Since last August I’ve sent Jeremy Hunt 57 tweets over 57 days, a few emails and one blog (Trust me Mr Hunt, I’m a junior doctor’s mam) and no response from him. Granted his department has emailed me back, but that doesn’t count. One email even said: “This may not be the reply you were hoping for.” So here is part two of my series of NHS blogs – even if it’s not what you were hoping for Mr Hunt.
Every time I’ve sat down to write this blog, I haven’t known where to start. And I really still don’t – because the NHS is in one, big, bloody mess. Every week, every day something hits the news about the patients and staff caught up in the quagmire and the demise of it. It’s like a game of Jenga. Piece by piece our NHS is being taken apart.
I have needed and used the NHS for the past 57 years. And when I returned from living in Athens for three years in 2010, the NHS was high on my list as a reason to come back. And now? Now a system so revered by the rest of the world, is on its knees. The situation was so bad the other week that the Red Cross described the state of our health service as a “humanitarian crisis”. Theresa May said the situation was “overblown” by them and Hunt had the gall to say in the House of Commons, that a “few areas” were of concern. He definitely becomes Pinocchio in that building, as it transpired later that day that in fact 20 hospitals had been put on a “Black Alert” (or on an “OPEL 4 Alert” as hospitals have been told to call them. Campaigners claim the ban on the term Black Alert came about to spin the NHS out of crisis). A Black Alert is the most serious alert; meaning a hospital is “unable to deliver comprehensive care and there is increased potential for patient care and safety to be compromised.” Out of 120 trusts, almost half have declared a major alert during January this year.
But whatever the semantics or codes used; the NHS is in crisis and healthcare practitioners (HCPs) and patients have taken to Twitter, with #NHSCrisis … to illustrate the fact. A litany of atrocious situations has been described. Trawl the hashtag on Twitter or read the chronicles on the internet to find out. Three news reports have particularly upset and outraged me.
Firstly, a mother released the photo of her child with suspected meningitis – lying on a makeshift bed – made out of two plastic hospital chairs pushed together.
Secondly, in November 2016 patients waiting on trolleys for over 12 hours, after a decision was made to admit them, totalled 456 – the second highest figure on record, 16 times higher than in November 2015.
And finally cancer operations have been cancelled. It is a humanitarian crisis – where’s the humanity or dignity in any of this? It’s criminal.
After the denial, came the deflection from May and Hunt. But none of the above is due to lazy doctors or GPs who already work all hours; nor due to people using A&E for a sore finger; nor due to tourists abusing the system (They account for 0.3% of the NHS budget) or immigrants (who contribute to our NHS) No; all of it is due to a shortage of hospital beds – we have fewer beds per head of population than our neighbouring European countries. All due to chronic underfunding – we spend less on healthcare, as a percentage of GDP, and have fewer doctors and nurses (part three on nursing out next) per head than many of those European countries too. Thousands of HCPs warned us last year though. Kevin O’Kane (consultant) was one, who simply summed up the situation last August in a tweet: “Too few doctors; too few beds.” He continued describing the problem: “Places for medical courses through clearing; deliberate underfunding and swingeing cuts.” Speaking with my son recently, who has just finished 6 months in A&E as part of his training, he said: “Not enough beds for older patients with complex needs.” (Can I add he looks dreadful too – exhausted due to a gruelling shift pattern. That’s the mam coming out in me again).
The emails I received from the Department of Health (DoH) extolling Hunt’s and the government’s intentions, made particular reference to the lie that they are investing £10bn in the NHS. Even their own Tory MP Sarah Wollaston, who chaired a cross party Health Committee, refutes it.
The emails failed to mention: the social care cuts of £4.6bn meaning discharged patients can’t get home to be further cared for; failed to mention the cuts in mental health staff and beds meaning distressed patients having to travel up to 100 miles and be away from family; failed to mention funds for mental health not being ring fenced; failed to mention Virgin Care managing over 230 NHS and social care services over the past 6 years meaning Richard Branson has secured contracts worth £1bn; failed to mention outsourcing of administration services meaning referral letters go to the wrong address causing patients to wait longer for specialist appointments; failed to mention PFIs (private financial investments that were used to build hospitals) continuing to accrue interest meaning the debt to the NHS is worth billions – think the biggest Visa credit card ever; failed to mention that they can advertise the sale of NHS contracts, the latest one is a transport contract worth £515m, meaning for-profit businesses can capitalise on a broken system; failed to mention the American companies who have their fingers in pies over here already, such as Bain Capital and United Health; failed to mention that DoH reported £8.7bn of NHS funds went to private companies in 2015/16; failed to mention nearly 100 GPs less in England in Sept 2016, than in 2015, meaning Hunt’s GP recruitment isn’t going too well; failed to mention GP surgery closures due to lack of funds, meaning loss of vital primary care and GPs having to take out personal loans to pay for redundancies; failed to mention rising business rates for some hospitals, our Specialist Emergency Care Hospital in Northumberland faces an £8m bill over the next 5 years, due to a 50% increase; failed to mention Sustainability & Transformation Plans (STPs) in the 44 “Footprint” areas in England, needing to find “efficiency savings” of £22bn, as part of the Five Year Forward View – some of the plans sound commendable, but some also mean cuts – e.g. by 2021 7k NHS jobs and 500 beds are to be cut in North West London (as part of the £1.3bn savings that have to be found) and in rural South Devon four community hospitals are to be replaced by Wellbeing Hubs (part of their £557m savings) and failed to mention that £2.3m will be spent, in London alone, on management consultants for these STPs.
