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Letter to the Editor: Another winter NHS crisis – an industry view

Now is the time for political courage

Last week we reported on the current problems facing the NHS this winter – check out my views here. And while The Secretary of State for Health & Social Care has done a better job than many guiding the health service through another difficult winter, there’s no doubt that a debate needs to be had over the structure and funding of healthcare in the UK. Today, Stuart Scullion (pictured), the chairman of the Association of Medical Insurers & Intermediaries, shares his views.

The problems faced by the NHS are complex, multi-faceted, and most definitely not all within the control of the NHS to resolve. The raft of illnesses associated with this time of year just serve to mask the underlying problem and, as noted by the Editor, these problems can’t be solved just by throwing more money at it.

Bed blocking, more commonly caused by elderly patients many of whom live alone, is actually a symptom of a failed and failing social care model. I have personal experience of this with my mother. Having had her acute urgent medical condition diagnosed and stabilised over seven days following her admission, she then spent more than eight weeks in hospital, moved to any spare bed in any ward that could accommodate her. Why? Because she lived alone and had no one nearby who could take care of her.  In years gone by, she would have been admitted to a local cottage hospital to recuperate before being discharged home once she was well enough.

This is just one example, but we know it is happening all over the country all of the time. The result? Cancelled operations and procedures, and not because there are not enough consultants or anaesthetists to perform the procedure. No, they are cancelled because there are no beds to accommodate people.

A&E patients are being held in ambulances for more than four hours because there is nowhere to admit them, and patients are being ‘treated’, if that is the description, for intimate and personal medical conditions on a stretcher in a hospital corridor. These are scenes you would expect in a war torn or third world country suffering from humanitarian crisis, not in the UK.

Someone needs to have the courage, yes courage, to stand up and say enough is enough, because in some respects this is nothing to do with the NHS. This is a political issue, where fear is one of the biggest contributors. Fear on every side of the political spectrum to stand up and endorse using a private healthcare system which is more than capable of participating and lending support to the solution. Fear because ‘the opposition’, any opposition, will castigate them for daring to visibly and publicly engage with private enterprise as part of the solution. Why? Because the NHS is seen as a vote winner and a vote loser.

The public are encouraged by politics to think that the NHS and all its services are ‘free’. Nothing could be further from the truth. They are free at the point of use but that does not mean they are not without massive cost.

Planned spending for the Department of Health in England is approximately £124.7bn in 2017/18, and Simon Stevens’ NHS Five Year Forward View projected a financial shortfall of £32bn per annum by 2020/21.

We need to visibly promote the costs associated with NHS usage at every opportunity in an effort to get the Great British public to understand that if they want to have an NHS which is the envy of the world, they must appreciate it more, support it and not abuse it. And yes, that does mean returning the NHS crutches so they can be used by other patients and not thrown behind the sofa before ending up in landfill.

Just as we need to promote the value of the private sector we must do the same for the NHS. We must incentivise people, everyone, to take greater responsibility for their own health because there is a massive disconnect between responsibility and cost. We have talked about the concept of wellness and preventative medicine for almost a decade, but I am of the opinion there are not enough people who hear it, see it, believe it and take action.

My fear is that unless we collectively grasp the nettle, the winter crisis in the NHS is going to become as common place at Christmas as turkey and all the trimmings.

Stuart Scullion is chairman of the Association of Medical Insurers & Intermediaries