Jeremy Hunt claims that lessons are being learned on patient safety (Letters, 2 March). But it has been specifically patient safety that has been put at risk by cuts to the NHS, and to social and mental health care. A BMA freedom of information request has revealed that the capital funding cost for the 44 sustainability and transformation plans across England, involving closures of A&E departments, hospitals, pharmacies and walk-in-centres, is £9.5bn.
STPs have been created to save – a euphemism for cut – £22bn over five years, equivalent to one-fifth of the total NHS budget. Thus the UK now has only 2.8 doctors per 1,000 people, fewer than most of Europe, and GP services have been cut 20% in the last five years. The UK also has 2.76 beds per 1,000 people, compared with Japan’s 13.2, Germany’s 8.2 and Greece’s 4.8. A “bed” is code for the doctors, nurses, ancillaries and equipment to make it viable. So it is bed-cutting, and not just social care cuts, causing “bed-blocking” and pressure on our hospitals. One can only conclude that Hunt’s cuts to staff and resources to support the beds is deliberate policy to run down the NHS ready for privatisation as an insurance-funded two-tier system.
• Jeremy Hunt refers to the “exceptionally difficult circumstances” faced by workers in the NHS. If only he had some sort of influence or power to address these deeply troubling issues.
“Gordon Bennett”, Shropshire Union canal
• The crisis in the NHS is being blamed on lack of finance, lack of staff, and lack of community care and GPs. But there is only a crisis because the service has not been properly managed since all the experienced managers were sacked in the last reorganisation in 2012. Health authorities used to monitor trends across the board in each region and take appropriate action, by redistributing resources or by giving government the evidence it needed to adjust the budget, or by concentrating on the more serious cases, while allowing waiting lists to grow. Staff recruitment was matched to need in each locality. We now have complete chaos, with no planning and agency staff being brought in at vast expense to fill gaps, while mortality rates increase. The NHS needs an urgent second opinion from a new minister if it is to survive. Disgracefully, Tory MPs have repeatedly blocked attempts to discuss this in parliament by filibustering, most recently last month.
Dr Richard Turner
Harrogate, North Yorkshire
• Polly Toynbee talks of Labour’s failure on the NHS (28 February), but what about the Tories’ failure? It is time for the government to acknowledge its responsibility for the current financial and operational crisis in the NHS. The Tories have been in power for nearly seven years and their damaging Health and Social Care Act has been in place since 2012. Their failure to fund the NHS adequately has led to financial deficits for most NHS trusts, especially those with punishing PFI debts. The requirement to put all NHS contracts out to tender has led to massive increases in management and administration costs, money which would be better spent on frontline services.
In 2015-16, nearly 475,000 A&E patients waited more than four hours for a bed on a ward. Record numbers of patients are waiting more than two months to start cancer treatment, while thousands of elective surgical procedures have been cancelled due to lack of beds. Instead of demanding unrealistic “efficiency” savings through STPs, the government should provide a sustained increase in NHS funding and scrap the costly and inefficient internal market, which is ruining our universal healthcare system.
• The only way to judge the NHS is to compare it with the other 20 western countries in what percentage of GDP they spend on health. Our recent research shows that in 2010 the UK spent 9.4% of GDP on health, the highest ever figure. It has now fallen to 9.1%. Financially prudent Germany spends 11.3%, France 11.6% and the USA 17.1%. We get our NHS on the cheap. Yet because of the dedication of frontline staff, the UK is still one of the most cost-effective services in reducing mortality – but for how much longer? If Britain spent the west European average on health, we could soon match the per capita number of doctors and beds that they enjoy.
Professor Colin Pritchard
University of Southampton
• There is a way forward for the NHS. It is the NHS reinstatement bill, stemming originally from Dr David Owen and developed by two academics, Allyson Pollock and Peter Roderick. On 24 February, the bill, presented in the Commons by Labour MP Margaret Greenwood, again failed to reach its second reading due to being too far down the agenda. The bill would get rid of all the markets which have been introduced into the NHS since the early 1990s and would reinstate the duty of the secretary of state for health to provide a universal, comprehensive service.
The internal and external markets have tripled the cost of administering the NHS, without improving its quality. The excess administrative cost is now some £10bn a year, money lost to clinical care. The disruption and fragmentation have been huge. Further, morale has plummeted. As your letter from Dr David Zigmond (21 February) said: “In attempting to replace vocational motivation with commercial incentives, we have all but destroyed the best of healthcare’s professional art, heart, spirit and intellect.”
• According to Phillip Inman (Report, 2 March), ministers are keen to point out that those with incomes above £150,000 a year contribute about £46bn in income tax. If they paid the full pro-rata national insurance contributions, instead of getting a discount, this would bring in an extra £4.6bn for the NHS. Some of this could be used to offset the cost of raising the minimum contributions threshold to match the personal allowance for income tax. If this were to be done, scrapping the age exemption for these contributions would not affect those on the basic state pension. Occupational pension holders, like me, would resume contributions in line with the income tax we already pay. If these reforms were to come about, we really would, in this age of austerity, be all in it together.
• I support locally, in any practical way I can, the fight against the destruction of our NHS in England. As I live in the north-east, the cost – and my age – preclude me from taking part in the protest march tomorrow in London (Why I’m marching for the NHS on Saturday, Letters, 2 March). It is most frustrating. So I am asking for someone who can spare the time and who lives in or near London to take my place on the march to represent my views.
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