Search This Blog

Tuesday 19 March 2024

The NHS Crisis (Spring 2024): now there is no more money!

The NHS Crisis is developing fast, getting worse by the day, and has become a year-long event. I have been writing about this crisis for over 11 years now. The underlying pattern of the crisis has never changed:

 >>> increased sickness >>> followed by increased spending on pharmaceutical treatment >>> followed by even more sickness >>> and then even more demands for even more money. 

During this time the NHS has never changed its explanation for the crisis. They don't have enough money, they need more, lots more, for more pharmaceutical drug treatment, for more adverse drug reactions, for more sickness - for which the NHS will want more money for treatment. It is a merri-go-round!

It has always been thus. It is contained within the 14+ blogs written over the last 13 years on the NHS Crisis, all listed and linked at the foot of the page.

And no one (outside this blog) has EVER questioned whether it is wise to spend more and more money on a medical system that is so demonstrably failing to provide an effective response to the constantly expanding levels of sickness. Yet the right questions are beginning to be asked. The NHS has routinely told us that it does not have enough doctors and nurses. Yet doctor numbers have risen by 37%, and other staff by 45%, in the last 10 years. This Expose article asks "How does the the NHS do so little with so much". It fails to come to the inevitable conclusion, but it does provide some useful statistics from the Office for National Statistics.

  • The number of doctors increased by 37,467 (up 37%) from 101,137 in 2013 to 138,604 by 2023.
  • The number of nurses and midwives increased by 68,063 (up 23%) from 295,163 in 2013 to 363,226 in 2023.
  • The number of scientific staff increased by 42,938 (up 13%) from 123,912 in 2013 to 166,850 in 2023.
  • The number of support staff increased by 125,510 (up 45%) from 279,579 in 2013 to 405,089 in 2023.
  • The number of infrastructure staff increased by 62,758 (up 41%) from 152,437 in 2013 to 215,195 in 2023.
  • The number of ambulance staff increased by just 1,721 (up 10%) from 17,537 in 2013 to 19,258 in 2023.

Even the BBC is beginning to ask questions about the viability of the NHS. In July 2023 it wished the NHS a happy 75th birthday - but asked whether it could survive to 100 years old. They are right to ask the question, but as usual, wrong in their assessment of what the problem is. They mentioned the "dire warnings" that it could not do so "without drastic change". A change in the medical system, dominated by pharmaceutical drugs, that dominates NHS treatment? No, let's blame the patient instead!

            "When the NHS was created the main focus was on short bouts of treatment for injury and infection, but now the challenge is completely different.The ageing population means huge numbers of people are living with chronic health problems, such as heart disease, dementia and diabetes that require long-term care and for which there is no cure. It is already estimated about £7 out of every £10 spent in the NHS goes on people with these conditions. On average, those over 65 have at least two. And the situation is only going to worsen. "The numbers are going to grow," Health Foundation director of research and economics Anita Charlesworth says. "The baby boomer generation is reaching old age."

Predictably the BBC fails to spot that heart disease, dementia and diabetes have grown to epidemic proportions during the 75 years of NHS treatment, but fails to take the comment "... for which there is no cure" any further!

It does, however, provide graphs about health spending as a percentage of day-to-day public service spending, indicating that this rose from 27% in 1999-2000, to 32% in 2009-2020, to 42% in 2019-2020, and to 44% in 2024 to 2025. More and more money for health clearly indicates that there is less and less money for any other public service - education, police, local government, defence. We are gradually, progressively, robbing Peter to pay Big Pharma!

This Medscape article outlines just how bad the situation has become, focusing on the situation in Northern Ireland.

            "Record-breaking waiting lists and emergency department times – the worst across the UK, healthcare staff at breaking point and leaving the region, GP practices closing due to financial issues, and a scheduled junior doctors' strike this week have seen the situation hit crisis point. The health service in Northern Ireland is now in “absolute meltdown” say clinicians working in the region, with even the Minister for Health acknowledging that the situation is “deplorable” and “unprecedented”."

