Last Christmas, a small National Health Service choir beat pop superstar Justin Bieber to the number one spot, yet again reaffirming the high level of affection in which the service is held.
As one of the main sources of national pride in Britain, the NHS represents a deep-seated fairness ideal – that healthcare meets the needs of everyone, irrespective of ability to pay. However, the NHS is today struggling to uphold these guiding principles.
A slowdown of NHS funding since 2010 and severe cuts to public health budgets and social care have led to years of increasing deficits which last year culminated in NHS providers and commissioners racking up a deficit of £1.85bn – the largest overspend in its 68-year history.
Nonetheless, the government continues to pursue relentless austerity measures, demanding that local health systems meet George Osborne’s requirement for £22bn of efficiency savings by 2021. These unprecedented financial pressures have led some organisations to restrict access to certain services, a dangerous false economy that not only dilutes quality of care but also compromises patient safety.
Last month, St Helens clinical commissioning group, the NHS organisation which provides health services to my constituents, proposed blacklisting a range of treatments, including hip operations, fertility services and cataract surgery, in order to fill its £12.5 million funding gap.
While decisions to withhold treatment are not necessarily harmful to patient care if based on evidence about clinical effectiveness, the denial of certain services and products such as hearing aids or medical nutrition undermines commitments to prevention and will not help Jeremy Hunt deliver his vision for the NHS.
As an example, many people who are critically ill or managing chronic illnesses such as cancer, epilepsy and dysphagia are dependent on medical foods as they cannot support themselves through conventional nutrition. However, a number of commissioning groups are perpetuating a postcode lottery of healthcare by restricting vital patient resources in order to balance their budgets.
Rather than making misguided cuts against NICE recommendations, use of medical foods designed specifically to supply nutrition which cannot be obtained through normal means presents a logical ‘invest to save’ case. In this example alone, NHS savings can be made through the reduction of inpatient time, readmissions and complications, thereby supporting carers, families and patients in managing their conditions.
Medical nutrition plays an essential role in helping people manage long-term conditions including the impact of a stroke, cerebral palsy and bowel cancer.
It can also help people with diseases and conditions including Alzheimer’s, pressure ulcers and chronic obstructive pulmonary disease.
To secure the long term sustainability of the NHS while also safeguarding public health, it is crucial that investment is placed in long-term solutions rather than short-term decisions in order to deliver better and more appropriate care while also tackling waste and inefficiency. The solution to this crisis has its foundation in focusing on better value across health spending, not spending in isolation.
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Conor McGinn is member of parliament for St Helens North. He tweets at @ConorMcGinn
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Good as far as it goes, but not far enough. We need to own up to the disaster of PFI and take NHS Trusts’ debts back in to the state’s accounts. We need to end the wasteful internal market which wastes billions in duplicated effort and admin and legal costs. And we need to take NHS spending back up to G7 levels as a percentage of GDP. Currently it’s low and falling. https://data.oecd.org/healthres/health-spending.htm
There are two problems with the NHS which Labour, once in Government can fix. First to recognise that funding of Social Care, especially for the elderly, is an integral part of keeping the cost of the NHS down. Second, to stop tinkering with the structures of the NHS. The NHS has had more reviews and more restructures and is overburdened with management and consultancy speak. It is also cumbersome and overburdened with bureaucracy. The NHS needs to be devolved. Hopefully Mayor Burnham and Mayor Rotherham will show that devolution works. The NHS is an anachronism as is most of Whitehall as we have become a more separated country with differing needs in different regions. I do not believe anymore in UK or England models except as a tool for Tory Governments to destroy public services and for Labour Governments to tinker. Time we brought the NHS monolith closer to the people.