The NHS as an election priority

Sickness is a threat we all want to overcome and a properly functioning health service is an obvious public good. The NHS was created in 1948 in recognition that health care is a right and should meet the needs of every citizen and be free at the point of delivery. Now there is concern that it has too much to do and has insufficient income to deliver what is needed. There are significant staff shortages and standards are being cut. That makes the NHS a priority issue in the election.

The demand for its services has increased because the population has grown in the last ten years from 60 million to 64 million. People are living longer now and there are more people over 65 but 47% of them have limiting long standing illnesses that require medical care. There are fewer smokers now but more people have obesity related problems such as diabetes. NHS Digital reports 17.1million admissions in 2018-19, 3% more than in the previous year.

Since 2010, Government spending has been squeezed as part of the Government’s attempt to reduce the budget deficit and this included the NHS. Its funding has been restricted to just 0.7% above the rate of inflation The NHS budget for 2018-19 is £115 billion whilst the Department of Health has spent another £14 billion on public health initiatives, medical education and training, and building new hospitals. An additional £20.5 billion will be spent by the NHS England over the five years to 2023-24. Nevertheless the increased demand for its services has compelled the NHS to ration some treatments and dilute the standard of service in some areas.

The NHS is the biggest employer in Europe with a workforce of 1.1million but approximately 100,000 posts remain unfilled.  One estimate in the last year is that there is an 8% shortfall of nurses in hospital and community services. That is 40,000 vacant nursing posts and over 11,500 doctor posts unfilled.

Campaigns to recruit nurses from overseas are currently being pursued. Hitherto the EU was a source of recruits but Brexit has made the UK a less attractive option now. In 2015-16 19% of nurses who joined the NHS came from the EU but that number had fallen to 7.9% and is still falling. It is reported that recruiters are now targeting poorer countries outside Europe but that raises moral questions about how that might leave those countries even worse off.

There is also an issue of morale in the NHS. Research by Exeter University revealed that 54% of the GPs who took part in their survey reported low morale. The Chairwoman on the Royal College of GPs said the health service was “haemorrhaging highly trained, experienced GPs at an alarming rate”.  She reminded us that “the future of the NHS relies on having a robust general practice service, with enough GPs to deliver a safe care and services our patients need”.

A spokesperson for the Department of Health said the survey doesn’t take into account measures to ease the pressures on front line medics. The Government has pledged to increase the number of GPs by 5000 by next year. It takes up to seven years to train a doctor so many of those recruits will have to come from abroad.

Each of the parties is promising to spend a lot more if they are elected on 12th December. Money doesn’t grow on trees. Schools also need increased funding whilst tackling climate change and knife crime will not happen cost free. There are limits to what the nation can afford and before each of us vote we have to decide which services we want to be better funded. 

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