1948-2018: Happy 70th Birthday NHS

The nation’s best loved institution. 70 years is a long time to endure at a time in this nation’s history of unprecedented and very rapid change. Conceived and introduced in the post-war era in recognition of sacrifices made, offering free health care to all.  The country it serves has changed so much in that time: a significantly larger population than ever before, comprising of more people living longer than ever before, needing a greater variety of medications and treatments than has ever existed. Serving that population with all that it has. Doing wonderful things with wonderful people. A testament to the nation’s goodwill. Representative of the best in all of us, but sadly and increasingly under threat.

The nation is slowly yet sadly falling out of love with the NHS. The British Social Attitudes Survey (which has measured the public’s mood since 1983) suggests a significant downturn in public satisfaction with the NHS, which up until recently had still been buoyant at 60%. With NHS funding not keeping pace with rising demand, recent polling for 2017 shows the overall satisfaction figure dropping to 57%. Members of the public polled cite a shortage of funding and staff and long waits for GP or hospital appointments despite NHS Trusts reporting deficits of nearly £1.3 billion. The public are becoming worried.

We are starting to see things that we have never seen before. The hypothetical, becoming real. An elderly man died while waiting in an accident and emergency unit this year because of ‘dangerous overcrowding of the department’ according to the director of the Northampton General Hospital NHS Trust. He was admitted with stomach pain on a weekday afternoon but waited too long to be reviewed by a consultant and died of a cardiac arrest. That hospital’s A&E unit had seen an average of 400 patients a day attending over the previous few months, an increase of almost 30% on the same period last year.

Nearly two thirds of doctors now believe patient safety standards have deteriorated over the past year and nine out of ten have experienced staff shortages according to a recent survey of 1,500 NHS consultant physicians in England, Wales, and Northern Ireland commissioned by the Royal College of Physicians (RCP). It describes an NHS being ‘pushed to the limit’, in which doctors express frustration and distress about the sub-standard care they feel they are now forced to deliver to patients.

According to the study, 80% of the doctors asked said the were worried about their ability to deliver safe patient care in the next 12 months and 84% believed the workforce was demoralised by the increasing pressures on the NHS. Many employees are leaving the NHS, their cherished, much needed, but sometimes poorly remunerated skills going to the private sector or abroad.

Against this backdrop, MPs have recently reported that NHS Trusts have a ‘prevailing attitude of defensiveness when things go wrong, and a reluctance to admit mistakes’ meaning unnecessarily injured patients are becoming doubly disadvantaged. There are some who would like to see those same patients disadvantaged yet further by narrowing access to justice and fixing the cost of bringing higher value personal injury claims for medical negligence.

It doesn’t have to be like this, and the RCP has proposed measures such as relaxing visa restrictions for health visitor workers, making more money available to match growing patient need. The UK is ranked 6th out of the seven countries that form the G7 for healthcare expenditure as a proportion of GDP, and 30th in a global list of countries assessed for health care quality in a recent study published in the Lancet which experts have blamed on its lack of investment, particularly in specialist cancer care. As winter ends, the RCP’s President, Professor John Dacre, was quoted as saying:

‘‚ĶIt is not as if the situation was either new or unexpected. As the NHS reaches 70, our patients deserve better. Somehow we need to move faster towards a better resourced, adequately staffed NHS during 2018‚Ķ’

Let us hope that the NHS can be made better so that it can continue to keep making us better for another 70 years.

Many happy returns!

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