In 2012, Britons delighted in the spectacular opening ceremony of the London Olympics celebrating British history. One of the curtain-raiser’s most popular sequences, drawing loud applause, involved 1,800 dancers and 320 hospital beds honoring the country’s National Health Service.
Six years on, and Britons are more likely to moan about the world’s largest single-payer health care system than praise it.
According to patients, doctors and analysts, the NHS is buckling and close to collapse, with emergency departments over-burdened, hospital wards full and all nonessential operations — more than 55,000 of them — suspended because of a winter surge in demand.
Fueled in part by unseasonably cold weather, an especially virulent flu strain and cuts in social care, leaving hospital beds occupied by the elderly who have nowhere else to go, the winter crisis has brought home to the country the fragile state of the NHS.
Last week, an 81-year-old pensioner suffering chest pains died after waiting four hours for the ambulance service to respond to her emergency call. Patients are being left on gurneys for hours in drafty corridors waiting for beds to become free, and hospitals in the northeast are reporting an outbreak among patients of the gastroenteritis norovirus, dubbed the vomiting bug.
Politics involved
Norman Lamb, a former health minister, blames “tribal politics” for failing to deliver “a solution to the existential challenges facing the NHS and social care.”
“The winter crisis of the past few weeks is unfortunate proof that the current situation is unsustainable, and these pressures will only get worse as we contend with an aging population and rising demand for care and treatment,” he said.
British Prime Minister Theresa May has apologized for the suspension of non-urgent operations and for some emergency departments having to turn away all but the most grave cases, but she insists there isn’t a crisis and the government is on top of things.
Asked during a BBC interview Sunday if she could remember a worse winter crisis, May said, “The NHS has actually been better prepared for this winter pressures than it has been before.” She added, “You mentioned operations being postponed. That was part of the plan.”
May pointed to top-up funding of $450 million announced last month. But her own health minister, Jeremy Hunt, has hinted much more needs to be done to restore the world’s fifth largest employer, and argues it would be better if NHS funding were set on a 10-year time frame.
More than 90 lawmakers have signed a letter calling for a cross-party convention to discuss how the NHS can be funded to cope with a graying population that lives longer. The Center for Policy Studies warned Sunday that money from general taxation won’t be enough to fund the growing pressures of an aging population and increasing demand. “Alternative, additional sources of revenue for the NHS” need to be identified, it argued.
Long view needed
Lord Saatchi, a coauthor of the CPS report, said a long-term funding plan not tied to short-term political objectives is needed.
“The wonderful dream of the NHS is turning into a recurring winter nightmare, and leaving it alone is a recipe for long-term catastrophe,” he said.
The NHS lags behind many of Europe’s other health systems — most funded by a mixture of private and public means — when it comes to medical outcomes. Britain has the most overweight young adults in Europe, with 29 percent of women under 25 classified as obese. Obesity, depression and dementia are all on the rise.
Analysts say the NHS can take partial credit for the rise by about 10 years in life expectancy during the past half century. But it is ill-equipped to deal with one of the spin-offs of increased life expectancy — chronic ill-health.
The service’s annual budget has risen over a hundredfold since its founding in 1948 — its annual budget is $170 billion, about 10 percent of the country’s GDP. But chronic care costs now account for more than 80 percent of the NHS budget. Some analysts are forecasting that treating patients suffering Type 2 diabetes alone will account for 25 percent of the NHS budget by 2025.
The frontline NHS emergency departments are taking more of the strain as other services are cut, including walk-in clinics — 40 percent of which have been closed in recent years. The service is woefully short of family doctors and nurses, whose salaries have been cut, and it is finding it hard in the wake of the Brexit referendum to recruit more from Europe, which supplies a large proportion of the NHS’s junior doctors and nurses.