Monday 16th January

The NHS is in crisis.  It has been for years really, but three factors have contributed to create the perfect storm.  Firstly and most importantly, funding.  Despite Cameron promising 50 billion more for the NHS (an election promise quietly forgotten) the NHS has received just around inflation increases for at least 6 years.  It seems the dim distant past when Gordon Brown promised to raise spending on the NHS to European levels, and to his credit he went some way towards this, but we are falling back as each year passes.  Secondly, what the NHS can do, or rather our expectations of what it should do are increasing.  Thirdly, the population of the UK has increased by 3 million in the last few years, and yet no extra money has been made available for these extra patients.

Solutions?  Well, before that we have to decide one fundamental question, do we want a first-class health system?  If so it will have to be paid for, and that will mean higher taxes (even under Thatcher we were paying 25% basic income tax, now only 20%) or some form of compulsory insurance; both of which of course will mean the public paying for it in one way or another.  The second question is what should the NHS be;  should it be there for every ailment, or just for serious sickness?  Should it, for example, be offering IVF treatment (is not being able to conceive actually an illness?) should it be doing cosmetic surgery unless after an accident, should mild hearing disorders be treated on the NHS (after all we pay happily for private dentistry and spectacles) and so on.  I am sure everyone will have different opinions, but a debate wouldn’t be a bad thing. Thirdly we must seriously join up the NHS with Social Care, far too much money has been wasted on re-organisations already, but the two are intractably linked and must be treated as a whole.  One other thing should be considered, a total ban on all agency staff.  This will probably need a couple of years lead-in time, but it is a nonsense that the NHS is paying 50% extra for agency nurses when they cannot recruit the same nurses because the pay is too low.

None of this will alleviate the current crisis.  Before we go any further we must give an immediate cash injection.  There was no shortage of money in 2008 when the banks went bust.  Most trusts are deep in debt and we need a fresh start and new budgets unemcumbered by past errors.