Britain loves its doctors but denying the NHS is broken is deluded
When Wes Streeting became Secretary of State for Health and Social Care on 5th July he struck a less jubilant tone than many of his colleagues. “From today, the policy of this department is that the NHS is broken,” he said. At the time it marked a welcome break from years of denial by previous governments and ever since, the rhetoric has ramped up even further. Now though, Streeting faces a backlash. Hospital leaders have gone to the BBC to say that the policy is “damaging morale” and “risks lasting damage”. The fact is that by almost every measurable metric, the NHS is in crisis. A return to denialism and failure to diagnose the problem risk delaying any potential cure.
It is worth pointing out that the fear of health leaders is completely understandable and rooted in some logic. As one put it on the Today Programme this morning, “the NHS runs on goodwill”, and any damage to that goodwill risks jeopardising everyday functions of health centres all over the country. The rationalisation is that if all a nurse reads about in the press is how poor the service they provide is then how likely are they to take up the overtime that they need to when asked? If patients believe that the treatment they receive will be poor then they may stay away altogether and worsen their condition. Unfortunately, this logic is fundamentally flawed.
Firstly, the fact that the NHS ‘runs on goodwill’ is in itself a symptom of just how serious the situation is. Healthcare may be an industry unlike any other and a vocation to which people selflessly dedicate their lives but no organisation is sustainable if it relies on thousands of people doing long amounts of unscheduled hours simply to fulfil its everyday function. One only needs to look at the rail industry in the UK. Earlier this year, when the RMT union announced an ‘overtime ban’ for its drivers it was enough to bring the large parts of the national infrastructure to its knees.
Earlier this month, Lord Darzi set out the findings of his landmark report into the National Health Service. As expected, those findings were beyond damming. People wait longer than ever before to see their GP, one million people are waiting for community services, and most people have to wait more than a year for a mental health referral. Only 60% of the most serious (Type 1) A&E patients are seen within four hours and 10% wait for more than 12. 15 times more people wait more than a year for scheduled surgery than they did in 2010, cancer care is worse than other countries, cardiovascular care is declining, and 40% more people are off work sick than in 2020. In every measurable way, the system is broken.
Some will argue that a system such as the NHS isn’t even viable today when life expectancies are longer, there are more treatments available, and expectations are higher. One thing is certain: without root and branch reform, it will collapse. There is no point in having a national health service that nobody can access or use. Funds must be allocated more efficiently and the private sector must be leveraged wherever required. Perhaps most importantly, the public needs to drastically change its attitude towards public health such as smoking bans and sugar taxes. The government cannot be expected to pick up the bill for the unhealthiest population in British history and not make some interventions. Otherwise, as Streeting says, the United Kingdom risks becoming “a Health Service with a country attached”.
The nation loves its donors, nurses, and everyone involved in the NHS. Nobody doubts their commitment and ability but the system is failing them. In turn, the system is failing everyone.
