday, our NHS was the envy of the world. However, in recent years a widespread belief has developed that the once revered system has fallen from grace. The numerous demographic pressures – aging population, increasing obesity rates and staff shortages, have all contributed to added pressure on the service. Furthermore, failure of the Care Quality Commission, the health service ombudsman, to expose NHS shortcomings, coupled with each successive government playing politics with the entire system, have contributed to a lapse in the quality of the National Health Service. 

The constant technological advances in the field of medicine that are being implemented have saved countless lives but at the same time are putting a huge burden on NHS budgets. 

The pharmaceutical companies are offering increasingly miraculous drugs to the NHS at ever increasing costs to the taxpayer, knowing that seriously ill patients and their families will be wanting to be treated with the latest life-saving treatments. 

One thing is for certain, there hasn’t exactly been a shortage of enquiries commissioned by the presiding government to discover the causes of failure. The Francis enquiry, Keogh’s report, Berwick report and Cavendish report (to name a few) have all come to the same conclusions – some NHS care is exemplary and some is abysmal. 

The 11 failing Trusts identified – most notably Staffordshire – have had scandalous reports where basic care regulations, like preventing dehydration and acknowledging patient requests, had not been followed and ultimately resulted in deaths that could have been avoided. 

These revelations, and the fact that they hadn’t come to light sooner, has clearly had an impact on the public. According to Ipsos MORI, the number of people saying they are very satisfied with the NHS has fallen from 24% to 17% since 2009, and 43% of people feel that the changes the government is making to the NHS will make services worse for patients overall. Many patients are unhappy with staff shortages, the GP locum culture and A&E closures around the country. 

The Health and Social Care Bill 2012 was legislated as a long term solution to the National Health Service’s difficulties and has therefore had an impact on healthcare professionals. Nevertheless, nurses continue to be short staffed as 6,000 have already lost their jobs under the coalition government, though Mr. Cameron has promised to raise quotas for health visitors. A BMA survey has reported that 95% of GPs believe their workload is now too high due to “unnecessary bureaucratic burdens.” 

Dr Gillian Braunold, a GP in Kilburn, London, commented: “The problem is that the amount of work that we’re all having to do is increasing and the workforce is actually shrinking. We’re having to do more and more work in less and less time, which means that patients are getting a bad deal.” 

Shocking results from the survey have also revealed that 85% of doctors say that they can’t now guarantee safe patient care at all times. 

The strain on hospital doctors will also increase. Consultants will soon need to adapt to a rota which will require them to work nights and weekends on a regular basis as well as tending to the work not being completed by junior doctors, who now answer to the European Working Time Directive. With the added pressure of surgeons being rated individually rather than in their teams, it is no surprise that more doctors are stressed than ever before.  

However, the core issues still remain to be addressed. Staffing shortages and A&E closures are a fact and the current political view is clearly angling for privatisation. With Virgin Care already boasting NHS contracts of over ¾ billion pounds, and Circle and Serco also bidding for contracts of a further £1 billion, there is a fear that in this time of austerity, budget cuts will be prioritised over quality of care. 

Businessmen, like Richard Branson, can always convince politicians about how they can make the NHS more efficient. However, they fail to add that the service could lose its heart. The reason the NHS has always been highly regarded was its ability to treat people in a caring and compassionate manner. If this ethos is removed from the NHS, the service will no longer be what we hold dear.

Hiba Khan