The Covid report has highlighted a truth the government can’t ignore – we need to fund healthcare properly

In a 1948 address to the House of Commons, Winston Churchill – paraphrasing the philosopher George Santayana – said the now famous words “Those who fail to learn from history are condemned to repeat it”. Given how often people have (in my opinion) wrongly referenced back to the Second World War during the Covid-19 pandemic, when reading the Coronavirus: Lessons Learned to Date report, I’m surprised more haven’t brought ol’ Winston up.

The findings of the latest government report will come as no surprise to most: our government could and should have done better in handling the pandemic, and as a result, lives were lost that need not have been. Its lengthy and detailed 150 pages makes for grim reading as opportunities to slow infection were frequently ignored and even turned down.

But it is the conclusion that is the most interesting to me, as it is a riff on an all too familiar tune: That a lack of resources, a lack of staff and a lack of support undeniably has devastating consequences in most sectors.

It is a song health and social care services have been playing for years. Desperately trying to get airtime for their less than catchy refrain of "less resources in health and social care increases health inequalities, which results in health inequities and poor health outcomes in our society". Instead of listening, our government has been changing the station for the last decade – unwilling to hear about the effect that cuts across the health and social care sector have had on the health of our nation.

The report lists 77 conclusions and recommendations. That number would lead you to believe that a number of things went wrong. That lots of little missteps brought us to where we are now. But reading through the report it becomes clear that all 77 conclusions and recommendations amount to only three important take-away messages for our government. To paraphrase the most often used sentence in my house, someone over at Number 10 has not been using their listening ears. But in the spirit of lessons learnt, I will lay those key messages out here again.

First, stop under-resourcing health and social care. The Covid-19 pandemic has shown what happens when we do not have enough capacity in the system to care for everyone who needs it, and yet even a global catastrophe has not been enough to bring about the necessary drastic action needed. The Health Foundation predicts that to just reach a point of stability, where the system can meet future demand and improve access to care, we need £4bn more to be spent on health and social care in both 2022 and 2023 alone. On a day when both the Royal College of Physicians and care providers have called for help with the workforce shortage, it is worth noting that the extra £8bn recommended by The Health Foundation does not even account for increasing staff pay to attract more doctors, nurses and care staff. For that we would need something closer to £15bn. Again in 2022 and 2023 alone. To ignore these shortfalls is to ignore what we have learned in the last 18 months, that we are damaging the health of our nation by under-resourcing its vital services.

Second, we need to treat health inequalities and inequities as true threats to the health of the nation. The pandemic has exposed the cruel ways that where we live, work, go to school and even our ethnicity has a huge impact on our individual health. As a future where coronavirus becomes more manageable starts to emerge, it is vital that we build back a country that actively reduces health inequalities and inequities.

As several reports have shown over 2021 alone, efforts to "reset" the NHS, to build back "better" must not do so at the cost of those most disenfranchised in our country. Instead, we must build back fairer, putting mechanisms in place that tear down existing barriers to good health and build up more accessible, better funded and more culturally competent services to support the good health of everyone in this country.

Finally, it is time to plan for the future. The report has highlighted how the inward, myopic and often backward-looking approach of the government over the last ten years has led the UK to having some of the worst outcomes in Europe – and with one of the greyest post-pandemic futures too. Looking into 2022, the UK faces a continuing pandemic, the extended fallout from Brexit and an uncertain economic future. It would be tempting to continue to fight the fires without taking all the steps needed to prevent them in the future. However, it is now time to consider how best to avoid an aging, ailing population being treated by a struggling, under-staffed and under-funded health and social care system.

The report concludes by saying: “We must ensure that the UK learns from its experience of Covid-19 and does not repeat mistakes in the future”. That is all well and good, however the experience of the pandemic in this country has been because we have continued to repeat the mistakes of the past and under-resource the key services that keep our country healthy.

It does not have to be this way. We can choose to learn, move forward and build back a healthier Britain than we have today. History need not repeat itself.

Dr Alexis Paton is a lecturer in social epidemiology and the sociology of health and co-director of the Centre for Health and Society at Aston University. Dr Paton is also chair of the Committee on Ethical Issues in Medicine at the Royal College of Physicians and a trustee of the Institute of Medical Ethics