I have written a series of blogs on "the NHS Crisis", the first one in May 2011, some 13 years ago, and here is yet another update. However, this time it has been written for me - courtesy of an official Government Report, "Independent Investigation of the NHS in England, which does not write off the problem as a little local difficulty that will be solved by pouring more money into a failed institution!
The report was published after a 9-week review of the NHS by Lord Darzi, an independent peer, and former cancer surgeon, initiated by the election of a new Labour government in July 2024. It has been widely reported in the mainstream media, and paints a stark picture, far beyond the usual problems with long and growing waiting lists and delays in response, diagnosis and treatment throughout the entire NHS organisation. The report states that:
- Accident and Emergency services are in "an awful state":, with long waits estimated to be causing an additional 14,000 extra deaths (annually).
- The health of the nation has deteriorated, and has brought in "a surge in long-term mental health conditions".
- Rising levels of illness risk economic prosperity, with 2.8 million people now unable to work because of poor health.
- Britain has higher cancer mortality rates than other countries.
- Although hospital staff have increased since the Covid-19 pandemic, the number of appointments and procedures have not risen because "patients no longer flow through hospitals as the should".
- The NHS has been starved of capital investment, leading to "crumbling buildings", mental health patients in "Victoria-era cells infested with vermin" and "parts of the NHS operating in decrepit portacabins".
My series of blogs (use this link to see my last one, in March 2024, which gives links to all of them) have charted the rise and rise of the NHS Crisis as it has developed through the last 13 years, highlighting (i) the nature of the crisis at the time of writing, (ii) predicting that the crisis would get progressively worse, and would NOT be resolved by pouring more money into it, and (iii) that no-one has yet had the wit to work out the underlying reason for this ongoing NHS Crisis!
Does the Darzi report, and the new government's initial response, address the issues I have raised? That's look at each one.
(i) Hitherto, the serious nature of the NHS Crisis has always been heavily discounted. It could be resolved by another management re-organisation, or (more usually) by putting in additional resources, by bringing in private investment: the problem was primarily one of under-investment. Now, we are told, the crisis will take 10 years to resolve, and no further money will be spent "without reform".
(ii) So the Darzi report has (at last) overturned the idea that the interminable saga of NHS Crises can be resolved by pouring more money into it. And for the first time in the 76 year history of the NHS, a British Prime Minister, Keir Starmer, and Secretary of State for Health, Wes Streeting, have openly admitted this. So my prediction has come true.
- Keir Starmer has said that although the NHS is in a critical condition, there will be no additional money "without reform". It must, he says, "reform or die". But what reform? Another structural management reform? There have been plenty of these, and none of them have prevented the NHS crisis spiralling, year by year.
- Wes Streeting has spoken about the three 'big shifts' that were needed. (a) a move from hospital to community care. (b) a move from analogue to digital technology "to empower patients and give them control over their healthcare". (c) moving from a treatment model to a preventative model. These are 'shifts' that have little or nothing to do with what I argue, that it is the treatment that the NHS offers its patients that is at the root of the problem.
(iii) So the fundamental reason for the ongoing NHS Crisis has still not been identified! Why, for instance, are "patients no longer flowing through hospitals as the should"? Is the medical treatment they receive not working? The question is not even asked. And why is there "a surge in long-term mental health conditions". What is causing this surge? Again, the question is not asked, leave alone given a response. So how will these proposals get 2.8 million patients back to work - if there is to be no change to the medical treatment they receive? The misguided and thoughtless assumption that pharmaceutical medicine is treating illness and disease successfully remains firmly in place!
So what, indeed, is causing the unprecedented/epidemic levels of chronic diseases, like ADHD, Allergy, Arthritis, Autism, Dementia, Diabetes, Epilepsy, Heart/Lung/Kidney/Liver disease, Mental Health, and so many more? It has little to do with hospital care or community care, with digital technology, and moving to a 'preventative' model. In pharmaceutical medicine, prevention seems to mean giving drugs like Statins, and vaccines, earlier - whilst people are still well!
If the NHS continues to provide patients with a diet o pharmaceutical drugs, which have limited and marginal effectiveness as treatment, there is little hope that it will ever be able to reduce the number of sick patients, and the amount of sickness they present.
If the NHS continues to provide patients with pharmaceutical drugs which cause serious adverse reactions, and disease in patients, there is every possibility that the number of sick people, and the seriousness of their health deficits, will continue to increase - as they have done for the last 76 years.
So the Darzi report, and the government response to it, is positive in the limited sense that the seriousness of the problem has at last been recognised, and the futility of throwing more money in the bottomless pit of the NHS acknowledged.
But without identifying the fundamental problem, the control that the NHS has gratuitously given to pharmaceutical medicine, and its almost total reliance on pharmaceutical drugs and vaccines, the solution has again been missed again.
When the NHS was established it was based on two important principles. First, that treatment should be free at the point of use. And second, that the best medical treatment should be offered to patients. I agree with both these principles, but the second has been badly neglected.
What was not envisaged in 1948 was that the pharmaceutical industry would achieve a virtual monopoly in the treatment options offered to patients by the NHS. The only change that has taken place regarding patient treatment has been the removal of Natural Medical Therapies, including homeopathy.
Pharmaceutical drugs are not making us better. Indeed they are making us sicker. But they now have a monopoly within the NHS. Visit a doctor, go to a hospital, and you will almost inevitably receive pharmaceutical medicine.
That is the fundamental basis of the NHS crisis.