Patients are paying for underfunding...and it is avoidable
If you have seen the new BBC series - Hospital you could not fail to be affected by it. A cast of real-life doctors and patients, shown as they experience the NHS struggling under the greatest of pressure. Compelling and heart wrenching, it is a powerful counter to those that say that the NHS crisis is not about money.
In an early episode the BBC film crew follow cancer surgeons as they try and find beds for their patients, who wait in gowns ready for their operations. But as fast as beds become free, more trauma patients arrive. The hospital is on code red, officially full.
Impossible choices are being made between patients that are all very sick. Not all can be treated.
Simon has cancer of the Esophagus and needs a six-hour operation to remove it. He will need post-operative care in an intensive care bed. His operation has been cancelled once already and he is worried that he will miss the window when his treatment is most effective. His operation is cancelled again, this time in favour of a woman who has hours to live unless her ruptured aneurism is treated immediately. You can see the fear in his face but he accepts that he is a lower priority.
"If they die then the bed Is available for me, but if not they've got the bed," he said. "[I feel] guilty, actually."
We all accept that the NHS has to ration its care but we should not be choosing between patients that are so sick. We should be able to provide care to all with the most urgent health need.
The main problem is a lack of capacity, in this case not enough intensive care beds, but there are shortages of beds and staff throughout the NHS.
The UK has 2.7 less beds per head of population - Germany has 8.2 in fact by this measure we have less hospital beds than all but three other countries in the EU
A report by the Public Accounts Committee warned the NHS was short of about 50,000 staff out of a front-line workforce of just over 800,000.
In recent weeks we have had to listen to ministers blaming GPs for not working hard enough and claiming that the NHS is getting more money than it asked for. Both are dangerously misleading.
A deliberate policy to underfund the NHS and social over the last 6 years has left both sectors unable to cope with rising demand.
The NHS has received the lowest rises in its history, under 1% on average, whilst social care has been cut by £5bn. Pressure is rising and people are not getting the care they need and sometimes dying whilst they wait.
The government have had months of warnings. From Royal Colleges, academics and staff who have all sent evidence from the frontline. Shockingly we found a dozen published reports in 2016 alerting the government to threats to patient safety, from overcrowding and a lack of staff.
Since the beginning of 2016 the following organisations have all issued warnings, supported
by evidence from NHS staff, about threats to patient care:
- The Royal College of Physicians
- Royal College of Radiologists
- Royal College of Anaesthetists
- British Medical Association
- Royal College of Midwives
- NHS Providers
- Royal College of Paediatrics and Child Health
- Royal College of Nursing
- Royal College of GPs
- The King’s Fund
- Community Practitioners and Health Visitors Association
- the government’s own task force on mental health
- the Children’s Commissioner for England
- Health Select Committee.
The government has been supplied with no end of evidence about the lack of capacity and its impact on staff and patients.
Overcrowding causes a rise in death rates - patients have already died in corridors whilst waiting to be treated, More than 10,000 patients waited at least two hours before handover from an ambulance to a casualty unit in 2015/16 – a five-fold rise in just two years. The Royal College of Emergency Medicine warned “the risks to patients aren’t acceptable.”
Delays in discharging patients stand at a record high, up 27% on last year, as do trolley waits, up 54% in the year to October
Demand for healthcare is at record levels, but it has been growing in a fairly predictable way for many years. So why isn't the NHS ready?
5 reasons why this is a crisis made in Whitehall
- Health spending has risen by under 1% in real terms since 2010. Yes money has gone in, but much less than was needed, in fact the lowest average rises since the 1950s.
- At the same time the government has forced the NHS to cope with lower funding rises by making efficiency savings, but this has left many hospitals under-resourced and in deficit.
- Cuts of £5bn in social care have meant that 25% less people are receiving care. More people are being admitted into hospital, through A&E and once recovered are unable to leave due to a lack of care in the community.
- Lack of investment in staff and low levels of hospitals beds has left hospitals operating at the limit with no spare capacity.
- We are also paying the price for reducing and privatising the supply of long term care nursing beds - as privateers are now closing down as their profits fall.