hthe hospitals are full of patientsthe staffing crisis in adult social care continues to escalate, and an alarming number of young doctors report that they are planning to resign their NHS positions to work abroad. The many problems facing the UK health and care system are interconnected and have taken years to develop. While the pandemic exacerbated many of them, enormously increased pressures on staff, political failures and, above all, a lack of investment are making it impossible for service to stop this winter, let alone recover.
The alarming but very real prospect is that things could get worse. In a Christmas message to staff, NHS England chief executive Amanda Pritchard said she had always been concerned that “the ongoing pressures… could be even more difficult” to deal with than Covid. Such fears seem prescient. with figures showing 13,697 hospitalized patients ready to be discharged But with nowhere to go in November, and more strikes expected, Rishi Sunak’s government appears committed to a course of action designed to maximize conflict and disruption.
As chairman of parliament’s health and care committee, Jeremy Hunt called for £7bn in additional funding for the social care sector, to prevent it from acting as a block and a burden on the health service. Appointed chancellor only a few weeks later, he has not served this sentence. The £500 million winter fund created to facilitate dumping has not increased. Now that flu cases are rising sharply, and more people in some parts of England are expected to be in acute hospital settings in the new year than in the past seven years, the inadequacy of such measures is painfully obvious.
It is highly doubtful that Sunak and his colleagues have the will or the courage to do what is needed. Number 10 is reported to have struck down a suggestion by health secretary Steve Barclay that a one-time payment to nurses could ease the deadlock. But the truth is that the years of underfunding, particularly in 2010-15, when annual increases in health spending averaged less than 1%, severely damaged the service. The lack of a social care strategy, or public health aimed at limiting the damage caused by obesity in particular, have made things much worse.
Ministers do not want to admit these mistakes of the past or explain to the public that if we want to continue to live longer and fuller lives, with access to the latest medicines and be cared for if we develop dementia, then our health and care services need more money. The £4 hourly rate that councils pay to residences, for those who need 24-hour care, is derisory. With the number of people living with dementia across the UK expected to rise to over 1.6 million by 2050, from an estimated 944,000 today, issues include distressing cases of abandonment and abuse should be expected to worsen in the absence of drastically altered public policy.
Whether four in 10 young doctors will actually quit remains to be seen. A wage increase was agreed, but has been outpaced by inflation. The danger is that as conditions worsen, so does morale. Frontline workers are already at greater risk of being physically attacked. The latest figures from Scotland show that there were almost 20,000 assaults on NHS staff there in the year to March 2022, an increase of about 34% from before the pandemic.
This is a shocking statistic to compare with the alarmingly high number of job offersand a Waiting list of more than 7 million people in England. Our health and care services are seriously threatened. The government’s obstinacy in the face of demands for reasonable wages could not be further from a solution.