The NHS is always a hot topic for political debate. People care about it, passionately. Our health service, for all its challenges, continues to command overwhelming public support – the polls show it’s what makes us most proud to be British. It’s understandable that, come election time, politicians will look to harness that popularity, inevitably casting themselves as champions and defenders of the NHS.
This political potency is often helpful for the NHS. But it becomes counter-productive when the NHS is used as a political weapon. Frontline NHS leaders are worried that is already starting to happen in this election.
This political potency is often helpful for the NHS. But it becomes counter-productive when the NHS is used as a political weapon. Frontline NHS leaders are worried that is already starting to happen in this election.
Of course we need to be open and honest about where the health service is falling short. It is clear that, despite treating many more patients than ever before, the NHS is falling back against key targets for A&E, cancer care, and diagnostic tests. Waiting lists for operations have climbed to nearly four and a half million and the pressures on our mental health, community and ambulance services are just as great. However hard the NHS frontline works, it can’t seem to keep up with growing demand.
This is particularly worrying with winter looming. But as pressures on the NHS intensify in the coming weeks, over-dramatizing or distorting the difficulties for political ends will do nothing to help those frontline staff who are working flat out for patients. Equally, disingenuous claims about extra funding, or promises that create unrealistic expectations, may be tempting in the heat of the election battle, but they do the health service no favours.
Already, we are starting to see a bidding war between the main parties as to who is the best friend of the NHS. As the health battle develops this may be expressed in competing commitments to increased NHS budgets. But voters beware! The NHS has, in the past, been a serial victim of politicians slicing and dicing funding numbers and making empty promises that were never actually delivered.
So here is a challenge to politicians who say they support the NHS. Be clear and straight about the numbers – for example, don’t double count what’s already been announced and don’t confuse five and one year commitments to boost a headline number. Acknowledge the scale of the funding needed to deliver services to meet our growing needs, and to rebuild our NHS, making it fit for the 21st century. That means looking beyond hospitals, important though they are, to other parts of the service which have suffered similar neglect, for which patients are today paying the price.
Politicians who are truly committed to the NHS will also understand that the biggest constraint facing the health service is our workforce shortages. So we need credible answers on how to close a workforce vacancy gap of more than 100,000; to resolve the damaging pension problems that are driving key staff away; and to ensure any new immigration system enables the NHS and social care services to recruit and retain the overseas staff on whom we will have to rely for the foreseeable future.
Politicians who are truly committed to the NHS will also understand that the biggest constraint facing the health service is our workforce shortages.
And make no mistake: the NHS and social care are two sides of the same coin. How often have we heard our politicians promise to develop a sustainable solution to our social care crisis? The time for heartfelt commitments is now past. We need a proper, sustainable, detailed solution and, in manifestos, as a minimum, a process and timeline for when and how that solution will be developed.
How often have we heard our politicians promise to develop a sustainable solution to our social care crisis? The time for heartfelt commitments is now past. We need a proper, sustainable, detailed solution and, in manifestos, as a minimum, a process and timeline for when and how that solution will be developed.
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There is a real risk that the public will be let down – yet again – by a superficial political debate on health and social care. In our recent survey, more than 90% of senior frontline NHS leaders said they didn’t think that, as a nation, we were having the right debate about the long term future of the service.
We need to properly debate what is needed in our taxpayer funded, free to use, NHS to provide the right quality of care and take advantage of exciting medical advances such as genomics, when we know demand for care is going to rise dramatically. NHS performance is now starting to struggle because we are failing to answer this basic question. That’s the kind of NHS election debate we actually need.
This piece was first published in the Times.