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We need to focus on the future of the NHS


By Dr Kailash Chand
21 May 2019

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While Brexit talks continue to dominate the headlines in the UK, there are fundamental concerns over the future of the NHS, says Dr Kailash Chand GP and honorary vice-president of the British Medical Association.

Speaking in front of the Health and Social Care Committee in February, Matt Hancock said that, following the committee’s recommendations last summer, the Department of Health and Social Care has decided that only public bodies will be able to hold integrated care providers (ICP) contracts.

The truth is that we’ve seen cancer PET-CT scanning services in Oxford privatised and he is going full steam ahead with NHS privatisation.

Twenty-one NHS contracts worth £127m are currently out to tender.Most of these private companies hide behind the NHS logo but siphon off a profit.

The Latest NHS performance figures show continued collapse. There were 2.17m attendances at A&Es in March, an increase of 212,500 from the previous month. Other key data includes:

  • 555,500 emergency admissions recorded, a worrying 6% increase from March 2018
  • Performance against the four-hour wait target at major A&Es in March was 79.5%
  • There were 59,500 trolley waits of four hours or more, making it the second worst March on record
  • Including estimates for missing data, the waiting list for elective treatment rose to 4.31m in February
  • There were 127,300 delayed days recorded in February

The NHS’s ability to provide universal, equitable, comprehensive, high quality healthcare that is free at the point of use is seriously threatened. A shortage of GPs, 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.

A&E services are in a permanent state of chaos. A situation that was once confined to winter is now an all-year-round occurrence and mental health services are still woefully underfunded. The loss of more than 4,000 mental health beds since 2010, and a similar reduction in the number of psychiatric nurses, is also a pressing concern.

The creation of a universal healthcare system, free at the point of use, was Britain’s greatest post-war achievement, but it’s now being set up to fail.The chronic staff shortages threatens the sustainability of the health service and have led to an increase in doctors’ workload.

Between 2013 and 2015, the number of vacancies for doctors increased by 60% and an estimated 10% of all medical posts across the NHS are currently vacant.Nearly three quarters of medical specialities are also under-recruited.

The elephant in the room is the trend for reducing public healthcare provision. The systematic closures and restrictions needed to phase out the ‘outmoded’ family GP are hardly making it easier for people to access their own doctor, with continuity of care suffering.

The unwillingness from the top to train and encourage new fully-skilled professional staff opting instead to find cheaper alternatives, such as volunteers or profitable apps  means (despite empty protestations to the contrary) a choice to replace rather than replenish the NHS workforce.

The private sector has metastasised to virtually every organ of the NHS. The agenda of privatisation continues unabated under numerous disguises.

The universal healthcare system at the heart of British society is under threat as never before from privatisation, fragmentation and under-investment.

Analysis by the Institute for Fiscal Studies (IFS) very clearly proves that Conservative policy for NHS spending is well below the historic average of four per cent.

The Government’s new plans for healthcare, which are being rapidly introduced and without proper public debate or parliamentary scrutiny, are drawing from experiences in the US healthcare system – the most expensive healthcare system in the world.

General practice would be decimated in the guise of modernising primary care, and replaced by salaried GPs, controlled by an essentially private corporate sector.

The thrust of these changes has been variously resisted by campaigners around the country. Too many councils are however, waving them through on the promise of pooled NHS funding for their depleted social care budgets.

Much like Theresa May’s recent bungs to Labour constituencies in Leave areas, but currently more successful.

Resistance to the service’s deliberate overall shrinkage in England is thus fragmented, its focus on funding failing to deal with the Government and NHS England’s agency and political intent.

The absurd idea that we still have a social democracy, and a Government sincerely trying to meet public need suffocates a genuine confrontation between the two very different models at stake: Bevan’s socialist principles and McKinsey’s healthcare market – and leaves a social safety net with gaping holes.

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