The State of the NHS: Why it’s dying, and not going to get any better soon

As featured in Edition 39, available here.


BY ZACH ROBERTS (2nd year - Law and PAIS - Aylesbury, UK)


As of this year, NHS waitlists have hit over 6 million, with the pandemic doing no favours for this figure. This is all down to a decade of cuts that has left NHS funding increases at their lowest ever levels, far below what is necessary for our growing, elderly population. As a result, 17,000 beds have been cut and there are over 100,000 unfilled vacancies.


The initial attempt at a solution? A pitiful 1% pay rise, that was only altered to 3% after a mass public outrage. The health budget has been decimated by 24% since 2015, and with this Conservative government now collecting an unimpressive record of failed promises, it's about time they fulfilled their pledge to restore proper funding for our NHS.


The Tory plan to do so starts with a restructuring of the way in which regions have control over their local part of the NHS as part of the new Health and Social Care Bill. 42 newly established Integrated Care Systems (ICSs) will each oversee a local NHS service that spans an area of 1-2 million people. These ICSs will include ICBs (Integrated Care Boards), and they will be “accountable for NHS spending and performance” according to the Government plans.


While these boards will include members from councils, charities, trusts, and local authorities, the controversy surrounds the fact that they will also include representatives of private health firms. The Government plans to be very hands-off with these boards, stating that they will only intervene and potentially block an appointee if “they could reasonably be regarded as undermining the independence of the health service.”


The fear then, of course, is that without ample state oversight, the private interest stakeholders on these boards can act as backdoor gateways for more privatisation of certain sectors of the NHS. Admittedly, the impacts of the COVID-19 pandemic mean that the NHS needs money that doesn’t presently exist, more than ever because of the unprecedented demand on the heath service over the last 2 years.


Privatisation may be able to restore the finances of the health service, but it would also do irreparable damage. Corporate monopolies would drive the price of basic health care and drugs through the roof, to levels comparable to that of the United States in worst case scenarios. This bill has the potential to entrench the role of private sector firms into the health service, and once they are no longer needed for financial support, they won’t be simple to get rid of.


Additionally, this bill gives huge amounts of power to the Health Secretary. They will be able to seize the power to overrule any decisions, mergers, or appointments made by an ICS, and will have absolute power over final decisions on appointments of directors that will sit on the ICBs. Not only does this plan allow for unprecedented corporate control of the NHS, but also cronyism through the Health Secretary. The Tories have been bombarded with numerous accusations and revelations that cronyism has been rife throughout their approach towards combatting the pandemic. Contracts have been handed out to friends, family, and donors of the party and its MPs, and this new bill would mean that there is nothing to stop this from leaching into the core of the NHS too.


Tory Ministers have tried to ease fears with reassurances about appointments, and health minister Edward Argar argued that “no one will be appointed to an ICB who would undermine the independence of the NHS” - but forgive us if public trust in the Conservatives is not at an all-time high right now.


The most important fact, however, is that this does not seem to address or offer solutions for the real problems present in the NHS right now. There are serious staffing shortages, with thousands that leave the sector every year, and that turnover of staff is a major crippling factor right now. It also does not specifically address funding, rather the finances are a sort of afterthought, with ministers hoping that the increased inclusion of the private sector = plenty of money for the NHS.


Sadly, despite even some Tory rebellions, this bill will likely be passed, and so now all that can be done is to remain observant and wary of how our NHS is evolving and doing all that we can to protect something so fundamental to British society, be it at the ballot box, or on the street (Provided we don’t get arrested under the new Police, Crime, Sentencing and Courts Bill!).



Image: Unsplash (Ehimetalor Akhere Unuabona)