'Starved' NHS needs urgent support

There has been, quite rightly, a lot of publicity about the NHS being 75 years old – and the benefits it has brought us.

But, sadly, like most 75-year-olds, its own health is not quite what it once was.

Indeed, it is my belief that it is critically ill and in urgent need of intensive care and radical surgery if it is to survive.

It was founded on the noble principle that nobody should be denied the care and treatment they need because of their inability to pay for it.

There was also a slogan that it should be “free at the point of delivery” because, prior to its birth, many people could not see a doctor because they could not afford to pay their fees.

Unfortunately, the Beveridge Report, on which the NHS was based, and Nye Bevan miscalculated the demand that was out there in the community.

So, in 1952, within four years of its birth, the ‘second principle’ had to be abandoned with the introduction of prescription charges and payment for dentistry and spectacles.

Thus, since its birth, it has suffered from ‘malnutrition’ – a lack of the necessary ‘food’ of front-line professional staff and beds needed to treat the ever increasing number of patients.

This has got worse recently to the point that it might be said that it is now suffering from ‘starvation’.

When it was introduced in 1948, the majority of diseases the people suffered from (which the NHS had to treat) were ‘life-threatening’ – cancer, infections, chronic chest and heart diseases. The investigations and treatments available were few, cheap and relatively ineffective.

Penicillin was just becoming available (other antibiotics and anti-TB drugs came in a few years later); there were plain X-rays but no scans (such as CT and MRI and UltraSound) which came in many years later.

There was no chemotherapy and most medicines were cheap but relatively ineffective. And life expectancy was only about 70 – the biblical “three score years and ten”.

Today, people are living longer; and old people get more disease than the young. The modern investigations, drugs and other surgical interventions and treatments are very effective – but expensive.

Today, many of the treatments are ‘life-enhancing’ (such as hip replacements) to treat diseases that are not life-threatening but are interfering with the quality of life.

Now we have reached the point where the supply of resources is failing to meet the demand to a critical degree – hence the long waiting lists, the lack of front-line professional staff because of a failure to recruit and retain them.

The NHS is suffering from a burdensome bureaucracy that hinders, rather than helps, the proper, safe care of patients.

Hence my suggestion that it needs ICU type of care, to provide an infusion of professional clinicians and an ‘airway’ to allow the proper flow of care. It needs radical surgery to remove (or greatly reduce) the malignant growth of bureaucracy. Even then, it will need to have a different ‘life-style’.

It is interesting to note that no other country has copied our “free at the point of delivery” approach; they all have the patient making some payment at some point in ‘the care pathway’.

We need a truly independent (free of party political biases) enquiry (possibly a Royal Commission) to determine what conditions the NHS should be treating, and which it should not – or, at least, have the patient make some contribution towards the cost. It should also review its management structure and funding.

Malcolm Morrison, Retired Orthopaedic Surgeon,

Prospect Hill,