Our NHS, started in 1948 by Aneurin Bevan, has provided free healthcare for many and has been part of UK national pride for decades. However, some argue that it is not without its price. Today our NHS is in crisis. Limited funding and finite resources are overwhelming NHS services. Many have debated over the sustainability of the NHS today and questions such as whether privatization should occur are rising. Public opinion remains that if the NHS can be sustained, then the NHS should be sustained. But the question is, can it?

Sustaining The NHS: The Future

picture from Evening Standard

The NHS is facing a financial crisis and its services are being overstretched beyond limits. The budget allotted by the UK Government is inadequate. The NHS budget will only grow by a meagre 1.2 % from 2009/10 to 2020/21. According to the Office of Budget Responsibility, the rate of increase needed is 4% annually in order to keep up with Britain’s expanding and aging population. In 2016 the NHS had a record deficit, out of all 233 trusts, 66% had overspent their budget. In 2018, 48% of the trusts are still expected to remain in deficit.

Consequently, the NHS is having to compromise with its core principle of quality and excellence in patient care. The A&E waiting time is increasing, and it only worsens during winter pressure. During winter months, pressure only intensifies and the NHS faces record levels of demand due to winter-related illnesses. The target set for 95% of A&E patients to be seen within 4 hours was not met and only were 89.7% were seen in target time in October 2017.

To deal with high demand, other areas of the service are being re-organised. For example, the target to treat 92% of the patients in 18 weeks for non-urgent surgeries was dismissed in March 2017. Since February 2016 this has not been met and NHS data shows that 1 in 10 people were waiting longer than 18 weeks for their non-urgent surgeries like hip, knee and cataract operations. NHS chief, Simon Stevens saw this move as a “trade-off” in an effort to improve hitting A&E and Cancer treatment targets. Despite the efforts, the 62-day target for cancer was breached and the A&E target is still yet to be met. In addition, the staffing crisis is further undermining the performance of the NHS. Although numbers of doctors and nurses are increasing (0.5% per year), the A&E has seen an exponential rise in patient numbers and has reported treating more patients than ever before.

Despite all these issues, the NHS is still ranked as the most efficient healthcare system of the 11 wealthy countries by the commonwealth fund. Public satisfaction with ‘how the NHS runs nowadays’ was 63 % (King’s fund survey 2017) and inpatient satisfaction was 62% (CQC 2016). It is noteworthy that the much-valued NHS principles founded by Aneurin Bevan are still as relevant today as they were when the NHS was first founded: that the NHS is still free at the point of delivery and is still based on clinical needs rather than the ability to pay.

There are still tough decisions ahead. The NHS is considered a representation of our core British values; it is considered as an asset for the country by the House of Lords and by the people. Therefore, the government needs to take more action. Thorough consideration should be given to certain solutions such as privatization, while solving the problem of the quality of care; it leaves thousands unable to access it. While making the NHS only free to those unable to access it raises questions about differences in standards maintained in care given. Leaving the NHS in its current state will only leave conditions to deteriorate. In the words of the House of Lords, “Is the NHS sustainable …? Yes, it is. Is it sustainable as it is today? No, it is not. Things need to change.”

By G Chakraborty