An efficient health care service
I am always impressed. I phone, there’s this issue. Frequent peeing, not eating or drinking well, listlessness, perhaps a urinary tract infection. An immediate reply. Of course. It might be an idea for you to come in. We could see you this afternoon. Just bring a urine sample.
We attend the appointment. Suggestions for encouraging drinking and what to eat. The next day the urine sample has been tested; yes, it is a urinary tract infection. Antibiotics are needed. If you come to the surgery, we can dispense them this afternoon.
What an excellent health service we have. For my dog!
I asked if the vet if they could take another client. Of course, I was told.
Laughter and then she said that they didn’t have the National Health service for my pet. Of course.
A struggling National Health Service
I value our National Health service.
I need health care. I phoned and was told I would get an appointment. The appointment was a few weeks hence. It was a phone appointment. At least the phone appointment was followed fairly quickly by a face-to-face appointment. I am referred to a specialist.
10 May, I receive a letter from the NHS.
The letter told me I didn’t need to do anything at this stage. I will be contacted either by the hospital apartment or by my GP practice.
Then the line in the letter:
“What to do if you have not been contacted”
Please wait until 5 July 2022.
“If you have not been contacted by this date call ****… (the hospital department).
The bigger picture for health care
It seems that my story is small fry. It was reported in HSJ on 16 May that almost 600 patients had to wait for ten or more hours in ambulances before being transferred to emergency departments during last month. One patient had to wait for 24 hours.
This month the Royal College of Nursing Director for England had this to say about A&E waiting times.
“Staff see patients waiting in cubicles, on trollies and being treated in corridors every day and it’s patients who are suffering. Ministers must invest urgently in the nursing workforce, which has seen so many leave and vacancies steadily grow. Health services need staff as well as beds.”
Compromised by crisis
The NHS Support Federation is an independent group of researchers and journalists that work to ensure that we all have fair access to high-quality healthcare and are a voluntary organisation and not allied to any political party.
The NHS Support Federation produced a video ”Compromised by crisis”
In this video, NHS staff gave examples of threats to care that they see and relate these to insufficient resources to care for their patients. One staff member reported that somebody with schizophrenia who was hearing voices and in major distress couldn’t get help. There are patients waiting for many, many hours in A and E and may or may not get seen. There are elderly people who are in hospital due to a lack of social care services to support them. There are problems for many referrals for children and young people with mental health problems which are rejected by local services because they say they don’t have the capacity to meet that demand.
Reasons for problems in the health service
Demand for the NHS is rising due to population changes, including an aging population and higher numbers of patients with chronic and multiple conditions. There have been cuts in social care budgets and there is a lack of a workforce strategy.
A huge part of the problem now relates staffing shortages.
According to the Guardian (3 March 2022):
“The Staffing crisis deepens in NHS England with 110,000 posts unfilled. One in 10 nursing positions empty as are one in 17 doctors’ jobs.
“There are currently 8,158 vacancies for NHS doctors in England with the shortest supply in the Midlands which has 2,202 vacancies. This is followed by London, the Midlands and then the North East and Yorkshire with 1,051 vacancies.
Patricia Marquis, the Royal College of Nursing’s (RCN) director for England said: ‘The fact that nursing vacancies remain stubbornly high, at about 40,000 in the NHS in England, is deeply worrying. With every job that remains unfilled, safe patient care becomes even harder to maintain.’”
Poor wages and the cost of living crisis
Staffing shortages, particularly for nurses, are exacerbated by poor wages. On 26 May the chancellor told us the total cost of living support is worth £15bn to help families with rising costs, while supporting the most vulnerable in society.
In a press release RCN General Secretary and Chief Executive, Pat Cullen, said about this announcement:
“Today’s announcement represents a drop in the ocean for nursing staff struggling with soaring living costs after more than a decade of real-terms pay cuts. If ministers are serious about helping nursing staff they would give them a fair pay rise which recognises their skills and professionalism.”
Funding for health care in England
The King’s Fund is an independent charitable organisation working to improve health and care in England. On 19 May The Kings fund said:
“Recent increases to the NHS budget were welcome and necessary, but the systemic challenges the NHS faces, particularly around workforce pressures, have grown and the outlook for Covid-19 recovery is uncertain.
“Between 2021/22 and 2024/25, total health spending will rise on average by 3.8 per cent a year in real terms. This comes after the longest funding squeeze in NHS history, with health spending rising by only 1.5 per cent between 2009/10 and 2018/19.
“A lack of capital investment has seen the NHS develop a maintenance backlog of £9.2 billion, which includes high risk and urgent repairs.
“The pandemic then created significant new cost pressures for the NHS both to meet the immediate costs of dealing with Covid (for example, supplying vaccines) and to then make up the lost activity suffered over the course of the pandemic…”
The multi-year investment in services was much needed, but even with this new funding the recovery and restoration of key services and performance standards will take years. Long-standing workforce shortages and the fact that the pandemic has placed significant extra pressures on staff – with growing numbers suffering from burnout and considering leaving their role in the NHS – may prevent progress.
“Ministers will need to revisit the current funding settlement if the NHS is to deliver on the government’s ambitions to recover and reform services.”
I needed a health care visit for another issue. I phoned the clinic. I was number 8 in the queue. I held on and on with the number before me reducing very slowly. I thought we sorted an appointment. I was sent a letter with an appointment in Tweedmouth, Berwick upon Tweed. I phoned again. This time starting with being number 4. I asked for an appointment closer to Hexham than Scotland. This got a laugh and hopefully my next letter will be more to my liking.
Still, even though I love our dog’s health care I do not wish for the private model. Though I fear that our current government will be using the current health care situation to gradually move us even closer to the private model.
The answer is health care in England is failing because it is not a priority for the current government.
The NHS Federation urge people to support sign up on support them and share this video on social media. Hear them talk openly about the effects of underfunding. Support the campaign to get the funding our NHS needs.