Bad news the NHS doesn’t deserve: a response to the King’s Fund Report
Edmund Stubbs, 26 March 2015
A new report claims that the NHS’s services are ‘deteriorating in a way not seen since the early 1990s’, but at the same time the NHS has been doing rather well!
The King’s Fund report reveals that many trusts are slipping into a funding deficit as the end of this parliament approaches, waiting times for emergency treatment and hospital treatment such as cancer care are being missed and that levels of bed occupancy are dangerously high. Despite this, the report concedes that frontline staff and managers throughout the NHS seem to have been doing a very good job.
Although there seems to be consensus that the large scale re-organisational reforms introduced during the early years of the coalition were detrimental to the provision of services, it seems that in the later years of its term the current coalition government could have done little to remedy the deteriorating services we are now witnessing. The coalition did, it appears, even succeed in increasing NHS funding by a little more than had been initially planned.
The NHS has generally succeeded in meeting most of the increasingly heavy demands placed upon it. Managerial staff levels have been reduced and the significantly raised productivity targets set seem to have been largely achieved. At the same time the NHS has also managed to reduce cross infection rates amongst hospital inpatients.
However, the King’s Fund report claims that despite growth in the numbers of GPs and Nurses since 2010, the ratio of health professionals to patients has not kept pace with recent population growth, a growing population which is ageing and increasingly reliant on long-term medical and social care. Demand on health services is therefore increasing, but without the staff and resources to meet it. The King’s Fund also repeats what others have predicted: that it is highly unlikely the NHS will be able to achieve the productivity gains of £22 billion a year as over optimistically predicted in NHS England’s ‘Five Year Forward’ Review.
The fact that overall patient satisfaction with the NHS seems to has increased may indicate that staff are working harder than ever ‘behind the scenes’ to prevent the strain on the system from showing. However, the King’s Fund and other investigations have discovered that in terms of staff morale, increased pressure is starting to take its toll. Staff members are feeling increasingly helpless and dissatisfied as they watch more and more patients receiving late and sometimes substandard treatment.
These hardworking staff deserve praise for their astounding effort and achievements in increasing productivity to the level they have, though it must now be recognised that we have reached the limits of what increased efficiency can do to improve our health system.
Yet another major reorganisation of the existing institution could easily do more harm than good. To maintain acceptable standards, funding will have to be increased by much more than the presently suggested annual £8bn. Failure to do so might entail the ending of some essential services currently offered by the NHS, causing serious damage to its social function and reliability.
In terms of reducing staff morale, increased demand on the service might already have made the NHS’s situation precarious. Many dedicated personnel are now realising that the real causes of the NHSs problems are not managerial or ideological but a simple lack of funding. Minor tweaks or even major reorganisations are unlikely to counter the harmful results of the funding gap, which, as the King’s Fund report points out, we are now beginning to experience. A funding gap predicted to reach £30 billion by 2020.
One can only hope for a serious discussion of the issue of NHS funding, but this, alas, is only likely to occur after the forthcoming election. In any case the time has come to say ‘enough is enough’. We cannot ask the NHS to make further cuts and or embark on further efficiency drives which both now threat the organisation’s own sustainability.
Edmund Stubbs, Healthcare Researcher, @edmundstubbs1