And definitely would have failed to mention May going cap in hand to see Trump last week, with the possibility of our NHS being on the trading table. And definitely would have failed to mention the revelation 2 days ago, that NHS England’s budget will face a reduction of 0.6% per head in 2018/19. So that IS one big £10bn lie. Expect another email from me Mr Hunt.
No wonder I didn’t know where to start… and I could go on and on.
While Hunt and May deny and deflect. It’s patients and frontline staff who take the brunt. The NHS in England sees one million patients every 36 hours. There are potentially 65 million users of the NHS. And ironically, because we have a population that lives longer, more people are using it today than they were in 1948 when it was founded by Labour. This poses a huge challenge for the NHS, hence the STPs. But why should health trusts and patients and staff bear the load of underfunding?
Yes, it’s in one big bloody mess, but through it all staff show care and tenacity. Someone who encapsulates what our NHS is all about at its best, is Dr Kate Granger, the doctor who pioneered #hellomynameis … simple words, a simple phrase, but they introduce a healthcare practitioner to a patient, a person and open the door to a dialogue. They begin the message: I care; you count.
Sadly, Kate died in July last year, from a rare terminal cancer, but her legacy carries on through that phrase by her husband Chris Pointon and every single doctor, porter, nurse, GP, physiotherapist and consultant who says it. No lip-service. It is part of person-centred care. My new dentist used it the other day when I met her for the first time. Hospitals, clinics and surgeries are less intimidating because of this person-centred care that pervades medicine today. Couple this compassion with collective knowledge, evidence-based practice, skill, training and the ability to stay awake for 12 hour shifts and you have our health service – one that is free at the point of use; publicly funded … you have OUR National Health Service. It says – we have your back. And every HCP busts a gut every day to deliver it. I think it was Ghandi who said: “A nation’s greatness is measured by how it treats its weakest members.” I want our NHS to continue for this very reason.
Trust me Mr Hunt; this is what the world reveres. What decent people revere. As a patient this is what I revere. This is what I need for me and my family and future generations. The NHS needs to be run efficiently, we would all agree, but like education our health is not a commodity… to be sold to the highest bidder.
Trust me Mr Hunt; as a patient I would like safe, non- urgent or elective 5 day care with 24/7 emergency care. I would like to carry on seeing my own designated GP, who I have built a relationship with, during the week, as I want continuity of care. Mr Hunt, you must know that a pilot study of 7/7 GP care showed it didn’t work – people failed to attend weekend appointments and it wasn’t financially viable. If I need urgent care then I know to seek it through a pharmacist, walk-in centre, GP OOH (Out Of Hours) or NHS 111 service. Although at the moment some don’t seem too healthy, eg in North Tyneside, three walk-in centres are being reduced to one (£904m of health & social care savings need to be found in this Footprint. Big question – are the walk-ins part of the STP? Answers are hard to come by).
I don’t need a truly 7/7 NHS. I need the services we already have to be robust and easily accessible and well-resourced and to carry on being publicly funded. Stop claiming you are fulfilling the promise of a 7/7 NHS, made in some general election manifesto in 2015, and that the electorate want or need it.
My part one NHS blog was viewed nearly 2k times and was all about my perceptions as the mam of a junior doctor. At the end I asked you Jeremy Hunt, our Secretary of State for Health, if you would recommend a medical career, without any caveats, to your own children? In the light of the above and the fact that your own constituency’s hospital, the Royal Surrey County Hospital, was also on a Black Alert, then I am now asking you: “Would you recommend using the NHS to your family, Mr Hunt? Would you, without any reservations?”
I’m imploring you to properly fund our NHS – cancelling the PFI debt would be a good start. Remember you are a civil servant to serve and represent us as a member of parliament, even if the Health and Social Care Act of 2012 does absolve you of total responsibility for our health. It is a political choice as to how you and your government spend our taxes and how you fund OUR NHS. But first you have to acknowledge you are part of the problem, in order to solve the problem.
Realistically? I think this will fall on stony ground… Hunt will carry on being self-serving and he will let the removal of the Jenga pieces to continue. And when it all tumbles, it will allow the full privatisation of the NHS to happen, with every Tom, Richard B and Harry running off with the pieces. A private health insurance system is not a pretty sight. Costs are the biggest cause of bankruptcy in the US. And people with a pre-existing condition, are uninsurable, or at the very best have much higher premiums. Healthcare can’t be paid for by insurers, because insurance needs appropriate risky ratios to succeed. Healthcare becomes a utility, instead of a right. It isn’t a pretty sight.
So now I implore you – the electorate – to keep making some noise by going on Twitter and Facebook, blogging, writing newspaper and journal articles, chatting to friends and family, petitioning, joining campaign groups and unions, getting involved in the next consultation phase of the STPs, lobbying your MP about funding and supporting the NHS Bill (to stop further dismantling and privatisation of the NHS and reinstate it as an accountable public service). Write to or email Hunt about anything NHS.
Engage. Spread the word.
Resist against cuts and closures now before anymore happen. Protest. Demonstrate. Go to the big #OurNHS demo on 4 March in London – backed by Unite, the BMA and the People’s Assembly. If you can’t go, then attend any local events ahead of the march and rally. Publicise and report the big demo on social media and inform mainstream media.
Basically bug the hell out of all of the political parties. Oust the Tories. Go on… you know you want to. It’s what most of us are hoping for.