            "Northern Ireland's Minister of Health, Robin Swann issued a stark warning of an "extremely difficult and worsening" financial position for health and social care ... (as usual) ... calling for increased resources and multi-annual budgeting".             "We have a system that is in very real trouble. Every part of it is in profound distress.... The risks of service breakdown are real and growing in a range of areas. I do not say this to frighten people but to help build a shared understanding. We continue to have expectations and demands of health and social care that we cannot currently meet, and on the current trajectory the situation is getting worse rather than better".

In other words, there is no more money, no more handouts for a failing medical system can be expected. The Westminster Government continues to trickle money into the NHS; but it recognises that taxes are too high, that more borrowing is untenable, and in a recent budget, has said that they are expecting more productivity from medical staff (blame the staff?). The Opposition Labour party, which might find itself in government by the end of this year, tells a similar story; they will not break their fiscal rules, which effectively means - no more taxes, no more borrowing, no additional money for the NHS.

This is what has changed since I last wrote about the NHS Crisis. Both government and opposition has now accepted that there is no more money. The NHS is not going to be bailed out, again, as has happened routinely during the last 75 years. The magic "NHS money tree" is dead!

Another new factor is that key NHS staff have gone on strike; senior doctors, junior doctors, nurses, ambulance staff - people who have never been on strike before. Why? Despite the money thrown at the NHS little of it has apparently gone to staff. So not even those who deliver pharmaceutical medical treatment are content. A newly qualified doctor, after 5-6 years of training, has a starting salary is about £33,000. And it has been estimated that junior doctor's salaries have fallen by about 30% in the last 15 years.

So the NHS has not only devoted itself, entirely, to a system of medical treatment that does not work, which is actually making us sicker, it cannot even treat its clinicians, the people who operate the NHS, properly. Staff morale within the NHS is not only poor, it is getting worse.

In a health service that cannot cope with the pressures it faces, recent news from the GP Magazine, Pulse, on 12th March 2024, reported alarmingly that "swathes of GP's were at risk of redundancy". Watch this space! Is the NHS facing self-destruction? A BMA spokesperson has recently warned general practice that it has suddenly gone from a recruitment crisis to an employment crisis. 

Surely the NHS crisis cannot get any worse! But I haven't mentioned NHS dental services, which in many parts of the country are now virtually non-existent. The Guardian reported, in October 2023, that there were a record numbers of patients complaining to the NHS Ombudsman about poor care, exorbitant fees and gaining accept to NHS dental services in England. The Ombudsman said that poor dental care leaves patients frustrated, in pain and out of pocket. The number of complaints received every year has risen by 66%, and the proportion of complaints being upheld has increased from 42% to 78% over the same period. The ombudsman is currently receiving about 100 calls a week from people worried about poor treatment, an inability to access NHS dental care, and being removed from a dentist's practice list.

So the NHS crisis continues and deepens, as it is likely to do so long as we fail to recognise the main reason for the crisis. No problem is ever resolved unless and until the cause of the problem is accurately identified. The NHS, and the Government, have been singularly unable, or unwilling to do so to recognise that it has invested in pharmaceutical medicine, a medical system that just does not work. So, bad as the current crisis is, it will only get worse.

According to the USA Department of Health and Human Services, as many as 1 in 3 hospital admission each year are linked to adverse drug reactions, and inter-reactions. The situation in the UK is similar, as it is in other countries with a so-called 'advanced' or 'modern' medical system. So we have the evidence that prescription drugs, legitimately prescribed, cause patient harm, and make them sick, can even lead to death. 

In fact, many do lead to death. This is from a paper published by Imperial College London, "National State of Patient Safety, 2022. What we know about avoidable harm".

            "In 2019 there were more than 130,000 avoidable deaths in Great Britain - more than 22% of all deaths. Of these, 64% were classed as preventable and 36% were classed as treatable"

The problem is that the conventional medical establishment is skilled at discounting any such evidence. They are the result of under-performance, mistakes, errors, accidents, all of which can be avoided by improved management practices. The motto of the NHS seems to be "carry on, regardless".


NHS Crisis: links to previous blogs