It is no exaggeration to claim that the National Health Service in the United Kingdom is the most admired public institution in the world. There can be no doubt that since its storied beginning in the aftermath of the Second World War, it has become a central pillar for its society for decades for its offering of free, quality, healthcare. (Read here for a history of the NHS).
Yet now, after more than 70 years, the Service is under an existential threat or ahead lies a challenge of the order it has never before faced. This summary cannot do justice to the full extent of the problems facing service; it can only provide a semblance of a picture of the extraordinary challenges facing healthcare in the United Kingdom. These are primarily in England since some of the issues raised and included in the articles referenced below have been resolved in Wales and Scotland.
BMJ, too summarises the NHS’s challenges succinctly. It notes: “We are seeing a whole system under sustained and mounting pressure as demand for services continues to outstrip capacity. Urgent and emergency care services are most visibly bearing the brunt of this pressure. Meanwhile, waiting lists for planned care have increased significantly, and the physical and mental health of the population appears to have deteriorated as health inequalities widen.”
The result of the imbalance between supply and demand is industrial action, staff burnout, long waiting lists, citizen desperation, and an inevitable turning to the private sector.
To this last point, CNN notes after years of falling wages, stretched budgets and staff shortages and the state of crisis while faced with an ageing population that needs its services more than ever has led to “a boom in demand for private health care from a much broader swathe of the UK population than ever before. This is the media outlet notes, “a fundamental shift for a nation with one of the world’s best-known universal health systems.”
According to CNN interviewee Dr David Furness at the Independent Healthcare Providers Network, an industry body for private healthcare companies, their providers are telling them “that people are going private, many for the first time, and the key factor driving that is the challenge in accessing NHS care.” In other words, the very aspect of the service that has for half a century made the NHS unique – its accessibility is now evidently under siege.
An escalating hospital bed shortage is also exacerbating the healthcare crisis as strains on the wider social network mean recovered patients who need further care have to remain in hospital because recovery places are unavailable.
It is incorrect to say that no salvage operations are underway, but these do not look promising. A Parliamentary Committee notes that NHS reforms will not work until Government fixes longstanding problems.
In all then, it seems clear that a generational challenge faces the NHS, the most admired healthcare system in the world. Once considered the most humane and compassionate of government systems by many, it is now pilloried on social media as uncaring and out of touch:
There are lessons for other nations who aspire to build a similar system. These lessons are for the reader to eke out.
To help further your thinking, this worthwhile podcast is a good starting point. In it, Rory Stewart and Alistair Campbell interview Alan Milburn, Health Secretary under Tony Blair. The title: Can the NHS be saved?
Good question.
