SO again we are being asked to stay home if we are unwell and wear masks if we go out – this time to control the flu and the Covid outbreak.
Advice from the UK’s Health Safety Agency this week had the inevitable echo of the Stay at Home, Protect the NHS, Save Lives crisis.
The inevitable cry is understandable. The NHS should look after us, not the other way around.
Yet despite huge amounts of money being pumped in non-stop – a further £3.3billion going into NHS England in 2023/2024 – hardly a day goes by without another horror story.
Worst case scenario
The NHS is on edge – perhaps unsurprisingly, desperate bosses are advising people to wear masks in crowded places or stay at home if they get sick.
But these preventive measures are not the answer.
I fear the signs of the imminent collapse of the NHS have been there for years.
And many of us who work in the health care system, as I have for four decades, are not silent either.
Five years ago I wrote that “once again our NHS is experiencing a winter of discontent; operations are suspended, aid units are surrounded and anyone who is not seriously ill is at risk of being turned away.
At the time, two NHS bosses warned the pressure on A&E was the worst they had seen in 30 years. Can you hear me?
After the Covid pandemic, we are now in a worse situation.
A&E units are overflowing, ambulances are stuck outside, with some patients waiting hours to be seen.
A number of health care unions are now on strike, exacerbating the problem.
Every winter the pressure on healthcare is great and we can’t rely on a few flimsy masks to save it.
And we cannot continue with the current broken system, where the Royal College of Emergency Medicine estimates there are 300-500 preventable deaths a week in the UK due to failing emergency services.
I believe that the NHS itself needs serious treatment. We don’t drive cars or fly in airplanes designed in 1948, so why should we rely on healthcare designed 75 years ago?
In general, we know the problems.
People are living longer with an increasing number of chronic diseases, including diabetes, heart disease, arthritis and dementia.
We now have ways to treat these conditions too, but that means our aging population – with good health care but a lack of social care – is “blocking beds” in our hospitals.
Up to 20% of hospital beds are occupied by medically fit patients.
These so-called “bedlockers” are your mother or father, your grandmother or grandfather, your uncle or aunt, none of whom have a place to go while recovering from their surgery or illness.
Since I graduated 40 years ago, the number of hospital beds has dropped dramatically.
To give just one example, Chelsea and Westminster Hospital was built to replace six hospitals.
The same has happened across the country with the closure of local and rural hospitals, which will be better for the rehabilitation and recovery of elderly patients.
So what can we do? The days of playing around are over.
We need major changes in the system, long term and short term.
This will be my remedy:
1: PRIORIZE EMERGENCY CARE OVER NON-EMERGENCY SURGERY: It can be obvious or cause angry screams.
But when we have terminally ill patients waiting in the hallways, we should abandon non-life-threatening hospitalization procedures, or relegate them to local private hospitals.
This has worked well with some NHS hospitals during Covid and should open up beds for emergency cases.
2: THE DOCTOR NEEDS TO SEE YOU NOW: GP surgeries used to be the first port of call when you were unwell – but now patients are finding it harder to see their GP and heading to the accident and emergency department instead of their local hospital.
We must stop online or phone consultations which are a hangover from Covid and force regular doctors to see their patients in person, using booking systems that allow them to make appointments in advance. by email and by phone.
Pharmacists can also help with minor illnesses and should be able to prescribe antibiotics for common illnesses, as is the case in Scotland.
3: STOP THE STRIKE: Nurses and health workers do not strike just to cause trouble or because they are greedy.
They have very valid grievances and are taking their current course out of desperation. But this exacerbates an already dangerous situation.
Both sides in the various wage negotiations need to come up with a sensible – and quick – solution that takes inflation into account but accepts that we have to pay the costs of shutting down the country during Covid.
4: REMOVE THE PINK GLASSES: We need a multi-party commission to look at how to create an integrated system of health and social services that will carry us into the 21st century.
One of the biggest problems with the NHS is its heavy politics: “Our NHS”, “Envy of the world”, etc.
We need to end the panic and have a mature debate about the future of healthcare.
We know the system is broken and now is the time to act.
The NHS and US systems are at opposite ends of the health care funding spectrum, so we need to look at the systems in France, Australia, Germany and similar, which are in the middle, and then consider slowly changing ours.
We also have to look at how their systems are managed. Anything not directly related to patient care should be left out unless a very strong case can be made for keeping it.
5: TEACHING OUR OWN DOCTORS – AND KEEP THEM: In recent years, the GMC has registered more overseas than UK graduates as doctors.
We must stop depriving developing countries of their medical and nursing staff and provide training to our countries.
But it does mean we need to rethink the way we train and pay our newly qualified doctors and nurses.
At the moment, we are losing a large number of people, who choose to either take agency positions, seek work abroad or leave the profession altogether due to poor financial remuneration and working conditions. Very difficult work.
One thing that could urgently be revisited is the massive student debt that new medical graduates are now saddled with – we shouldn’t burden these much-needed workers with a huge financial burden.
6: PAYING MONEY IS NOT ENOUGH: The NHS is getting worse every winter – and the population is getting older, and the demands on the system are getting heavier.
Now is the time to fix this, because decisions made quickly when the system crashes will be wrong.
Not much has changed in the last five years other than the huge amount of money going into the NHS funding black hole.
This cannot continue. Which politician will have the moral courage to stand up and demand a complete overhaul of the system?