Henry Roberts shares his opinion on the current situation of the NHS, stating that ‘the longer the fiscal-roots of the health problem is ignored, the worse conditions will get both locally and nationally.’


Most People Want It; All Recognise a Problem. Where We Disagree is in the Solution 

Just before the general election in 2015, a YouGov survey asked people what they considered the most important issues facing Britain to be. The survey is conducted fortnightly and the results had been largely consistent, but this one from April showed a difference in the mind of the electorate. Whilst the economy still took the top spot, health overtook immigration as a close second of the most important issues facing Britain. The NHS was clearly on the public’s mind. A similar YouGov poll from 2013 saw 73% of Britons list the NHS as one of the UK’s greatest achievements.

Cut ahead to January 2017 and the NHS is still very much a leading concern. Whilst always coming under additional stress during the winter months, long-term economic problems have caused serious problems in hospitals, with the chief executive of the Red Cross calling the current conditions of the NHS a “humanitarian crisis.” In the first week of the year, 40% of hospitals had to issue an alert due to having too many patients. Eight of England’s hospitals in the first week of this year issued a “black alert” (the most serious level of alert) under increasing pressures that meant they were unable to deliver “comprehensive care” to those who needed it. Furthermore, in these early weeks of the year, more and more cancer patients are having their operations cancelled, some with only a day’s notice.

The rise in patient numbers, waiting times and hospital demands will continue to fuel the debate between the government and campaigners as to who is to blame and what solutions should be put forward.

The main problem is, of course, funding. In order to keep up with increasing demand, Bob Kerslake, Chair of King’s College Hospital NHS Foundation Trust, states that the NHS “needs additional funding year on year of around 4% above inflation” and asserts that whenever the health service has not received this in the past, there have been difficulties. Writing in The Guardian, he also elaborates on the problems in social care, as local government councils have had to continue providing services whilst simultaneously reducing spending. However, spending will continue to be cut, meaning that social care will inevitably be damaged.

Whilst there are indeed ways to make hospitals more efficient, a long-term solution to the NHS crisis will have to be financial. However, Philip Hammond chancellor of the exchequer speaking to The Economist, was terse in his outlook. He stated that there was no spare money for the NHS, but also that raising taxation was an unlikely outcome. Despite the fact that “there isn’t a pool of cash available”, the NHS, according to Hammond, is expected to deliver within its existing budgetary constraints. Concerning a rise in tax as a means to increase spending, Hammond stated that “personally” he did not think such a solution would prove popular with the public. “I don’t imagine a great enthusiasm for rising taxes.”

There never is. Historically and presently, the idea of the state taking more money from us has caused anger and resentment. However, there has to be a point where the desire to preserve a safe and well-funded NHS is balanced with the need to pay for it through taxation. This will of course differ from person to person, depending on individual ideology concerning both taxation and health provision more generally. But for those who believe in a safe and secure NHS —which seems to be millions of Britons who have relied on it in the past— solutions for improving patient care, and the idea that this may have to include tax increases, must be addressed. Whilst the government may wish to make hospitals more efficient and ease the pressures on A&Es by increasing GP hours (which GPs claim to be government “scapegoating” for NHS failures), the longer the fiscal-roots of the health problem is ignored, the worse conditions will get both locally and nationally. A public debate is needed where we ask ourselves whether the original principles of the health service are worth fighting —and, yes, paying— for.

 

Henry Roberts