The NHS will continue to be a blackhole of cash until we confront its underbelly
Can enough money ever fix the NHS? Rishi Sunak is the latest in a long line of Chancellors to promise increased spending for the health service, after the Government committed a further £5.9bn.
The investment is welcome for a health service that has suffered enormously. But it only touches the surface of answering the problems plaguing the system.
The NHS faces a complex and interconnected mixture of acute and chronic issues. The short-term pressures are clear. As of May this year an estimated 300,000 people had missed urgent cancer checks since the start of the pandemic. Over 5 million people are waiting for routine operations and procedures. 19 per cent of ICU beds and 4 per cent of general hospital beds are currently occupied with Covid-19 patients. ICUs generally run at 80 per cent capacity or more during past winters, and general wards at 90 per cent. This leaves little spare capacity in the coming months, either to handle Covid cases or to work through the backlog.
Underlying these acute problems are deeper structural issues. Before the pandemic, the health service was experiencing its worst performance against waiting times since they were set by the last Labour Government in 2007. There are also deep staffing problems, with almost 100,000 front-line vacancies reported by NHS Digital in June. All of this is in the context of the population living longer (13 years more than when the NHS was created) and the rise in prevalence of chronic diseases such as diabetes, heart disease and dementia.
The government has set out the ambition to get the NHS to 130 per cent of pre-Covid capacity to work through backlogs. But without further and faster structural reforms these backlogs will remain with us for years to come: money alone is not enough.
Outcomes can improve in the context of spending but only when they are coupled with deeper structural reform. The last Labour government showed us as much. So what else is needed?
The NHS should partner with the private sector to increase capacity to work through the backlog of cases. This is a view echoed by NHS Chairman, Lord Prior of Brampton,. For him, dealing with the backlog means “working with the private sector”.
To provide a solid framework to reduce pressure on the system, the next step has to be technology. There has been an ongoing debate over the how and when of online consultations, as people across the country have reported challenges getting access to a GP. But where appropriate, these should continue, alongside in-person appointments. To completely backtrack on many of the technological gains, made during the pandemic, to how the health service functions would be a mistake. Making it easier for patients to access prescriptions and tests online is also crucial.
Long-term, we need to fully embrace all of the potential that technology has to revolutionise healthcare. This should include harnessing decentralised diagnostics, AI, robotics and prioritising preventive and personalised medicine, for instance through genomic sequencing.
The health of the NHS is a key priority for the public, according to polling conducted for the institute by JL Partners. It also shows, however, that the public remains to be convinced on the vital role technology can play. Politicians need to be honest and courageous about how it can revolutionise healthcare for the better, rather than heading off into short-sighted dead ends like forcing GPs to meet targets on face-to-face appointments.