Fundamental NHS reform is now unavoidable

There was always something perverse in the lockdown slogan: “Stay home, protect the NHS, save lives.” The NHS is surely meant to be there to protect us. However, in the decades since its founding, the relationship between the nation and its health service has slowly altered. Rather than the NHS shaping itself to meet people’s needs, the public has increasingly been asked to adapt to the failures of the NHS.

The effects of this are now all too apparent. Despite inflated budgets, waiting lists have grown to more than seven million; ambulance queue out of hospitals, unable to discharge patients or pick up new ones; cancer care has reached the point where two-week goals for visits and two-month goals for treatment are lost by a significant margin.

Behind such statistics are needlessly cut short individual lives. Each one is an avoidable catastrophe. Each is an indictment of a system now in need of a fundamental reassessment.

Today, with the worst of the pandemic behind us, the NHS continues gobble up an ever-increasing share of public spending with each passing day, however, he seems to do less and less with money. That is a spending trend that is patently unsustainable, as it requires growth-damaging tax increases and cuts in real terms in other areas of public spending.

Yet, as readers’ letters to this paper attest, while the public is acutely aware of the problems now besetting the NHS, the country’s politicians still shy away from talking about real change.

This is strange. After the financial crisis of 2007-08, in which the bailout of the banks nearly bankrupted the country, followed an intense period of introspection. The financial system was reformed. A new regulation was imposed in an attempt to ensure that such a disaster never happens again. Nothing similar is happening with the NHS today.

The Labor leadership has made some vague noises about the need for reform, but on much of the left to even consider the issue is sacrilege. Conservatives are too terrified to propose anything more than minor bureaucratic fixes. There is a general feeling that the problem is too difficult to solve.

That’s not good enough. In fact, given the crisis that now engulfs health provision at all levels, silence is the real scandal. If neither party is brave enough to tackle the problem alone, it may be time to a cross party inquiry into the future of the NHS. It has played an immense role in the life of the country after the war, but we cannot go on like this: there is an urgent need to examine from first principles how best to care for patients in the years to come.

There is a large body of international evidence that could be considered. Both France and Germany manage to put more money into health care with their blended insurance models, which are also far more responsible than the UK monolith state. Consequently, many Germans are shocked to learn that it is impossible for us to see a GP; the French can rely on a system that is often considered the best in the world.

Meanwhile, as our society ages, the foundation of health care may also have to change. Some argue that the focus will have to shift to prevention to delay or prevent costly chronic diseases like type 2 diabetes. If so, people will need to be incentivized to take better care of themselves. Surely private health insurance should attract tax breaks, instead of being punitively taxed as it is today.

However, whatever solutions are proposed, we know the cost of not addressing important issues like this. More than a decade ago, an independent commission was created under andres dilnot Review the financing models for social care. His recommendations, fair contributions from both individuals and the state, were widely applauded. However, nothing was done to legislate for change, and hopes that a political consensus could be built around the reform were dashed. The consequence is today’s social care crisis, which only compounds the problems of the NHS.

The country cannot afford for this to continue any longer. Everyone should be able to access high-quality, affordable health care, when they need it, but the NHS no longer provides that. British politicians must realize the need for major change before it is too late.