Virtually every day media headlines include adverse news about the state of healthcare, and the NHS in the UK is no exception to this rule. Over the past few weeks, for example, the media have included the following news items:
- Doctor’s workload: Care system in crisis, says GP
- UK Faces nursing shortage due to cutbacks
- The NHS needs an extra £8 billion a year to survive and meet its challenges
- Paramedics facing stress over long hours, staff shortages and tough demands
- ‘Creaking’ mental health care keeps children waiting years
- A million elderly people lack basic social care as unprecedented funding cuts leave struggling NHS to pick up the pieces
This is just a small selection of the headlines identifying the issues facing the UK healthcare service, which for decades past and, unless a change of approach is adopted, leaves it firmly imprisoned in a dark political dungeon where there is little hope of release. Leaving aside political preferences and rhetoric, it is argued that this dungeon is being formed by a perpetuating circle of inequality, discrimination and waste, which no political party appears capable of, or willing to breach.
The dungeon of triangular NHS constraints
The constraints that have been identified are intrinsically interconnected, related to the headlines, and impact on the NHS workforce and the patients they are tasked to serve.
For healthcare professionals inequality exists in the poor working conditions they are required to work in. Long hours lead to exhaustion stress and fatigue, all of which have an adverse effect on the quality of care provided by the patient. Yet at the same time, there are NHS executives, managerial teams and external consultants employed by the government to report on failures and policies who are being highly paid to perform tasks that are not nearly as stressful. Indeed many NHS trust CEOs are being paid the equivalent of 10 nurses wages per annum. Where is the equality in such a system?
It is equally apparent from some of the headlines presented that discrimination is actively present in the structure and management of the NHS. When funding is short, as appears to be the case at present, who is discriminated against by the healthcare system? Clearly it is the most vulnerable people in our society, the young disturbed children and the elderly. Is it because they are assumed by politicians to have no economic or political value? Or are we too busy building state of the art offices and medical centres costing hundred’s of thousand’s of pounds to bother about those who deserve our care?
The NHS apparently requires £8 billion to avoid a funding crisis and this excludes ongoing increases in funding levels. Good value and much-needed you might say if it helps to return the quality of patient care we all want to see, and we would not disagree with you at all. However, why do the politicians give the impression these funds need to come from the resources of members of the public. Why not reduce the waste associated with the NHS and social care. I am not talking about the physical services provided but the ancillary spending of consecutive governments. Take for example, the wastage in costs spent on public inquiries and reporting. The inquiry into the sad case of child abuse that led to the death of Victoria Climbie cost in excess of £13 million. Yet were the lessons implemented and learned – No! A few years later there was another inquiry, this time into the case of ‘Baby P’ who suffered a similar fate to Victoria, costing further tens of millions.
Where is the key to unlock the door?
When you consider the countless numbers of public inquiries and reports commissioned by government, at a cost of £1,000’s per hour, it does not take a genius to work out that, if these were more closely monitored, if lessons were learned and the appropriate action was implemented and, more importantly the outcomes monitored, it would not take long for this wastage and savings in time costs and resources would more than cover the of £8 billion the NHS is now requesting. At the same time, improvements in training and rationalisation of the ‘cost’ top-heavy managerial structure would serve to reduce workforce inequalities and end patient discrimination.
It is for government and political parties to act rather than continuing to use the NHS as a tennis ball in the unsavoury game of electioneering.
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