What is Westminister politics doing to the NHS?

NHS Hospital

Westminister parties may appear well meaning, but could their policies undermine the NHS?

Running a political system whereby new administrations may enter the picture every 5 years has a range of different flaws. Perceptions of what constitutes the long term, tend to become compressed into short five year periods and this is especially true of many of the policies revealed at party conferences.

There is a tendency, once elected, to push policy through at breakneck speed. Aiming to give off the appearance of post-election vitality. Of course there are upsides as well. Chiefly that the electorate can get rid of any administration they dislike fairly promptly.

It also forces policy makers to update and revaluate policy to coincide with the next election. Nevertheless the downsides of our political system can be easily viewed in party approaches towards the National Health Service. Issues which are going to become apparent over the next 10 or 20 years were painfully underrepresented during healthcare speeches given by each party. Particularly the sizable funding gap which is unlikely to improve over the coming years. There are therefore many questions as to whether the NHS will be able to cope with the long term threats which are already impacting on its’ operations.

Monitor, the NHS regulator, has illustrated many of the difficulties the service has in coping with modern demand and expectation. Given this has occurred with only a relatively small increase in demand, suggests that long term trends like obesity or an aging population are going to heavily impede the service.

This year A&E, cancer and referral to treatment (RTT) targets have all been missed. Indeed it was the first time the NHS missed the 85% target for cancer patients to be seen within 62 days of a GP referral. Demand pressures have also translated themselves into financial deficit. 86 Foundation trusts possess unplanned deficits. Collectively this totals £227 million. Much of this is due to the increases in demand over the course of this year.

A&E was up 3.5% compared with last year. NHS waiting lists hit a record of 3 million patients for May 2014. Given these upward trends are only likely to develop due to an aging population with many lifestyle related ills, it does not bode well for the NHS.

Meanwhile policies revealed by the major parties appeared unwilling to offer a credible solution which recognised the long term pressures. Labour has led the pack by promising an additional funding increase of £2.5 billion. It is hoped this will help to train 20,000 nurses, 8,000 GP’s and 8,000 other medical staff. However the other proposals unveiled by Labour are simply putting more pressures on the service. Allowing for more care options at home may be the best for the patient but it will further stretch the NHS’ resources.

Likewise the “right to die at home” policy will require additional resources to transport patients home. Therefore it is unlikely the £2.5 billion funding increase will ever train the doctors or nurses promised. Conservative policy is similar, in that it is likely to increase constraints on NHS staff. Pledging to raise the NHS budget in real terms will certainly allow it to keep up with inflationary pressures. Nevertheless the “eight till eight” pledge will continue the trend of adding to the NHS’ workload.

The Liberal Democrat drive towards improving mental health was certainly an innovative piece of policy. It is an often ignored area of National Health Service policy, yet according to the Department of Health it accounts for 11% of the NHS budget. Indeed, given the range of other illnesses which are linked to mental health, it may be a very effective policy idea. Although all of these policies may certainly bring some benefits, without dealing with the funding gap in a meaningful way, many of the ideas will never become a reality.

Of course many of these provisional policy ideas could certainly over the short term improve the quality of healthcare. However without a marked improvement in funding many of the policies are expecting the NHS to cope with even more duties on the same level of resources. Comparing healthcare spending during 2011 demonstrates that the UK has lagged behind its European counterparts. The UK spent less than the average for the EU’s 15 most developed members. Indeed we were a full 2.2% (relative to GDP) behind the Netherlands who were the highest spenders. Therefore it is certainly plausible for healthcare spending to increase.

Given the demographic trends of the UK population this may be the only way forward. By 2050 one-in-four of the UK population will be 65 and over. These individuals requires increasing amounts of care as life expectancy continues to rise. Naturally one of the key policy tools which will be used to respond to this shift is another increase in the state pension age, forcing elderly individuals to continue to work in order to fund essential services. Where this is an unavoidable problem, many of lifestyle illnesses are entirely avoidable.

The Health and Social Care Information Centre found that 24.4% of men and 25.1% of women are categorised as obese. Likewise the rise of alcoholic consumption has caused a 40% increase in liver disease deaths. Educational policies may go some way towards stemming this. However given that the health risks are so well publicised, it may be time to consider alternative policies. Chief amongst these should be a drive to give far more time to physical education in schools.

On balance it is difficult to see a single way of alleviating the pressures on the NHS. Of course parties have tried to present themselves as being able to do so. Andy Burnham notably stated that Labour could restore morale within the “shattered service.” However it is a far more complicated venture than the odd funding rise and a raft of additional services which will stretch resources. The NHS confederation has given a voice to healthcare professionals through its “2015 Policy Challenge.” It calls for a £4 billion funding rise over the course of 2 years. However this is only to make the changes needed to help improve the NHS. Yet it is candid in admitting that “the solutions identified (in the report) cannot come close to filling the whole NHS funding gap.” Only via a cross party conference on the NHS with serious dialogue involving healthcare professionals can any solution begin to be formulated for the long term.