NHS strains: Without health there is no wealth

Whatever you do, however you live your life, you need the National Health Service. If you do not believe me, read on.

A recent Tweet I read said: “Somewhere, a nurse is doing something seemingly insignificant that is having a profound impact on someone’s life”. The same can be said of many of professions in the NHS.

Without the clinical and support staff in the NHS many people reading this would be struggling. If you doubt me let me take you back to pre-1948, before the NHS.

Prior to World War Two healthcare had been an unsatisfactory mix of private, municipal and charity schemes. Then, if you became ill you had to pay your GP. Consequently, in many families, mothers and children never got to see the doctor because they could not afford it.

Fathers did because they had to be well so they could work. In reality, no health no wealth, something I have been saying for a couple of decades now. The result of this was women and children’s health was very poor, unless you were very wealthy

During WWII William Beveridge, an economist, identified the five “giant evils” in society: squalor, ignorance, want, idleness, and disease. He went on to propose widespread reform to social welfare system. From his report was born the NHS, though not without objections from Churchill, Conservative Party and doctors.

Aneurin Bevan’s national system was aimed at preventing inequalities between different regions by proposing every legal UK resident would sign up to a specific General Practice (GP), this being the point of entry into the system. From there they would have access to any kind of treatment they needed without having to raise the money to pay for it.

The NHS was born on July 5, 1948 and Bevan said at the time “We now have the moral leadership of the world”. What developed over the following decades was a massive improvement to the country’s health and resulting increase in productivity. With health we have wealth.

Through 50s and 60s the NHS grew, it provided all the care Britain needed and became a world leader in healthcare. Nevertheless, during the 70s and early 80s increased pressures caused governments to rethink the system.

However, the first major change to the system by the government in the early 1980s was probably the most damaging, resulting in the decline of the NHS. That was the introduction into the system of managers with no clinical skills or knowledge – the bean counters.

In the James Bond film, Goldeneye M says: “You don’t like me, Bond. You don’t like my methods. You think I’m an accountant, a bean counter who’s more interested in my numbers than your instincts” – if you change the word “instincts” to “clinical skills” it can be argued that this represents the modern management style of the NHS from the Cabinet down.

In 1948 there were just under 340,000 nurses, 55,000 doctors and no managers in the NHS (No figure available for PAMs), with around 1 million staff working in the NHS as a whole. By 2010 those figures were 410,615 nurses, 130,000 doctors, 130,000 PAMs, 41,962 managers and total workforce of 1,431,557.

This shows an increase in nurses, doctors and PAMs and a massive increase in bean counters to quote M. However, if we look at last year’s figures we see the number of nurses down by over 8% (33,424), the number of doctors up by 15.59% (20,273), and PAMs up by almost 20% (25,960).

What of the managers? Well they are down by 4,884 (11.6%) many of whom were made redundant with handsome packages. There were 1,077,268 full time posts but many of these were filled by part timers.

The Secretary of State in taking on the junior doctors over their working hours has clearly failed to realise that most clinical NHS staff already work seven days a week and what he should be doing is increasing the number of nurses and junior doctors so that cover at night and weekends is less demanding.

To do that he needs to tell the Chancellor taking away student nurse bursaries will not increase the number of nurses but will dramatically decrease the number of nurses.

Hospitals need to look at the administration cover for wards and clinics so that the paperwork, which is essential, is completed without taking the nurses, radiographer, OT away from their patients.

The NHS is the world leader in healthcare. Since the 1960s clinical staff from all over the world have come to UK to gain skills and knowledge from their colleagues in the NHS. This had not changed in 1990s when I was working in London I had two colleagues, one from India and the other from Gambia, who worked as staff nurses. Their aim was to gain a higher level of qualification and then returning to their home countries with the aim off moving swiftly up their promotional ladder.

If there is one thing that we as a country can be proud of it is our NHS. It is the Jewel in the British Crown, smashing it up to make lots of little gems will devalue it and once broken you cannot put the jewel back together.

It appears fairly obvious what the Cabinet has to remember is without health there is no wealth, but who is telling them?