When the Leave campaign backpedalled on claims it made during the EU referendum, particularly the claim that leaving the EU would free up £350million a week for the NHS, there was outrage. As accident and emergency (A&E) services struggled once more to cope with demand this winter, there was even more controversy: the Red Cross declared the state of Britain’s health service a ‘humanitarian crisis’.
The NHS is seemingly in constant crisis. Patients are left on trolleys to massage waiting times. Hospitals are dangerously overcrowded. Trusts are running up deficits approaching a billion pounds this year. Then there’s the crises in recruiting nurses and paramedics, the problem of burnt-out anaesthetists, overburdened GPs and striking junior doctors.
Why is the NHS crisis, much like the housing crisis, so apparently intractable? Part of the problem is that, for all the hot air, the debate rarely moves beyond funding. Funding is not unimportant. Crisis or no crisis, paying for a healthcare system is always going to be expensive. This is not primarily because the NHS is badly run (although that is true), or even because of the demands of an ageing population (though that also has a part to play). As national prosperity rises, and as new, life-saving treatments and technologies are made available, costs inevitably rise. It should go without saying that this is no bad thing. If we want to live longer, healthier lives, our healthcare cannot be bought on the cheap. However, we must recognise that there’s more going on here than funding problems.
Unfortunately, the health secretary, Jeremy Hunt, is avoiding the bigger issues. His battle against ‘health tourism’ is a case in point. Requiring GPs to inquire into the residency status of their patients (a move initially described by the British Medical Association as an attempt to turn GPs into ‘border guards’) is counter to the ethics of good health practice. It doesn’t even make financial sense. The amount that could be potentially recovered is trivial – no more than hundreds of millions, compared with the billions the health service needs to get back on its feet. Then there’s the adult social-care crisis, which is also the responsibility of the Department of Health. Local authorities have faced large cuts to their budgets in recent years, and are now struggling to provide even the most basic care to their older populations.
The chair of the Health Select Committee, Sarah Wollaston, recently called for an all-party group to review how tax and national insurance could be used to raise funds. She wants us to move closer to what our European neighbours pay for their health services as a proportion of GDP. But should we really just be throwing more money at an evidently failing system? If we can land a satellite on a comet, surely it’s not beyond the wit of man to do something about the relatively mundane problem of bed-blocking?