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Paul Vallely: NHS needs more than sticking-plaster policies    

18 November 2022

Vague talk of savings is not enough to solve the crisis, declares Paul Vallely


Rishi Sunak visits Croydon University Hospital last month

Rishi Sunak visits Croydon University Hospital last month

NOT long before he died, Rabbi Lord Sacks broadcast a Thought for the Day asking whether life would be different after the pandemic, or whether we would merely revert to bad old ways. He offered two templates.

After the First World War, and the pandemic of Spanish Flu, little changed, he said. Out of the individualism and inequality of the Roaring Twenties came the General Strike, the Great Depression, and the rise of European fascism. We learned nothing from history. But the Second World War was followed by free education for all, the National Health Service, and the birth of the welfare state. That war taught us to care for one another.

Today, the end of the costly pandemic — exacerbated by a global supply-chain problems, war in Ukraine, rocketing energy prices, and worldwide inflation — has brought us to a new crisis point in that post-Beveridge settlement.

Today, the NHS is in crisis. Waiting lists are at a record high of 7.1 million. People are dying on trolleys, as tens of thousands wait more than 12 hours for a bed after arriving in A&E. Maternity mortality is rising. Ambulance response-times for heart attacks and strokes are the worst on record. Elderly patients cannot leave hospital because there are no care beds.

All this is exacerbated by staffing problems. Overworked and overstressed medics are quitting the NHS. Nurses have voted to strike for the first time in the 106-year history of the Royal College of Nursing. The UK’s four chief medical officers this week told doctors that they might not face disciplinary action if they made medical mistakes because of this winter’s “significant and potentially prolonged” pressures.

The Government’s response to all this has been the usual vague talk about “efficiencies” and savings. The Health Secretary even told the Treasury privately that he would not be asking for more money. Although the nation is short of 10,000 doctors, the Government has not expanded places at medical schools. The Conservatives’ 2019 manifesto pledge to build 48 new hospitals lacks a budget, scoping, or timeline.

There are myths about NHS waste and inefficiency which need exploding. Research by the University of York’s Centre for Health Economics shows that NHS productivity grew by 16.5 per cent between 2004 and 2016, compared with just 6.7 per cent for the rest of the economy. Oft-derided NHS managers account for just two per cent of the NHS workforce, compared with 9.5 per cent for the whole UK workforce.

The Government routinely boasts that NHS spending is constantly rising; but data from the Nuffield Trust, an independent health think-tank, shows that, if you factor in population changes, NHS spending has actually flatlined since 2010. The amount needed to modernise buildings and kit has doubled since 2011-12. On hospitals, beds, equipment, doctors, and nurses, Britain trails almost every other OECD country.

The NHS has been knocked for six by Covid. But its problems long pre-date the pandemic. This is no time for the usual Conservative sticking-plaster policies. It is time to spend to build a health service in which human values count as much as economic ones. We have, in the words of the late Lord Sacks, been through too much simply to go back to where we were.

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