January 10, 2014
UK’s NHS Under Funding Pressure
It is January 2014. The National Health Service in the United Kingdom is under financial pressure as never before. Established on the 5th of July, 1948, it was described by its leading architect (the then Minister for Health Aneurin Bevan) as “the biggest single experiment in social service that the world has ever seen undertaken.” Its’ aim was to provide health care free to all at the point of use regardless of ability to pay.
There is no doubting the success of the NHS in providing such care and it is still the most treasured of institutions for most British people and the envy of many nations around the world. But it has become a political battleground with the health of the majority of UK citizens at stake. Spiralling costs and increasing demand on the service have pushed it to the brink. People living longer, more sophisticated and expensive treatments, increasing population and the sheer size of such an operation mean that all political parties, while fearing being seen as attacking the NHS directly, have accepted that changes have to be made. The NHS has been tasked with finding £20 billion of efficiency savings by 2015 at a time of economic downturn and austerity and the cracks are showing.
Several Health Trusts (the larger components of the NHS) are effectively running out of money. For example, Bart’s Health NHS Trust in London is losing £2 million a week and is having to take urgent measures to balance the books including the shedding of up to 1,000 of the Trust’s 15,000 jobs The NHS has been hit by scandals over care and management failings and there have been predictions of a severe crisis in Accident and Emergency departments this winter; some A and E departments are already failing waiting time targets and more are expected to do so. Some are described as close to collapse.
Dr. Mark Potter, who is chairman of council at the British Medical Association (BMA), has described the financial outlook for the NHS as being so poor that if it were a country it would “barely have a credit rating at all”. The NHS has already gone a long way towards achieving the efficiency savings demanded of it, but with the costs of the service rising annually at a far greater rate than general inflation, finding more savings will be extremely difficult if not impossible. This means that eventually the funding gap would be so great that huge changes would be necessary. Unless more funds are found in future (something that seems less and less likely with every passing year) drastic solutions would have to be found. One senior NHS official has admitted that efficiency savings would not be sufficient in future years and that the NHS would have to “take out capacity” – in other words there would need to be savage cuts to services.
Come what may, tough choices will have to be made and it seems that in the not too distant future the great institution that is the NHS will need to change with the bleak choices being driven by financial constraints. Bevan’s great dream may just become unaffordable in its present form.
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