NHS: A genuine crisis

Despite general modern overuse of the word, Larry Sanders shows that the NHS is genuinely in a state of crisis and in need of serious intervention. 

Larry Sanders

State of the NHS

Crisis is a drastically overused word. But what do we say about the experiences, images and statistics coming from NHS patients and clinicians? We see very ill people on makeshift beds in corridors, doctors and nurses in tears and statistics about excess deaths and unprecedented delays. There is indeed a crisis which is having terrible effects and the prospects are bleak. The Conservative government denies it and the Labour Party says it can be cured by using private hospitals and without large injections of resources. The BMA Chair, Professor Phil Banfield, is surely right when he says that the damage is due to political choices made since 2010. Equally significant is the major parties’ lack of will for political change. Only the Green Party has been clear for many years that the solution is a fully funded, public NHS. About seven years ago Caroline Lucas introduced a brilliant and comprehensive Bill to ‘Reinstate the NHS’. It was quickly supported by 6 Labour MPs, including Corbyn and McDonnell. I don’t think their number ever grew beyond 40. In 2022 the Green Party adopted a policy to make social care a fully funded, public service free at the point of use. 

Basic Lack of Capacity

At the root of the problem is a basic lack of capacity. There are large and growing shortages of GPs, hospital doctors, nurses, hospital beds and social care workers. There are hundreds of thousands of vacancies. If they were filled the UK would still be towards the low end of staff and resources per capita for industrial countries. The shortages have translated into delays, which are not the result of strike action or Covid. There were 2.5 million people on waiting lists in 2010, 4.6 million in 2019 and 7.2 million in 2022. 2.9 million of these had been waiting more than the target 18 weeks. Cancer targets, which are particularly important for survival, have not been met since 2014. The Royal College of Emergency Medicine estimates 300-500 deaths a week are caused by staff shortages. Ambulance officials say 160,000 people a year are being harmed by their inability to help people in time.

Ways forward

It is not difficult to see solutions. Though the NHS is a large and complex institution, requiring much thought and experiment the basic structure is sound. By the end of the Labour’s time in government funding was near that of our European peers. Waiting times were shrinking and international research rated the NHS highly. With consistent funding that increases to meet numbers of people, their increasing needs and the clinical ability to help we could move towards a good and fair service. It will take time. Staff need to be recruited and trained. Privatisation has fragmented the service and wastes many billions but it is important to keep perspective. Depending on definitions, from 75 per cent to 90 per cent of the work is still done by NHS staff. 

Social care is a bigger problem and a total mess. It is almost entirely private and there are substantial charges, even for the poorest and most disabled. Age UK has found that hundreds of thousands of people in need get no help. New Nursing Homes are too large and use minimum staffing to extract large profits. Green Party policy for a public service free at the point of use would be an immense gain for the country. It would be expensive but would allow hundreds of thousands of carers and disabled people to work.

Labour’s solutions

Wes Streeting, the Labour Party’s Shadow Health and Social Care Minister has advocated that more NHS money and patients should go to private hospitals. This is nonsense. Many billions have already been wasted by contracts that gave them vast sums for doing nothing. They absolutely lack the resources to deal with emergencies. The work they do has to come from poaching NHS staff. They add nothing to the total but extract very large profits and subsidies. David Rowland of the Centre for Health and Public Interest said: “Multinational investors have bet against the NHS for years, knowing this moment would arrive.”

The Labour Party has also refused to promise increased funding. There is absolutely no way to escape the crisis without a massive injection of funding. There is a lack of buildings, maintenance, equipment and, of course, that massive shortage of staff, without whom nothing can be done. The question is not a lack of money. The UK government has created over £800 billion since 2008. The bulk of this has ended up with the richest people. The wealth of billionaires in the UK has risen from £200 billion in 2011 to £653 billion in 2022.

Keep Our NHS Public estimates that the crisis is causing between 300 and 500 unnecessary deaths per week. There is no way to calculate the immense amount of needless pain and suffering. The total death toll of 14,550 a week is 21 per cent higher than is usual for this time of year. The average age of death has increased year on year for over 100 years. That has stopped since 2010. That reversal represents a premature loss of life for 335,000 people between 2012 and 2019. A University of Glasgow study concluded: “A great many more deaths are likely to have been caused by the UK government’s economic policy than by the Covid-19 pandemic.”

The Politics of the NHS, Austerity and the Green Party

UK politics is in a new place. The fight for decent pay, conditions and the right to be able to do your job well is being waged by hundreds of thousands of people in and out of the NHS. The Government will not give up easily. Whether or not the unions succeed in their immediate demands their willingness to do battle has changed British politics. Being the only political party in full solidarity with the strikers may change the role of the Green Party. We are genuinely in a crisis: the point at which things can go one way or another. Failure would mean increased pain and death. Or we could use our energy to create a society where all can flourish.