Every newspaper headline, news bulletin and radio phone-in programme in recent weeks has declared that the NHS is in meltdown: that the system is broken and is on the verge of collapse.
What is seldom examined is exactly what the crisis is, how it has been caused and why it will continue under the present system.
Many of the stories of ten-hour trolley waits, backed-up ambulances, bed shortages and of an exhausted workforce are truly horrendous. These are the lived experiences of patients, relatives and staff.
But this, ongoing, crisis hasn’t been caused by the doctors, nurses, carers and support staff who are struggling to deliver the service. While there are particular organisational issues locally which are contributing to lengthy waiting lists, our healthcare problems are political and they are systemic.
From the day the NHS was founded, over 70 years ago, right-wing politicians, many of them close to home, have been orchestrating its downfall and planning to capitalise on, and profit from, our collective health and care needs. The plotting has been relentless and only the strong public support for the concept of a health service free to all at the point of delivery has helped fend off the many attacks and treachery.
Despite the esteem in which the NHS is often held world-wide, UK spending on healthcare is lower than in Finland, Iceland, Belgium, Luxembourg and Austria. In fact, it is the second lowest, per head of population, of the world’s large developed economies.
Healthcare expenditure based on Gross Domestic Product (GDP) is also the second lowest of the large economies.
The current crisis has been brought into sharp focus by the demands of dealing with the Covid pandemic but its roots lie in the last ten years of austerity, the cuts to funding, staffing budgets and building maintenance; outsourcing, blatant privatisation of a public service and pay freezes. This is what many in the media refer to as ‘financial pressures’, as if they were part of the latest weather front
This is what many in the media refer to as ‘financial pressures’, as if they were part of the latest weather front.
In parallel, the number of nursing and midwifery training places has been decimated since 2010. That led to staff shortages and they were filled by agency staff, supplied by private companies at a cost, just a few years ago, of over £115 million.
In that same decade, the number of hospital beds in Belfast alone, where most of the regional services are provided, were cut by 20%. This occurred during a period when the number older people over 75 rose by 12%. The cost of providing care for this age group, and above, is around three times higher than for the under fifties., Meanwhile, the health inequalities gap continued to grow and the ill health effects associated with areas of social deprivation added significantly to the problems and the pressures.
These are not just statistics. It is estimated that last year 5,000 people in Northern Ireland died while they were on a hospital waiting list. That is what austerity, attacks on the NHS and privatisation by stealth looks like.
The NHS has been under attack since its inception. Those attacks continue unabated today. A right-wing agenda to privatise the lucrative aspects of healthcare, politically motivated cuts to funding, staffing levels and resources and increasing calls on the service, are combining to make us believe that the very concept of a national health service is no longer viable. The additional ravages of Covid are being used to boost that deception.
The NHS is indeed in a crisis. It is being undermined, underfunded and cherrypicked for privatisation.
We owe it to the generations of front-line workers and support staff who have developed and delivered one of the best healthcare services in the world to defend it and their efforts against those who would sell it off to the highest bidder.
For now, a concerted effort will keep the NHS afloat, but only in a socialist society can it be guaranteed to achieve its full potential.