Today the NHS turns 75. You've probably seen or heard some commotion as the country collectively says three cheers to our most precious institution. At Glastonbury recently, crowds were encouraged to celebrate the milestone. Memories of the doorstep clapping of 2020came flooding back, and it left a hollow feeling.
The last time the nation seemed to feel a pride in the NHS was in 2012 at the Olympics, during the opening ceremony. But things are very different now.
As a doctor, I value the NHS; I've devoted my working life to it, so I wondered, why did it jar with me when I heard people speaking about how marvellous it is?
The following day I got my answer, when a report from The King's Fund was released advising that we are experiencing huge numbers of excess deaths. It's the equivalent of a small town, like Great Yarmouth, or half the audience at the Pyramid Stage, being wiped out every 12 months.
I, and so many of my colleagues, already knew this.
Patients are dying prematurely on our watch. We just have the data now to prove it. The UK has woefully underspent on health compared to other nations and the service is chronically understaffed. The NHS is failing, and 40,000 people each year are leaving this life too soon. The UK is dying too young.
And do you know what these excess deaths mean?
It's means the 57-year-old who dies before their cardiac bypass surgery, which has been postponed four times. It means the 38-year-old mum with breast cancer whose malignancy spreads whilst she waits for lifesaving treatment. It means the 68-year-old who has a stroke because they gave up trying to get their blood pressure managed when they couldn't get a GP appointment. The ambulance to get them was then delayed and they missed the four-hour window to have clot busting drugs which could have reversed the devastating damage of the stroke.
It means the times we could have saved a life but there weren't the staff or resources to do it.
For the NHS to function it needs to be agile, and there needs to be a pace to our treatment. We cannot allow people to languish on waiting lists. They die there.
Furthermore, if we want to grow our economy we need a fit and healthy population. The Office of National Statistics data shows we're having more sick days than ever. More than two and a half million are not working due to health problems, the ONS said. The reasons for this are unclear but not being able to access timely treatment is likely to be contributing.
This Government have not kept NHS pay or funding in line with inflation. And now working in the NHS is not affordable, with many doctors and nurses graduating with over £50-100k worth of debt. You cannot pay this off on a salary of 29k-a-year, which is the salary of junior doctors.
If we look at GP funding each year, your GP receives £163, half the price of a Glastonbury ticket, to look after you, no matter how many times you attend. Most people go to the GP seveon to nine times a year. There is no way good quality, accessible care can be provided at prices lower than pet insurance. This amount increases at around 2% each year. No where near enough to keep up with energy or staffing costs.
When there are these gaps in funding what happens? I've had to give fit notes for years to people unable to work because they're waiting for a new knee or hip. I've seen their partners in subsequent appointments struggling with their own mental health, living with someone in chronic pain, unable to work. I've seen women with bleeding problems wait six months for biopsies showing the early changes of womb cancer because they couldn't get to see a gynaecologist any sooner.
In my practice and amongst colleagues, how do we cope with such demands? We write letters, we ring around, we work late, trying to find a way to treatment for the patients we worry about. This has taken its toll on me and others. Most of my medical friends I've spoken to have needed mental health support in the last three years, including myself. We are stranded in the ever growing crevasse between patient needs and resources. The cost has been our own mental health.
It's truly terrifying.
I think somewhere along the way we've gotten confused between free at the point of access, the vision on Aneurin Bevan (the politician who spearheaded the creation of the NHS), and completely free. We've forgotten the NHS is not a charity, full of volunteers. It's a taxpayer-funded service, vital to keep our economy working.
So as we 'celebrate' the NHS today, I worry that the subliminal message to those of us working within it is that we should be so proud and we should sacrifice our own health to work in it, and not complain too much about conditions and pay.
The Government has tried to tackle staffing with the release of their NHS Long Term Workforce Plan. I, and many others, have no confidence it will help. The current workforce is burnt out from chronic understaffing and under resourcing but the plan focuses mainly on expanding medical and nursing school places. It will take 10-15 years to see any benefit from this. Patients are dying prematurely now. Meanwhile there is absolutely no focus on retaining the current staff and preventing the UK's haemorrhage of highly trained workers, who are retiring, moving abroad or switching to the private sector.
The main question in my mind is: who will teach all these extra students? If we do not value our current staff, we have no hope of training the numbers needed for the next generation. A survey this week by The Doctors' Association UK has shown nine in 10 medical students have been sent home early because there were not enough doctors to teach them, and some even reported never having touched a patient to examine them.
Each day NHS staff are facing an uphill struggle to do their jobs the way they were trained to, simply because there are not enough of us. Add to that below-inflation pay rises, a toxic culture which has allowed bullying, sexism and racism to infiltrate some departments, and a lack of the very basics such as hot food and rest areas to support shift workers and you can see why the NHS might have a staffing problem. Very few NHS staff are feeling valued right now.
The Government could choose to correct this, with meaningful actions such as free parking, hot food, and dare I say it, pay rises in line with inflation, but they do not do it.
So I would ask people today to not be blind to the current state of the NHS. We have to find a way to pay for it, or British people will continue to pay for it with their lives. We have to find a way of making the 1.27 million people who work in the NHS feel valued, so they and all their knowledge, experience and skills stay put.
Let's not wave flags, or clap, or talk about what a wonderful institution the NHS is on its 75th anniversary. Let's be realistic and get to work giving it the financial injection it needs to get us healthy again.