Last week national media reported the BMA’s warning that the NHS ‘winter crisis’ is now a year-round crisis.
Hospital doctors, GPs and patients have just endured one of the worst winters on record, with thousands of cancelled operations, unacceptably long waits to be seen and people who are already at their most vulnerable having to face the indignity of being treated in hospital corridors.
This Government has been in denial throughout the crisis; their arrogance shows this is the level of service they want the public to accept as the norm.
The NHS in general and primary care in particular entered this, the worst crisis of its 70-year history, since Jeremy Hunt became the health secretary. And how can Hunt’s performance be rated? All the key indicators within the NHS worsened, with waiting lists reaching 10-year highs.
Politicians’ reckless exploitation of goodwill means the NHS and its staff have come to end of their tether
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. Despite Hunt’s boasting, mental health services are still woefully underfunded. We have seen more than 4,000 mental health beds close since 2012. Social care services are in a state of paralysis. All these indicators mean more work in primary care without resources and funding.
The pressure on secondary care directly increases workload in primary care. Many GPs believe that however much capacity is provided, whether by telephone, in person or over the internet, this capacity is rapidly filled. GP services are in a perilous state. There were 70.1 GPs per 100,000 population in 2017 compared with 75.7 in 2014 – a drop of 7%. Almost 4,000 GPs have retired early in the past five years – nearly one in 10 of the profession. New figures show the number of GPs per head of the population has fallen for each of the last four years. The GP workforce really is in dire straits across the country.
Factoring in inflation, we know the NHS is suffering the longest budget squeeze in its history. From 1948 when it was formed, through to 2010, the NHS has received an annual funding uplift of around 4% each year. By contrast, from 2010 to 2020, this increase has more than halved, working out at just under 2% per annum. In England, NHS trusts are on track to overspend by more than a billion pounds this year.
We are the sixth wealthiest country on the planet and it is indefensible to starve the NHS of the funds it so desperately needs. To make things worse, billions of pounds of health service funding have passed to non-NHS providers under the Tories. That sum will continue to grow.
Jeremy Hunt may be the longest serving health secretary ever, but he will in my view primarily be remembered as the worst. The only ‘progress’ Hunt has made over the past five and half years is to turn the NHS into NHS plc, increasingly drawing on public funds to line the pockets of wealthy venture capitalists or multinationals.
My verdict, as a doctor working in and for the NHS for almost 40 years, is that history will judge this administration’s record as one characterised by broken promises, reductions in necessary funding and destructive legislation, leaving health services weaker, more fragmented and less able to perform their vital role than at any time in the NHS’s history.
And despite the best efforts of doctors and nurses, many patients are receiving ‘very poor care’ within the NHS. The core infrastructure of the NHS is also being eroded with the closure of many GP surgeries, hospitals and thousands of NHS beds since 2010.
Our NHS is being placed in the hands of accountants and businessmen who make financially driven decisions on which profitable future contracts should be awarded to what provider, including GP support services. Politicians’ reckless exploitation of goodwill and its product – low morale – means the NHS and its staff have now come to end of their tether. There is no doubt in my mind it is Jeremy Hunt and the Tories’ ideological dislike of a publically funded health service that has reduced our NHS to its knees.
We must let the public know what is being done to their NHS and general practice. And the public needs to stand up for the NHS; otherwise it is finished.
The NHS is 70 this year – defend it or lose it.
Dr Kailash Chand is a retired GP in Tameside