So once again we are being asked to stay home if we are unwell and to wear masks if we go out, this time to control the flu AND covid epidemic.
The inevitable protest is understandable. The NHS is meant to take care of us, not the other way around.
Yet despite the huge sums of money being poured in unabated (£3.3bn more to go into England’s NHS in 2023/2024), not a day goes by without another horror story.
even worse situation
The NHS is on the edge; It is perhaps no surprise that desperate bosses are advising people to wear masks in crowded spaces or to stay home if they get sick.
But this lockdown-Light measures are not the answer.
I’m afraid the warning signs of the impending collapse of the NHS have been there for years.
And many of us who work in the health system, as I have for four decades, are not silent either.
Five years ago I wrote that “once again our NHS is suffering through a winter of discontent; Operations are being cancelled, casualty units are under siege and anyone who is not seriously ill faces being turned away.”
At the time, two NHS chiefs warned that the pressures on A&E were the worst they had seen for 30 years. Sounds familiar?
As a result of the COVID-19 pandemic now we are in an even worse situation.
A&E units are overflowing, ambulances are stuck outside, and some patients are waiting hours to be seen.
Several health services unions are now implement strike actionadding to the problems.
Every winter there is enormous pressure on the health service, and we cannot count on flimsy masks to save it.
And we cannot continue with the current broken system, where the Royal College of Emergency Medicine estimates that there are between 300 and 500 preventable deaths a week in the UK due to failures in emergency care.
I think the NHS itself is in need of a radical cure. We don’t drive a car or fly an airplane designed in 1948, so why should we trust a health service designed 75 years ago?
To a large extent, we know the problems.
We now have the means to treat these conditions as well, but that means our aging population, with better healthcare but lack of social care, is “blocking beds” in our hospitals.
Up to 20 percent of hospital beds are occupied by patients who are medically fit for discharge.
These so-called “bed blockers” are your mom or dad, grandma or grandpa, uncle or aunt, none of whom have anywhere to go while you recover from your surgery or illness.
Since I became eligible 40 years ago, the number of hospital beds has plummeted.
To give just one example, Chelsea and Westminster Hospital was built to replace six hospitals.
The same has been happening across the country with the closure of local hospitals and cabins, which would be ideal for the rehabilitation and recovery of elderly patients.
So what can be done? The time to touch up the edges is over.
We need major system changes, both in the short and long term.
This would be my recipe:
1: PRIORITIZE URGENT CARE OVER NON-URGENT SURGERY: It may sound obvious, or it may elicit howls of rage.
But while we have desperately ill patients waiting in the hallways, we must stop elective hospital procedures that are not life-threatening, or contract with local private hospitals.
This worked well with some NHS hospitals during Covid and should free up beds for urgent cases.
2: THE DOCTOR SHOULD SEE YOU NOW: General practices used to be the first port of call when not feeling well, but now patients find it almost impossible to see their family doctor and instead go to the accident and emergency department at their local hospital.
We must complete online or telephone consultations which are a hangover from Covid and forcing GPs to see their patients face to face, with booking systems allowing them to make advance appointments via email and phone.
Pharmacists can also help with minor ailments and should be able to prescribe antibiotics for common ailments, as is the case in Scotland.
3: STOP THE STRIKES: Nurses and paramedics are not on strike simply to cause troubleor because they are greedy.
They have very legitimate complaints, and they are taking their current course of action. action out of desperation. But it is making an already dangerous situation worse.
Both sides in the various wage negotiations need to find a sensible – and quick – solution that takes inflation into account but accepts that we have to cover the costs of shutting down the country during Covid.
4: GET RID OF THE ROSE-RED SHOWS: We need an all-party commission to see how to produce an integrated health and social care system that will carry us through the 21st century.
One of the biggest problems with the NHS is how heavily politicized it is: “Our NHS”, “Envy of the world”, etc.
We need to end the hysteria and have an adult discussion about the future of healthcare.
We know the system is failing and now is the time to do something about it.
The NHS and US systems are at opposite ends of the health care financing spectrum, so we need to take a look at the successful French, Australian, German and similar systems, which are in somewhere in between, and then look towards the slow conversion of ours.
We also have to look at how their systems are managed. Anything not directly related to patient care should be ruled out unless a very strong case can be made to uphold it.
5: TRAIN OUR OWN DOCTORS AND KEEP THEM: Over the past few years, GMC has registered more doctors abroad than UK graduates.
We must stop stripping developing countries of their medical and nursing staff and train our own.
But that means we need a radical rethink of how we train and pay our newly qualified doctors and nurses.
Right now, we are losing large numbers of people who are choosing to take on agency roles, find work abroad, or leave the profession altogether due to the meager financial rewards and extremely challenging working conditions.
One thing that could be urgently reviewed is the large number of students debts As newly qualified physicians are now piling up, we should not saddle these desperately needed workers with such an enormous financial burden.
6: INVESTING MONEY IS NOT ENOUGH: The NHS gets a little worse every winter, and the population is only getting older, and the demands on the system are getting heavier.
Now is the time to address this, because the decisions made in haste when the system finally collapses will be the wrong ones.
Little has changed in the last five years, apart from the staggering sums of money being poured into the black hole of NHS funding.
This can’t go on. What politician will have the moral courage to stand up and call for a complete overhaul of the system?