The NHS is broken. As I write that, I hear friends and colleagues gasping in shock but hear me out.
The NHS has long been held as a beacon of pride for the UK. Generations of MPs champion it and argue we are the envy of the world (a point anyone who has been to Scandinavia would dispute, but I digress).
Political parties on all sides have used promises about the NHS to win votes and, once elected, make wholesale changes without properly considering what works and what doesn’t. Before those changes are fully implemented, let alone evaluated, in comes the next government to make a whole lot more changes.
This has been the case for decades so why do I think it’s broken? First of all, there is no such thing as a national health service any more. This thing many governments use to win votes by promising reform and improvements does not exist.
“Surgeries, departments and specialist services are sold to the lowest bidder”
Many departments are no longer provided by the NHS: from catering and cleaning, through to some surgeries and specialist service provisions, many are now sold to the lowest bidder and not provided in house. Their priority is the bottom line, not patient care. It falls to the NHS to try to police these departments – but in services they no longer have power over. As such, accountability and standards fall by the wayside. This is a result of government after government privatising the NHS by stealth.
In addition, take Jim (not his real name). Jim experiences chronic pain as a result of a surgery. A surgery that was ‘under the NHS’ but, in actual fact, was sold to a private provider. Since the surgery, Jim has to fight to get support with pain relief. Services are not there for patients and, once he does get access, he is dismissed multiple times with no pain relief in place. He is treated as an inconvenience.
Another challenge for Jim is that he lives on the border of three counties and the service he is trying to access dictates which county he has to go to. Over the years, he has been to services in all three counties. The problem is, the services do not all communicate because they are not a national service. So, Jim spends each appointment telling his story. This is a waste of his time and that of the health professionals.
Another point: Jim had to move house as, due to his health, he can no longer work. A service he accessed in one county is not offered by the other two and so, after moving, Jim was referred to one of the other counties and cannot continue going to the original service. This is despite the fact that, for other things, he does get referred to services in that county. If we had a truly national health service, the same offer would be available wherever you live, no matter to which county you are referred.
For many years we have heard the term ‘postcode lottery’ regarding health services but, until you try to access them, you may not fully understand the extent of it. If we have a national health service, the same services should be available across the nation.
Giving a brief snapshot of what Jim has to endure has given some of the points as to why I say the NHS is broken. I know many will disagree; I know it is an unpopular opinion.
But, until you have tried to access fairly basic services for a severe long-term condition, you cannot honestly say how your regional health service fares. I hope for you it’s better than it is for Jim.
Dr Justine Barksby, associate professor and head of division (learning disabilities and mental health), De Montfort University