Stop focusing on hospitals and we could still save the NHS

If you get sick this Christmas, are you confident you’ll get the treatment you need? Or are you afraid you won’t?

Even before emergency workers and nurses go on strike later this month, we are increasingly concerned about what will happen if we call for help.

Funding must go to GPs and help reduce ambulance queues outside hospitals


Funding must go to GPs and help reduce ambulance queues outside hospitalsPhoto credit: Getty
Rescue workers and nurses will go on strike this month


Rescue workers and nurses will go on strike this monthPhoto credit: Getty

We know we may have to wait for hours, whether it’s on our floor at home, in the back of an ambulance queuing outside a crowded hospital, or in that hospital as staff walk around trying to go through huge lists of sick patients .

The NHS was set up to help patients not fear getting sick, but today that looks more like an ambition than the norm.

There is clearly something wrong that goes beyond industrial action or even the crises that seem to come every winter.

There are many simple answers to the chaos in healthcare.

These include ‘militant’ unions representing staff, or that there aren’t enough staff, they aren’t paid enough, there are too many fat middle managers, GPs still hiding behind computer screens, the NHS needs more money – or some think that the NHS actually has too much money and is not using it efficiently enough.

Most of these are half-truths.

The Royal College of Nursing has not historically been militant at all, certainly not compared to the British Medical Association, which is a well-dressed gang of stethoscope-wearing street fighters.

The RCN’s current salary requirement of 17.6 per cent is clearly prohibitive in the current circumstances, but it is not unreasonable that nurses who do a job that most of us could not handle physically or emotionally should assume that they can do their Must meet basic needs to cover their food and heating covered by their wages.

Inappropriately, the system cannot extend to paying health workers decently.

The NHS is quite efficient compared to the healthcare systems of many other developed countries and has had to become even more so over the past decade due to lack of funds.

But it still has insane flaws.

Chronic underinvestment in IT, for example, means that even within individual hospitals, computer systems cannot communicate with each other, meaning staff must manually transfer a patient’s data from one screen to another when moving to a different part of the hospital in the same emergency room.

It’s even worse in other departments, where waiting lists are on post-it notes taped to the wall.

The system is obviously not working.

It has built-in inefficiencies that have little to do with managers clutching clipboards and much to do with where politicians’ money and attention goes.

These are the tough answers to the NHS’ mistakes. But this is exactly where the government needs to focus.

We cannot keep throwing money at the NHS without asking why the problems never seem to go away.

Health care in England received £172bn in 2021/22 but funding increases have been tight for more than a decade and demand has risen too.

Squeezed Funding

And the money to keep hospitals and buy equipment is astoundingly low at just £10billion, despite many buildings falling into disrepair.

A record seven million people were waiting for treatment in September this year – and those lists had been rising before Covid.

We need a new way of thinking about healthcare.

We are obsessed with acute care to the extent that we pay little attention to the reasons people end up there.

When we talk about the NHS we generally think of hospitals rather than the community services or primary care, which by and large should keep us away from acute care.

While working on my book on the history of healthcare, I found countless examples of MPs opposing the closure of hospitals because they had been warned repeatedly by experts – including the doctors who work there – that people were so bad are unnecessary to die in them.

No MP would dare swim against it, they’ve seen former colleagues lose their seats for being honest with local hospitals.

Even when local hospitals are of good quality, they often contain people who simply shouldn’t be there.

Calms our fears

This may be due to a previous error in the system, meaning that a diagnosis has not been made, or that a person’s condition has deteriorated when it could have been treated very easily at home.

Or it could be that the issue that led to her hospitalization has now been addressed, but there is no welfare package to ensure a safe discharge.

It costs hundreds of pounds a night to keep a medically fit person in hospital, but politicians never get around to reforming welfare.

How can a system ever work when it’s being let down so badly?

There will always be staff shortages and overworked, underpaid doctors and nurses if we continue to view the NHS as just a hospital and not as people.

Serious politicians know that.

Health Secretary Steve Barclay is as aware of this as his ambitious shadow, Wes Streeting.

The problem they both have is convincing their political colleagues, or even the public, that the NHS doesn’t need more fumbling or a bonfire of bureaucrats, but an end to the obsession with hospitals.

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Which courageous politician can do this will calm our fears about our health care system.

  • Isabel Hardman is a political journalist and Associate Editor of The Spectator.
Health Secretary Steve Barclay is aware of the problems facing the NHS


Health Secretary Steve Barclay is aware of the problems facing the NHSPhoto credit: Getty Stop focusing on hospitals and we could still save the NHS


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