How it came to this.

How did it come to this? A week is a long time in politics, apparently. Imagine the impact of 10 years. After 13 years of a Labour Government, dear international reader, The Conservative Party took power in the coalition of 2010 and have been in power ever since. But the Tories have always spoken with “forked tongue” when it come to the NHS. They claim to be supporters when their actions would lead you to believe otherwise. Now the country needs the NHS, its systems, equipment and staff, to be as robust as possible. We need it/them more than any time since … 

Let’s begin with funding. Research by the BMJ states that as a share of GDP, spending on health in the UK in 2018/19 was more or less the same as in 2011/12, and marginally above where it was in 2008/9. In fact, the growth in health spending has risen by just 1.6% a year since 2011. 

“…This is less than half the long-run trend of growth in health spending, which is 3.6% a year in real terms…” (BMJ)

So, average 1.6% increase over a 9 year period. 

Patience ran out in 2016 when in February of that year junior doctors went on a national strike for the first time in 40 years. Was the dispute resolved satisfactorily? Who really knows? But by then the long term staffing damage had already been set in motion. The number of junior doctors who completed their 2 year training, and then went into the NHS as a specialist or train as a GP was just 50%. In 2015 it was 52% – 2014 58% – 2013 64% – 2012 67% – 2011 71% .

Nurses pay has fallen by 7.4% in real terms since August 2010. (Fullfact)

A joint briefing on the health care workforce by the Health Foundation, The King’s Fund and the Nuffield Trust showed that the number of nurses and health visitors leaving the NHS increased by 25% from 2012 to 2018, from 27,300 to 34,100. Today, there are 100,000 health care vacancies across the board.

In the midst of this the country bought into the Brexit myth. A Tory miscalculation that became a jingoistic clarion call when they saw which way the wind was blowing for UKIP. The net inflow of nursing staff from European countries became a net outflow almost immediately. Why would you stay if you didn’t feel that you were wanted? Between July 2017 and July 2018 the net outflow was over 1500 nursing staff.

In 2016 the Government ran “Exercise Cygnus” – an internal exercise to examine the state of health service provision should there be a pandemic. to quote the summary findings; 

However, the exercise did show that the UK’s capability to respond to a worst case pandemic influenza should be critically reviewed. (Exercise Cygnus Report Final Version 1.0) 

The report goes on to list several pages of recommendations and objectives. 

Then, at the beginning of 2020 – BOOM – and Boris went to the rugby. It would seem that, and maybe I should have read every line of the Exercise Cygnus recommendations, not much has been learned from the “dry run”. The most incompetent politicians, having depleted the morale, staffing level and funding of the NHS, found themselves dealing with matters of life and death and, oh, the economy. Ten months later we have over 1,000 deaths per day from Covid related illness, and there doesn’t seem, still, to be a plan to get us out of it.

The Tories have turned to their friends in high places lavishing lucrative contracts upon them to deliver a specific service, – everything from PPE procurement to the ill-fated Track and Trace system – and then shrugged their shoulders when services and promises fail to deliver. 

There are no lessons being learned for future pandemics (heaven forbid). Johnson has openly stated that if it happens again the Government will turn to “free enterprise”(his words) ie, his rich mates, to get us out of danger.

It is science that is riding to the rescue. And science will do it in future. It remains to be seen how the Government will treat the NHS after this.

(Featured Image : London Standard)