Safety levels fall while deficits rise in the NHS
Edmund Stubbs, 15 October 2015
The Care Quality Commission’s ‘State of Health Care and Adult Social Care’ report has compounded the woes made apparent in last week’s announcement that NHS trusts have accumulated £1 billion of deficit in the first three months of this year.
The independent health and social care regulator’s report has identified inadequate safety practices in three quarters of the hospitals it has so far studied 14 months into its 24 month programme. The regulator has judged 13 per cent of hospitals, 10 per cent of social care centres and 6 percent of primary care services actually ‘unsafe’ respectively, although it should be stated that they have investigated those institutions deemed to have poorer reputations first.
There is obvious concern when a system is running into huge deficit while not being able to guarantee patient safety. This indicates that the effects of insufficient funding the NHS, in its current form are more serious for the individual user than the bald figures suggest.
Any honest appraisal, which, I would suggest, has not been available to date, would be forced to admit that our health system is now evidently struggling to cope with dramatically increased demand, at least in part the result of unhealthy 21st century lifestyles and increasing population. Perhaps now, with the revelation that patient safety is seriously compromised the British people might start to realise that the health service as a panacea for all ills cannot be simply taken for granted.
It has further been reported by Kings College London this week that 2,400 cancer patients die needlessly each year due to late specialist referral. It is already acknowledged that clinical outcomes and survival rates are fairly poor in the UK compared to other comparable countries.
Indeed, within the healthcare system, caring staff are frustrated, tired and sometimes depressed by not being able to provide the care they regard as being necessary due to factors outside their control. Senior NHS executives, such as Dr Keith McNeill, widely regarded as highly competent, are leaving their posts due to what they regard as the impossibility of adequately doing the job they are employed to do. The issue is well illustrated by the case of Hinchingbrooke Hispital where the previously confident Circle Health chose to withdraw from managing the institution due to the impossibility of running the hospital on inadequate resources.
The NHS as we know it is beginning to falter. It is no individual’s nor any one political party’s fault; perhaps some blame can be attributed to our whole society. Our population is unwilling to modify unhealthy lifestyles and reduce the exponential demand for acute healthcare, nor willing, it seems, to pay more tax to allow increased investment in the healthcare sector.
On the policy level, for example, the government’s desire to introduce a seven-day NHS, has led to bitter confrontations between it and medical professionals, perhaps unnecessarily. As John McTernan stated in a recent Civitas seminar: it seems arbitrary to focus so emphatically on one issue when there are plenty of other areas where population health could be significantly improved with the same amount of effort and investment.
In short, no new top-down reorganisation can save the NHS without increased resources. If spending is to be increased it needs to be focussed outside the acute hospital sector where in time a preventative healthcare emphasis might be encouraged. In effect, healthcare services must become producers of health rather than providers of emergency damage limitation.
Edmund Stubbs is Healthcare Researcher at Civitas. @edmundstubbs1