For millions of people on the NHS waiting lists, the arrival of a letter from the hospital is a source of both excitement and fear. If they’re lucky, they find that they’ve finally gotten a much-needed consultation with a specialist or a date for surgery. All too often, such communication leads to disappointment, as patients are cold-bloodedly informed that their appointment has already been postponed.
Sometimes the response to tearing the envelope is one of outright confusion, as patients are offered appointments on dates that are already in the past; sent duplicate letters they have already received; or reprimanded for missing an appointment that no one ever told them they had.
With Boris Johnson spending tens of billions of pounds more on the NHS, the question is whether voters can expect anything better in return for all this extra money.
What I have learned is that the old clichés that the NHS is institutionally inefficient are true
I spent 18 months researching the state of health care for a book due to be published early next year. It’s a topic close to my heart, not only because it’s so often at the top of voters’ lists when I conduct my political surveys and polls, but because I’m only here today because I’ve been lucky enough to receive a treatment world class for several serious health problems, one of which – sepsis – nearly killed me.
My life was saved at the Cleveland Clinic in Ohio, of which I am the trustee. It ranks second in the world and provides a standard of care that I believe should be available to everyone in the UK.
What I’ve learned is that the old clichés that the NHS is institutionally inefficient are true, although that doesn’t mean we should dismantle them. Either way, there is no public need for a dramatically different system, so politicians and health chiefs have to find ways to improve what we have.
And what a magnificent institution it is – at least in theory! At the height of the pandemic, I appealed to the courage and dedication of the staff to be recognized with bravery awards, and led calls for the NHS as a whole to be awarded the George Cross. I was delighted when the Prime Minister took up this matter. But the truth is that our health service is not – as it is so often presented – the ‘envy of the world’.
In fact, it does not rank in any significant international rankings on any significant measure of quality, lagging far behind other rich countries when it comes to cancer, heart disease and stroke outcomes; number of doctors, nurses and hospital beds; and – crucially – waiting times for treatment.
In the late 1990s, during the John Major years, patients routinely waited more than a year for surgery. Tony Blair made it his business to put an end to this stain on our most beloved public service. Now we’re right back where we were — and it’s not all thanks to the coronavirus.
The problem is that despite its massive funding, the NHS is woefully short of doctors and nurses and far too relaxed in its attitude to taxpayers’ time and money
As things stand, the harsh reality is that no country in the world is as impressed with our health care as we are, and no one has tried to copy it. While it works wonders, it also routinely loses patient records; confuses medications; dual diagnostic tests; pays way too much for drugs and medical equipment; and fails to treat patients before it is too late.
Each year, the completely predictable arrival of colder weather heralds the annual ‘winter crisis’, with patients being treated on corridors and hospital floors and ambulances reversing outside the overcrowded emergency rooms.
The problem is that despite its massive funding, the NHS is woefully short of doctors and nurses and far too relaxed in its attitude to taxpayers’ time and money.
Often it’s the low-level things that are most frustrating for patients. Take the experience of a friend who suffers from a painful spinal condition. Lately he has received a deluge of letters from his local NHS Trust, repeatedly scheduling and canceling his much-needed appointment with a specialist.
With the last message, this long saga sank into a farce, like a blundering computer or a blundering secretary canceled the appointment again, only to reschedule it for the exact same date and time — all in the same letter. Was it on or off? He had no idea – and probably neither did the hospital. There was no point in contacting anyone at the clinic to find out as no one ever picked up the phone.
These day-to-day shortcomings are accompanied by outrageous waste, such as millions of pounds worth of life-saving hydrocortisone, which initially cost 70 pence per pack and ended up costing £88. The NHS continued to pay (although the pharmaceutical companies involved were subsequently fined £270 million by the Competition and Markets Authority for price fixing). A shocking amount of time is wasted due to poor tracking and sharing and hopelessly outdated computer systems. Some doctors still need 20 minutes in the morning to turn on their computers.
Then there’s the fortune spent on legal fees defending the indefensible claims of medical negligence; millions in the pan on pills that patients don’t need; billions in management consultants whose recommended actions never seem to change anything.
How painful it was that the day after the £36bn health tax hike was approved by MPs, and as concerns grew that the money won’t be spent wisely, it turned out that the NHS is hiring an army of 42 new managers with a salary of up to £270,000.
Breaking an important manifesto promise is a serious decision for any political party. Let’s hope health chiefs use this bonanza wisely – otherwise not only will patients die needlessly, but so will the Conservative Party’s chances of reelection
Fortunately, there are some of the craziest abuses and excesses: 66 pence for a single toilet roll that could have been had for a tenth the price; £5,000 for hip replacement parts available for £650; patients not returning valuables, including wheelchairs and crutches, are a thing of the past, but even the most ardent admirers of the NHS admit it could get a lot more value per pound spent.
My co-author, journalist Isabel Oakeshott, saw this firsthand when she shadowed a urologist consultant for a day at his NHS hospital, followed by a day at his private clinic.
Both operating rooms had the same world-class equipment, but in the space of a few hours Prasanna Sooriakumaran, who specializes in robotic surgery for prostate cancer, was able to perform several more procedures at a private London hospital, where patients pay thousands of pounds to treat, than he could. at an NHS hospital where he worked.
The main difference is that the private hospital puts productivity first. Everyone involved not only showed up for work, but also showed up on time, then flipped through the patient list without long breaks for coffee and thumbs up between surgeries.
After 18 months of making huge sacrifices to ‘protect the NHS’, missing the patience of many of those forced to put their health on hold, potentially life-saving treatments for cancer, heart disease and stroke and crippling pain as routine procedures such as hip and knee replacements are constantly delayed, is thin.
With Boris Johnson acting like a deranged Formula 1 racer with a Moet & Chandon magnum, showering the health department with cash at risk of being sprayed against the wall, the silent self-sacrifice of millions who put others first. putting in place during the coronavirus crisis could quickly give way to anger that the NHS is still not fit to care for them.
Breaking an important manifesto promise is a serious decision for any political party. Let’s hope health leaders use this bonanza wisely – otherwise not only will patients die needlessly, but so will the Conservative Party’s chances of reelection.
Life Support: The State Of The NHS In An Age Of Pandemics, by Michael Ashcroft and Isabel Oakeshott, will be published in February 2022. For information on Lord Ashcroft’s work, visit lordashcroft.com. Follow him on Twitter and Facebook @LordAshcroft.