Is The NHS Fit For Purpose?

Battle of Ideas audio archive

Subscribe to the Academy of Ideas Substack for more information on the next Battle and future events: https://clairefox.substack.com/subscribe IS THE NHS FIT FOR PURPOSE? https://archives.battleofideas.org.uk/2021/session/is-the-nhs-fit-for-purpose/ The NHS has been under incredible strain since the Covid-19 pandemic hit the UK in March 2020. In the early days, hospitals had to reorganise rapidly to cope with a huge surge in demand. Ventilators, protective equipment, beds and staff were in short supply as intensive care capacity needed to expand rapidly. Temporary ‘Nightingale’ field hospitals were created in just a few days to provide emergency capacity, but barely used. Thankfully, no one went untreated for Covid and when even greater demands were placed on health services during the second wave in January 2021, hospitals again managed to cope – showing what could be possible when bureaucracy is pushed aside. However, the diversion of resources caused by the pandemic has led to a backlog building up of other untreated patients. In August 2021, a record 5.45million patients were recorded waiting for hospital treatment (although the number waiting more than 18 weeks for treatment was 1.7million). The backlog is not simply a matter of resources. Some patients have delayed coming forward for treatment when ministers were demanding that we ‘protect the NHS’, and infection control measures continued to reduce the number of beds available. According to the British Heart Foundation, delays in treatment for cardiac and circulatory issues could lead to further deaths if patients are unable to be seen early enough for optimal treatment, a problem that equally applies to cancer patients. Yet problems with the NHS are not new. Almost every year there is a crisis during winter as a variety of pressures combine to stretch healthcare resources. Long waiting lists for treatment seem ever present. While reports for the Commonwealth Fund have frequently suggested the NHS is one of the top health services in the world, when it comes to patient outcomes, the NHS lags behind most other wealthy economies. Moreover, the UK population is ageing, leading to ever-greater demands over time – particularly when it comes to social care. Is it time to look again at the way we organise healthcare? The UK is relatively unusual among wealthier nations in having a health service that is mostly financed and provided by the state. Is this near-monopoly of provision a strength or a weakness? Moreover, the NHS has been subject to multiple reorganisations over the years, with a panoply of oversight boards, commissioning groups, health authorities and other bodies now overseeing different aspects of the system. For some critics, the pandemic has simply highlighted the diffusion of responsibility between different parts of the NHS, leading to an inability to hold any part of the system accountable for its failings. How can we solve the problems of the NHS? Is it simply a matter of providing extra resources, or is the way those resources are used a problem, too? Do we expect too much from the NHS? And with some observers likening the NHS to a national religion, are politicians brave enough to have a proper debate about reform? Speakers Dr Frankie Anderson psychiatry trainee; co-founder, Sheffield Salon Parth Patel research fellow, IPPR; junior doctor; writer, The Lancet, BMJ, Independent and Financial Times Professor Karol Sikora chief medical officer, Rutherford Health; founder, Cancer Partners UK; author, Treatment of Cancer; honorary consultant oncologist, Hammersmith Hospital Christopher Snowdon head of lifestyle economics, Institute of Economic Affairs; editor, Nanny State Index; author, Selfishness, Greed and Capitalism Dolly Theis PhD student, MRC Epidemiology Unit, University of Cambridge Chair Dave Clements policy and strategy consultant; writer