The NHS needs reform to survive

18 Jan 2018

On July 5th 1948, then Health Secretary Aneurin Bevan launched the National Health Service at Park Hospital in Manchester. The aim of such a venture was to provide free universal healthcare, at the point of use, to be funded through general taxation.


To this day, many of the founding principles of the NHS remain intact. It is still largely funded through general taxation and provides free healthcare to over 1 million people every 36 hours. However, the recent winter crisis that has struck through the heart of the NHS has left questions over its lack of funding, management, and organisation.


Rising flu cases and cold weather have had a significant impact on the health service this winter, with every hospital in the country being ordered to cancel all non-urgent surgery until at least February. Around 50,000 planned operations have been cancelled by the NHS and Prime Minister Theresa May apologised directly to both NHS staff and patients earlier this month, saying ‘I know it's difficult, I know it's frustrating, I know it's disappointing for people, and I apologise.’


This isn't just a recent problem in the NHS either. In a similar, but not so serious, way the health service was at breaking point this time last year, and the fact is that a winter crisis is almost an annual occurrence. The question now is how we deal with it.


If you were to ask the Labour Party, the solution would be blatantly obvious; the NHS needs more funding. In their election manifesto, Jeremy Corbyn’s party pledged an extra £30 billion of funding for the health service, funded through increased income tax for top 5% of earners and increased tax on private medical insurance.


However, the problem might not be as simple as that. Yes, in the short term extra funding would undoubtedly improve the NHS, but the problem runs a lot deeper than that. Since 1987 funding into the NHS has increased by more than £100 billion, with inflation taken into account. Spending per person has also risen substantially, from roughly £767 in 1987 to well over £2000 in 2017.


Despite this huge increase in funding, the NHS comes under pressure every year in someway or another, and it begs asking whether any amount of money can truly deal with the problems. The NHS was introduced at a time when many of the social factors in modern society simply weren't relevant. Obesity, high treatment costs, an ageing population, as well as the rapid increase in population size, were all not even considered when the NHS was established. There’s also the obvious issue of how well the money invested in the health service is spent.


The NHS is perhaps one of the most obvious examples of mismanagement and inefficiencies. At the end of 2017, new NHS league tables identified that some hospitals are spending £16 on packs of rubber gloves, which can actually be purchased for as little as 35p. Furthermore, a standard box of 100 plasters was purchased for £1.68 by one NHS trust, whilst another paid £21.76; a difference of over 13 times more. Simply put, this is wasted money.


The NHS also suffers from a serious case of top-down management. Regulatory bodies such as NHSE and NHSI impose upon the health service unrealistic financial targets, with many of their executives sitting on comfortable six figure salaries whilst doctors and nurses are saddled with low wages and exhausting hours.


The bureaucracy and excessive administrative costs are what’s hurting the health service the most, and the NHS desperately needs reform. A system that was designed almost seventy years ago is simply not suitable to function in 2018 Britain. Before we consider additional funding in the health service, we must first deal with the already apparent issues. Paper-pushing and constantly changing social trends are damaging the NHS, and reform is crucial to its survival.

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