youThe gap between order and chaos is narrow. A patient from Swindon wait 99 hours for a hospital bed. A Gwynedd woman lies screaming for 25 hours for an ambulance to arrive. It is said that 500 people a week die for lack of emergency care. Britain’s much-vaunted NHS seems to have hit a wall. Winter after winter has cried crisis as numbers have risen towards capacity. Now everything has combined against him. Flu stacks on top of Covid, strikes stack on nursing home lockdowns and labor shortage. Whitehall targets for ambulance waiting times, GP appointments and free bed slots have taken on the ghostly uncertainty of Chinese pandemic statistics.
Health crises are different from crises in public services like education and transportation. They imply life and death. But given the fractured supply line from 999 calls to A&E admissions to hospital beds to nursing homes, it’s hard to know where to point your finger at cause and effect. The whole system seems to be about to explode.
Under Tony Blair, Labor oversaw one of the biggest increases in NHS spending in the post-war years. However, his policies failed miserably. Since the 2000s, Britain has lagged behind Germany, France, Canada and even the US in the availability of quality healthcare. Eight hundred GP practices They have closed in the last eight years. seven million patients await hospital treatment In England. A third of those under 35 years of age they are ready to spend their own money in private. national health service dentistry it is almost extinct. Many point out that other countries in Europe are currently facing similar crises – and that must be taken into account when reacting today. But be that as it may, the problem is still urgent and guilt is not the solution.
Politics is of little help. Both parties have “prioritized” the NHS before the election and have thrown money at it afterwards. Politicians yell at each other to spend more. It was even reported that the health secretary, Steve Barclay, had told the Treasury I wouldn’t know what to do with more cash if I got it.
Rishi Sunak and Keir Starmer recognize the urgency of National Health Service reform and improvement, so much so that it may be worth treating this like a war, with a parliamentary coalition while it lasts. It’s hard to think of anything more fatuous than the current weekly shouting match at the checkout counter. The model of a large centralized public corporation is no longer fit for purpose. It is not used anywhere else in Europe, where the management of health services is regionalized and localized. Britain’s layers – GPs, hospitals, nursing homes – are rigid and uncoordinated. Their occupational demarcations are archaic. Nothing changes.
The case for deep reform is slowly taking hold, but it carries a dire warning. Previous attempts, such as greater centralization, privatization, and the charitable state, have had their flaws. The NHS is manifestly too big, and bigness leads to ruling by edicts and targets. Nye Bevan erred in dismissing Herbert Morrison’s Wish make national health a local service. Attempts made in the 1980s to reduce the total waste of additional beds are one reason for the current acute shortage of beds. Little has been done to reform the care sector. Allowing the privatization of council residences has been an outrageous waste of money, but nothing has been done to stop it. It’s hard not to see the NHS as a model for everything that went wrong in the British public sector.
So we are left with today’s emergency. Nothing diminishes the support and affection of the front-line personnel. Like soldiers in times of war, they are workers that people instinctively turn to when all seems lost. This makes the decision by nurses to go on strike at such a time all the more reckless. The system has clearly failed nurses. NHS employment must be improved and localized somehow, and all energies must be directed at changing it.
Outside my local hospital, ambulances pile up, burying patients and medical staff. The scene inside is one of silent despair. Triage is blocked. The beds have run out. People must be suffering; some dying. The priority must be to empty the ambulances somewhere, anywhere (schools, churches, town halls) so that trained volunteers can come to their aid and the ambulances go into service. Health it is a local crisis. Retired doctors and nurses must be begged, summoned and, if necessary, bribed to return to work; private sector hospitals and clinics should be requisitioned. If this is like the 2020 pandemic again, then we should treat it as such. And maybe this time we can learn from our mistakes.