This week we’ve heard from eminent and prominent medical names on what it is that our NHS needs to survive into the future. We’ve seen in black and white the future impact and long-term implications of outsourcing to private companies, the importance of planning ahead on infrastructure and what is needed to secure the NHS’s financial future.
We’ve heard firsthand what it’s like to work out on the frontlines of the NHS and what we need right now, just to make it to tomorrow. Over the course of the past few days, The Independent has been writing the book of NHS revelations – and it is full of sad, scary predictions.
Not to get all mystical, but as it happens, while on holiday in Canada this past few weeks, I’ve seen one of the possible futures for healthcare in Britain that is often brought up. While the setting is gorgeous, overall, the image of what the NHS may become is bleak. As a Canadian, I am well placed to explain why a combination of free, insurance-based and private healthcare providers is no answer to our problems across the pond.
Here in Canada, the system is free-ish. That “ish” is rather important. Hospital care, urgent care, GP appointments, surgery – that sort of care – is in fact free. But, a bit like a RyanAir flight to Lanzarote, the patient has to shoulder the costs of all those “extras”. And they add up.
Prescription drugs not administered in a hospital? Well, that’s on you to cover the full market cost. Dental? The only option is private. Same goes for vision, rehabilitation medicine and physiotherapy. Having trouble hearing? Hearing aids cost up to $3,000 per ear. Does your kid need antibiotics? Better hope you live somewhere like Ontario, because every province and territory has different rules about what they will and will not cover for “free”.
If you live rurally – or you are from the First Nations community – just getting a GP can become a lifelong quest. Even if you find one, their list is probably already full. I won’t even begin to delve into the pay-per-service healthcare system, but for those of you looking to Canada’s southern neighbour, Gilead, as a possible future for the NHS: know that even in Canada, birth control is not free.
So, if we can’t individually pay our way out of the problem, how do we safeguard the future of the NHS? We begin by acknowledging two basic truths about the health of modern British society.
First, while we may be living longer these days, many of us are now living that life with at least one long-term illness. As a result, we have an ageing, ailing population who will require more doctors, more clinic time, more medication, more treatment, more equipment and more beds than the system has had to handle before. Ever.
As we’ve already heard this week, we need more money to invest in infrastructure and the workforce so that we can meet the needs of the NHS now and into the future. This is real money with real outcomes. A major project of financial investment into the future health of the nation.
We are also a sicker, poorer nation than we’ve been in a long time. After housing costs (which are rising unchecked thanks to the cost of living crisis), around 20 per cent of the whole UK population lives in poverty. With deprivation being one of the key indications of future or current ill health, that is 13.4 million future patients waiting to onboard into the system. Most are, in all likelihood, already patients.
For this, we need to rethink how we understand and treat health. For too long, personal responsibility has been allowed to sweep health inequalities under the rug.
Read more from our series on ‘How to heal the NHS’ by clicking here
We must now openly address the relationship between wealth and health by linking the healthcare system with the social care system. This means funding the social care system as an active and necessary arm of the healthcare system. It may seem simple, but a well-funded social care system means that beds are not blocked, people can get well in the community and poor nutrition and fuel poverty do not contribute to illness and burden the NHS.
I don’t need a crystal ball to tell you that without explicit and ringfenced financial support from the government, we will one day too soon have to make decisions between eating, heating and healing.
At its inception, the NHS sought to avoid the need for fortune-telling on our health. It promised to care for us from the cradle to the grave. But, like a single parent, it has been doing it on half the money and people-power it needs. It’s time for the government to pony up its maintenance for the nation and secure the future health of its population.
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