Is Brexit Really What Its All About Prime Minister??
Mrs May has called this snap election to, she tells us, strengthen her hand at the negotiating table with our EU soon-to-be-ex colleagues. But she already had a Parliamentary majority and, seemingly, faced very little effective opposition to anything she put forward in terms of Brexit. We got it: we were leaving, face it and man up.
But that’s not really what this election is about. Really Mrs May just wants a bigger majority to strengthen her hand in her larger aim: she wants a smaller state. Is that what we citizens want though?
Us citizens, trying to get GP appointments, trying to ride the trains, with a seat (if we’re really lucky!), trying to get help for a loved one who needs it, trying to get a hospital appointment, or supposedly ‘non-urgent’ surgery. The Conservatives have spun us a tale that the pressure on our public services is all down to the influx of immigrants. But if you look around you, is that what you see?
What I see is the effect of cuts, to each and every one of our public services, and all in the name of Austerity. Because ‘we must reduce the deficit’! But must we, really? When so many public sector workers are telling us of the stress they are working under, that they can’t do their jobs to the standard they believe they should because colleagues are either off sick or been made redundant. Public services are labour intensive. To deliver a service means some person has to be there, in place, to provide it. And yes, that does imply a wage bill to match. Cutting the money to pay for those services means there are fewer people to provide them. And this is then reflected in longer waits for care. And sometimes it also means a poorer level of care, too.
In the case of the NHS, capping pay has already adversely affected nurse recruitment. Retention of existing nurses is hit, too. I recently met a nurse who told me that she had worked for the NHS for 25 years but had had to give it up. “I found myself in charge of a whole ward, overnight, by myself and got so worried and upset that I drove off the road on the way home one night. I had to recognise that I couldn’t go on like that; for the sake of my family, I had to leave”. She had two teenage daughters to support.
But for each nurse who leaves, and isn’t replaced by another full time equivalent, the NHS is forced to buy in agency nurses – who cost more. This is having a hugely disruptive effect on hospital planning and financing. This downward spiralling situation is not a given. It doesn’t have to be like this. It is a direct result of the decisions taken since 2010 in the name of Austerity and the erroneous belief that we have to ‘reduce the deficit’. The decision to shrink the State is not a financial imperative, it is one driven by dogma. If we want to improve our public services, to ensure that they are functioning adequately when we, our neighbours, or our loved ones need them, don’t vote for Mrs May!
New Regulatory Bodies for health professionals?
Jeremy Hunt has just produced a White Paper on simplifying the regulatory machinery for health professionals – again. This, on the same day that figures emerged showing that the NHS has failed to meet waiting targets for A&E:
- 82% of patient were transferred or discharged within 4 hours of arriving in A&E compared to the target of 95%;
- 60,000 spent between 4 and 12 hours waiting more than 12 hours trolleys in A&E corridors
- 780 people waited more than 12 hours for a bed.
This is the worst performance since the targets were introduced in 2004.
And its worth remembering that each of these 780 is actually a sick person needing hospital level care.
The BMA, the head of the Royal College of GPs, the head of the Royal College of Surgeons: all have expressed – this week -their concern that the NHS is facing crippling pressures. And what does the government do: it orders a review of the royal college regulatory machinery!
Proposing a review of regulatory machinery is not cost free. It costs money to ‘review existing arrangements’. Senior staff have to make time to read the proposals, consult with colleagues, write responses, when they could be contributing that same time to patient care. They are already using their administrative time to try to improve the way their services function by better integrating services locally. And so these proposals also increase ‘opportunity costs’ – the costs of not doing one thing to do another – adding even more to the time pressures experienced by already over-burdened health professionals.
This Mad Hatter of a Health Secretary is doing everything he can to ignore what seasoned – and long suffering – health professionals are pointing out is a crisis in health care provision. We are simply not providing sufficient resources to tackle the problems we are facing. This week a new category of health personnel was invented: ‘corridor nurse’. Surely it is clear that we do not have enough people to do the jobs we are demanding of them in the NHS today. One Junior Doctor is quoted today as saying he is ‘falling down with exhaustion’ – and he isn’t alone.
Is this really what we as patients, as taxpayers, as citizens want? An Ipsos/Mori poll out this week reported that more than 2 in 5 people would pay more taxes to fund the NHS. Fifty-three percent – more than voted to Leave the EU – favour increasing National Insurance payments to increase NHS resources.
So, why are we waiting? And what are we waiting for? These problems can’t wait for Brexit to be sorted out. They need tackling now. Call your MP; do everything you can to help Mrs May see the problems she is missing, veiled by Brexit and an overly optimistic Health Secretary.
NHS: Why Are We Waiting?
Waiting times in the NHS are going up. The situation in England got so bad this year that some targets were removed. The rationale given for this is that ‘targets are detrimental to improving performance as they focus attention on the wrong issues’. Well let’s see how that is working out in practice.
First a little history: in 2009 waiting lists were low enough for leading economists to propose that variable waiting times be introduced, set by local area health authorities, to better match clinical need and demand.
In 2009 a Labour Government was still in power and funding for the NHS was at, for the UK, historically high levels (But not out of line with spending levels in comparable countries).
Today in 2016 NHS spending is lower than it was on 2009, both in real terms and as a proportion of GDP. In terms of international comparisons. For example:
- In 2000, the UK was spending 6.3% of its GDP on healthcare.
- Tony Blair, as PM, committed to increasing this spending to 8.5 % of GDP to bring the UK into line with the other 14 EU countries’ then level of spending on health care.
- By 2009, the UK was spending 8.8% of its GDP on healthcare (by which time the EU average had increased to 10.1%)
- By 2014, the UK spend on healthcare as a proportion of GDP had gone down to 7.3%.
- Between 2014/15 and 2020/21, the UK’s GDP is expected to grow by 15.2% BUT the proportion of spending on healthcare by then is not expected to increase by more than 5.2%, meaning that we will be spending only 6.6% of our GDP on healthcare.
- By this time (2020/21) we would need to increase our spending on the NHS by 30% -£43bn – to match our EU neighbours’ healthcare spending levels.
Is this really what we want for ourselves or for our nearest and dearest? The UK government is committed to increasing healthcare expenditure but the projected increases are nowhere near to helping us match our EU neighbours’ spends on healthcare.
Does this really matter? Well, think about the waiting times for diagnosis and treatment that you, your neighbours and friends, and relatives are currently facing.
We know that waiting a long time for diagnosis and treatment is not only a source of great anxiety for individuals and their families. It also can result in people getting sicker and thus needing more treatment for longer. It can make the difference between outpatient treatment and inpatient care too.
In the past 6 months I’ve had two reasons for referrals for two different -both cancer-related, though- problems. In each case the referral was classed as ‘urgent’. The first was a source of a lot of anxiety because of family history. After 6 months’ wait I gave up and went privately (a year later an NHS slot became available). The other was quicker, but still too long-and in the end needed a bigger incision, and more stitches, than it would have if it had been dealt with as quickly as my GP had expected it to have been.
I bet that you and your family can recount similar stories. It is not good enough for any of us. Maybe its time we spent less time and energy talking about the terms of Brexit and more time debating what really will make a difference to us: the NHS and how to ensure it is fit for our purposes!
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