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Friday 10 November 2017

The NHS Crisis (2017-2018)

This is becoming an annual blog - the British NHS in crisis! Despite spending increasing £ billions on the NHS over the last 70 years, the amount of sickness and disease continues to increase, demand for conventional health care expands year by year, hospital waiting times lengthen, difficulty getting an appointment with a doctor more difficult, and major demands for yet more funding become shriller and more strident.

So the pattern is this - increased sickness, followed by increased spending on conventional medicine, followed by even more sickness, and increased demands for even more money. Yet no one EVER questions whether spending more money on a medical system that is clearly and demonstrably failing is the appropriate response to NHS problems. It has always been thus - read my previous blogs.

This year, the expected crisis has been heralded by Simon Stevens, Chief Executive of NHS England since April 2014. His recent speech, made two weeks before the Budget, outlines the crisis that he is expecting this winter. For a fuller account of what he said go to the Telegraph report of his speech.  Basically, what he said was that NHS performance would decline significantly without an immediate cash injection, and made the usual case for spending more money, - an extra £4 billion next year. He warned that if increases were limited to 0.4% next year, as currently planned, it would mean deeper rationing of care, staff cuts and record waiting lists. He added that the budget for next year would fall “well short of what is currently needed to properly look after our patients.” He continued

               "Our duty of candour requires us to explain the consequences of these decisions to help inform the difficult choices that will be made in the years ahead.”

My duty of candour is to ask why it is that, year by year, the conventional medical establishment is still unable to cope with the demand for health services, and ask the pertinent question - why the medicine the NHS is using consistently leads to increasing rather than reducing demands on those health services. 
  • Should we not expect that patients get well after treatment? 
  • And certainly that they don't get sicker, leading to increased levels of health need.
Anyway, these are a few of Simon Stevens chilling warnings about what he expects to happen over the winter of 2017-2018, and his demands for yet more money for the NHS.
  • He says that without extra funding, waiting times would rise to a record high of 5 million patients, an extra million people on the waiting list, with 1 in 10 people stuck on a waiting list by 2021. It would be, he said, the highest number ever!
  • He stated that the deterioration would be so steep that Parliament would need to pass new laws, abolishing rights to treatment within 18 weeks.
  •      "It boils down to this, on the current budget, far from growing the number of nurses and other frontline staff, in many parts of the country next year hospitals, community health services and GPs are more likely to be retrenching and retreating.
  •      "On the current funding outlook, it is going to be increasingly hard to expand mental health services or improve cancer care. Services the public need and rightly want.
  • He said that the NHS has already "reluctantly" limited the annual increase of waiting list operations, to protect funding for Accident & Emergency, Mental Health services, and GP care, and that these temporary measures to manage demand would have to become permanent.
  • He said that this would mean that the government would have to publicly, legally abolish patients' national waiting times guarantees.
Stevens went on to claim that the British NHS were underfunded by some £20 to £30 billion per year! This is on top of the (approximately) £120 billion already being spent on conventional health care! And in demanding more resources he referred to the Brexit battle bus, and the slogan on its side, 'Vote Leave for a better funded health service, £350m a week'. This is the amount of additional money he is looking for, amounting to £18,200 billion every year. Stevens demands also came with a threat to politicians.

               "Rather than our criticising these clear Brexit funding commitments to NHS patients - promises entered into by cabinet ministers and by MPs - the public want to see them honoured. Trust in democratic politics will not be strengthened if anyone now tries to argue, 'You voted Brexit, partly for a better funded health service. But precisely because of Brexit, you now can't have one.'"

So what would this staggering increase in NHS resources be spend on? The same as before! The same failed conventional treatments, the same failed pharmaceutical drugs and vaccines, with all their side effects and adverse reactions. 

In the Telegraph article, referred to above, it is interesting to see a conventional medical explanation for why the NHS is under so much pressure. It gives 4 separate reasons.
  1. An ageing population. There are one million more people over the age of 65 than five years ago. This has caused a surge in demand for medical care.
  2. Cuts to budgets for social care. While the NHS budget has been protected, social services for home helps and other care have fallen by 11 per cent in five years. This has caused record levels of “bedblocking”; people with no medical need to be in hospital are stuck there because they can’t be supported at home. 
  3. Staff shortages. While hospital doctor and nurse numbers have risen over the last decade, they have not kept pace with the rise in demand. Meanwhile 2016 saw record numbers of GP practices close, displacing patients on to A&E departments as they seek medical advice
  4. Lifestyle factors. Drinking too much alcohol, smoking, a poor diet with not enough fruit and vegetables and not doing enough exercise are all major reasons for becoming unwell and needing to rely on our health services. Growing numbers of overweight children show this problem is currently set to continue
These are all inadequate explanations, singly and together.
  1. There are indeed more older people, but demand is not coming just from older people now. Diseases once believed to be a product of ageing now strikes people of all ages. The huge increase in Cancer now affects all age groups, including very young children. Diabetes strikes irrespective of age. Arthritis and joint replacements is no longer age sensitive, with younger people suffering the complaint, and replacement surgery. The rise and rise of heart, liver and kidney disease, and the need for organ transplantation, similarly affects younger, middle aged and older people.
  2. Conventional medicine has been able to keep people alive, but it has not been able to maintain people's quality of life. So whilst more people may be kept alive after illness, but without the ability to function adequately, or to cope with the everyday tasks of living. They are alive but dependent, and this is the result of health services, dominated by conventional medicine, for over 70 years.
  3. This is not an explanation. Staff shortages are the direct result of the failure of conventional medicine to make patients better. More demand for health services, more sickness, more dependency on car leads to the need for more doctors, more nurses, and other medical personnel.
  4. Lifestyle factors have always been a factor in our health, both individually and as a nation. In the past conventional medicine has been tardy in its recognising the importance of lifestyle factors to health, preferring instead to prescribe pharmaceutical drugs to deal with the resulting problems rather than pointing to the need for lifestyle change.
So how difficult the winter of 2017/2018 will be for the British NHS remains to be seen. No doubt I will be blogging about this in due course! But one thing is certain - spending more money on the same old, failed medicine will not improve matters. Indeed, it will make matters worse. The side effects and adverse effects of pharmaceutical drugs and vaccines are misnomers. They are really new illnesses and disease, all of which have to be treated. And when they are treated, with more pharmaceutical drugs and vaccines, the sicker patients become, and the more demand they make on health services.

It is a horrible vicious circle that no-one has yet considered!