The Washington-based Commonwealth Fund’s recent assessment of the NHS in its report on world healthcare systems stated that: “The United Kingdom ranks first overall, scoring highest on quality, access and efficiency.”
Since its inception, the NHS has practically become the quintessential British institution; something that British citizens are a part of, and should remain, incredibly proud of. The opening ceremony of the 2012 Olympics celebrated the NHS for all of the world to see. However, it is hard to believe that the NHS has been classified as number one when avoidable tragedies such as the death of Sonia Powell are able to happen. Mrs. Powell tragically passed away whilst waiting in an ambulance 36 minutes after arriving at the Morrison Hospital near Swansea, unable to be seen by a doctor due to an overflowing A&E unit on the 17th of September.
One of Mrs Powell’s granddaughters released a statement blaming NHS cuts for her grandmother’s death, citing lack of communication between hospitals and lack of facilities as the main causes of overcrowding in A&Es across the UK. The root of these problems is more down to the freezing of funding, increasing only in line with the rate of inflation, as the NHS has been protected against direct budget cuts under the Cameron administration. A budget freeze may work in a textbook, but with increased demographic pressures due to an ageing population, and rising drug prices, the NHS faces a £2 billion funding gap for the 2015-2016 financial year as it struggles to balance efficiency savings with high quality service provision.
One way in which the Department of Health has attempted to making savings within the NHS is scrapping the 1% yearly wage increase for NHS staff in line with cost of living rises, freezing general staff pay rises for up to two years. Incremental wage increases have been maintained, but this creates an imbalance in salary increases as it is necessary to pass through salary points to get a wage rise, thus staff at the top of their salary bands get no wage increase whilst others do. This lack of fairness in wage structure, allied with expecting the same amount of staff to do overtime and deal with more patients, has led to Unison calling for strike action, backed by 68% of medical staff, for the first time in 32 years. Given the ethical considerations of strike action by medical professionals, this is not a decision that has been taken lightly. Health Secretary Jeremy Hunt continues to refuse to meet with Unison officials, a move that will seem irresponsible given the potentially disastrous implications of a strike as Britain commences the autumn and winter months. Unison say that they are working to ensure that any strike action does not affect frontline services, but when staff are already being asked to work overtime, this seems unlikely. A fairer solution to the salary concerns of medical staff would be to reinstate the 1% annual pay rise, and scrap imbalanced incremental payments, which tend to reward experience as opposed to ability. This would in turn discourage strike action that currently appears likely to take place.
The NHS is something that the UK should indeed be proud of, but it must not be treated as a kind of sacred cow. New long-term funding needs to be allocated if serious budget cuts, which would directly impact the quality of care provided, are to be avoided. Other tragedies like Sonia Powell’s death must be avoided at all cost in the future, and such long-term funding may help to prevent such incidents. Matt Tee of the NHS Confederation has called for a 10 year funding settlement, to create a sense of certainty so that local health authorities can plan without the prospect of having to change tack at short notice. With the certainty that a long-term funding guarantee would bring, the NHS could guarantee staff the pay that they deserve, which would prevent strike action and make necessary efficiency savings that would not affect frontline services. By integrating this with a new focus on preventative and localised healthcare, which would relieve pressure on overcrowded hospitals, the NHS would be able to continue to provide the high quality service that has made it the model envied by the rest of the world.
Photo credit: Ralf (Flickr user)