Every January when the post-Christmas news is thin, reports of the winter crisis in the NHS take up any slack in the news-feed, and with plenty of hyperbole. Of course, this doesn’t mean that there aren’t severe problems facing the NHS, there definitely are. Nothing however, is ever as bad as reported.
From my own experience, a close relative required treatment and an emergency ambulance over Christmas and the service could not have been bettered.
Over the last 20 years I have measured progress in the NHS by the temperature in my postbag (now replaced by my email inbox). It was once at boiling point, but in recent years has come down to room temperature. That measure is corroborated by patient satisfaction ratings, and the fact that independent think tanks and international organisations rate the NHS the best, safest and most affordable healthcare system in the world.
Yet, there are enormous challenges that the NHS has to deal with more effectively.
First, people are far too fat. This obesity epidemic places an enormous chronic burden on the NHS as patients present with any number of conditions that ultimately arise from eating unwisely and doing too little exercise.
Second, the success of advances in medicine over the last half-century brings its own challenges: new treatments have added eye-watering expense to the system; and the beneficiaries of those treatments over the last few decades, who previously would not have survived, now present in their eighties with multiple and complex nursing needs.
Despite these challenges, the NHS treats millions more patients every year and performs millions more operations. This should not surprise anyone because there are thousands more doctors and nurses in the NHS, more than ever before in fact.
(Statistics often mislead: when figures are published showing that the percentage of patients being treated within the target time has fallen at the margin, they conceal the fact that the absolute number of patients treated within the target continues to rise.)
The NHS winter ‘crisis’ however, has become an annual fixture when flu and respiratory conditions, particularly among the elderly are at a peak. Taken together with all the other pressures facing our healthcare system, the organisation is at full stretch and routine treatments have to be delayed in order to manage. This has become part of the annual planning cycle, but given that none of these pressures are going to diminish in future years –on the contrary they are bound to get worse, clearly the organisation needs to change in order to cope more effectively.
All this is true of every other healthcare system in the developed world. The difference is that because ours is a ‘nationalised’ healthcare system, we tend to blame government and complain to politicians.
I don’t believe that money is essentially the heart of our problem. NHS funding is at a record high, and our adversarial political culture will ensure that the parties always competitively bid up the amounts that we are prepared to spend.
The real problem arises when the NHS needs and wants to change and modernise the way that it delivers treatments in order to be more effective and efficient. Invariably vested interests are affected and local concerns may be at variance with larger regional needs. The appeal is then to the politicians, with the NHS becoming a political football. Alas, politicians are not best placed to decide what ought to be clinical led decisions.