The UK鈥檚 hallowed National Health Service (NHS) turns 70 this week, and Prime Minister Theresa May has said that she will be giving it a special birthday present: an extra 拢20 billion in England per year by 2023. As a result, NHS funding in other parts of the UK will rise too. She wants the 拢20 billion to 鈥渟ecure the future鈥� of the service while delivering 鈥渨orld-class鈥� care. But she risks failing to achieve either aim.
For starters, the sums involved are simply not enough to make radical improvements. The NHS has been woefully underfunded since the 2008 financial crisis and experts . May鈥檚 gift equates to 3.4 per cent per year.
Nevertheless 拢20bn is not to be sniffed at, and targeting the investment could lead to a cluster of strategic gains. In her announcement May singled out four areas: mental health, Accident & Emergency waiting times, cancer survival rates, and employing more doctors and nurses. These are important issues and it is clear where they have come from: improving mental health is one of May鈥檚 long-standing pledges; waiting times are the public鈥檚 biggest gripe; cancer survival rates blemish an otherwise spotless international record; and staff and unions will be somewhat appeased by the promise of fewer rota gaps.
Advertisement
Future-proof the NHS
Nevertheless, these issues are possibly bigger political problems for the government than they are strategic issues for the future of the NHS. Rather than patching-up holes, I believe the 拢20bn should be used to future-proof the NHS鈥檚 increasingly outmoded organisational structure. Here is an alternative wish list:
- Over 90 per cent of NHS activity takes place in general practice with family doctors, but surgeries are struggling. . This places a huge burden on those who remain, and the vicious cycle of burnout and early retirement underlies long waiting times at surgeries and rising A&E attendances. Nearly 90 per cent of newly qualified GPs plan to leave full-time general practice after five years. Getting general practice back to health is the most pressing short-term issue for the health service.
- In the longer term, the focus of NHS activity has to change. Around half of all premature deaths and disability is caused by unhealthy behaviours like smoking, drinking, diet and inactivity. Yet is spent on promoting health while 95 per cent goes towards managing sickness. Keeping people well should be the main activity of the NHS. Sadly, May has made it clear that none of the 拢20bn will go towards this.
- Thirdly, the funds should be used to update internal communications. Community services, GPs, hospitals and A&E departments all bear the same NHS logo, yet communication between these siloes is fractured. Each has its own incompatible electronic record system and there is no uniform means of conveying referrals or results. While past experience shows this won鈥檛 be easy, it is time to move beyond fax, towards a single, integrated electronic record that patients can also access. This would speed up care, reduce errors and boost system-wide integration.
The NHS is 鈥� rightly 鈥� the pride of the UK and envy of the world, but a decade of austerity has led to falling standards. May鈥檚 approach illustrates what is wrong with our current medical model: an overemphasis on rectifying things that have already gone wrong.
An extra 拢20bn a year may not be enough to deliver system-wide improvement, but it could help to safeguard the organisation鈥檚 future by boosting integration with a harmonised e-record, supporting the reform of general practice, and putting 鈥渉ealth鈥� back into the centre of National Health Service.
Read more: How Theresa May鈥檚 plan for an AI-powered NHS could go very wrong; US ranked worst healthcare system, while the NHS is the best
