The NHS Cares For Us, But Who’s Caring For The NHS?

The 99-year-old war veteran Captain Tom Moore has raised more than £27 million for the NHS by walking one hundred lengths of his back garden – an unbelievable and astounding story of both public generosity and one man’s charm and endearing determination. Mr Moore is arguably the most cherished British citizen at present. A truly inspirational man, one who without a doubt deserves all the praise, recognition, and encouragement he is gaining.

My bewilderment and heartbreak, however, is that the reason the public feel compelled to make donations of this sum is that it’s all too evident the NHS desperately needs it.

A health service which is excruciatingly underfunded and under-resourced – so much so that they will welcome £27 million in donations from the public – is not an unfortunate inevitability. A health service in this condition is instead a consequence of deliberate, unforgiving neglect from those charged with looking after it – the Government.

A crippled NHS will, I’m sure, accept Mr Moore’s incredible fundraising efforts with both delight and immense gratitude. “Crippled?” Well, what word is more apt? Since the Conservative & Liberal Democrat coalition took office in 2010, the NHS has been victim to austerity and privatisation. Over the past decade, the NHS has suffered the most dramatic reduction in hospital bed numbers, seen a record shortage of nurses, and has begun to succumb the pressures of under-funding and under-resourcing during the coronavirus pandemic. NHS staff are constructing PPE out of bin bags and improvising make-shift masks out of snorkels. “Crippled?” I can’t envisage a more appropriate term.

Whether it be incessant cuts to services or surreptitious privatisation, the Government has catastrophically failed in their responsibility to take care of the National Health Service. “The NHS is safe in our hands”, David Cameron’s 2011 slogan, couldn’t have been more inaccurate.

The repercussions of funding cuts have been momentous and far-reaching, but maybe the two most notable are the record shortage of nursing staff and dramatic reduction in number of hospital beds.

The NHS published its highest ever rate of vacant posts for nurses in the first quarter of 2019-2020, equating to more than 43,000 missing roles. It was reported that 93% of NHS trusts missed their nursing staff targets. Without intervention, this shortfall is predicted to worsen and reach 68,500 by 2023-24. Whilst the NHS is tackling the largest-scale shortage of nurses it’s ever seen, the Government voted in 2017 to abolish bursaries for nurses and midwives, despite evidence that nursing shortages have a “detrimental impact on patient outcomes, including survival”. In the same year, the Government also blocked scrapping the nurse 1% pay-rise cap. The Conservatives, who are publicly hailing the NHS and its heroic staff during coronavirus, are the same party members who shamefully cheered in Westminster in response to winning that vote. As pay-rise caps are occurring simultaneous to training becoming unaffordable, it’s not surprising that we’ve seen a reduction in applications to nurse training posts and that nurses are feeling forced to leave the profession. In the wake of the Brexit vote, it was reported that 5,000 nurses had quit the NHS to go back to other EU countries.

Not only is there an alarming shortage of nurses, but the number of NHS hospital beds fell to 127,225 in 2019 – the lowest ever figure since records began in 1987. In comparison to other European countries, the UK ranks 29th out of 31 for hospital beds per head of population. Looking at ICU beds specifically, the UK ranks 24th, with Germany having approximately four times as many ICU beds per capita according to the most recent data.

Alongside ceaseless funding cuts, another problematic affair of the Conservative party has been privatisation. The Government have been jeopardising patient safety whilst prioritising profit, by quietly selling off sections of the NHS to private offshore companies. The biggest scandal was arguably in 2013, when Jeremy Hunt sold 80% of the state-owned blood plasma supplier to a US private equity firm. “Scandal?” Let me explain. In the 1970’s and 80’s, more than 4,500 patients with haemophilia became infected with HIV and hepatitis after contaminated blood products were brought on the cheap abroad from the US. In response to this, David Owen, the Labour Health Secretary in 1975, took blood plasma collection into public ownership in order to protect the quality of blood products. Jeremy Hunt however, decided to sell 80% of this state-owned supplier to Bain Capital – a US private equity firm which has invested in Burger King, Dunkin Donuts, and Domino’s Pizza. A Professor of Public Health Research & Policy stated that there was “not a shred of evidence” to support Government claims that private firms would boost innovation in plasma treatment. David Owen himself warned that Bain had a predatory reputation for asset stripping, warning that the NHS risked losing control of the regulation and safety of blood plasma products. However, Jeremy Hunt insisted the deal go ahead, and assured Bain had promised to maintain development of the company in Hertfordshire. What happened? In 2016, Bain Capital sold it on to a Chinese company for £820m.

Incessant cuts, privatisation, and record low number of nurses and hospital beds could potentially be put aside – not forgiven, but put aside – if the Government response to coronavirus hadn’t been one of sleepwalking. I don’t wish to overly criticise the Government, as I don’t envy anyone in power having to make decisions right now. When the scale and nature of this situation is one that no UK Government has ever faced, I appreciate that some decisions will, in hindsight, be recognised as incorrect. However, when countries such as Germany, with a population far higher than ours, have seen less than a third of total UK deaths, and when the severity of circumstances is so evident that a concerned public are donating in the region of £27 million, it’s impossible not to question our Government’s actions.

The World Health Organisation issued its highest level of alert on January 30th, warning all Government’s around the world of the seriousness and urgency of coronavirus. The approach advocated by WHO is widespread testing, contact tracing, and strict isolation. Countries who have seen far fewer deaths than us, such as Germany and South Korea, followed WHO advice by investing heavily during the first few weeks of the epidemic in testing capacity expansion. The UK Government however, failed to act on or prioritise this. It was not until late March – far later than other European countries – that Boris Johnson announced a complete lockdown. The misjudgement and inaction of the UK Government cannot go unrecognised or unquestioned.

Not only did the UK Government fail to prepare for widespread testing and ignore advice about contact tracing before transmission became uncontrollable, but the UK chose not to join EU efforts to obtain sufficient medical equipment and PPE. The Government missed three separate opportunities to be part of an EU scheme to bulk-buy masks, gowns, and gloves during February and March. I don’t need to relay the severity about PPE shortages, but here are some shocking statistics if you’re unaware of the gravity of the situation. A survey found that only 52% of clinicians carrying out high-risk procedures said they had access to correct PPE. Hospitals are relying on the charity of local schools and businesses for visors, masks, and protection. Staff in care homes have disclosed they are limited to drinking every 4 hours by employers to avoid multiple glove and mask changes. My mum’s GP surgery, due to fears of not being provided with adequate PPE, have had to source their own online. The fact that there is a PPE shortage of this scale is inexcusable. If you’re in doubt that the PPE shortages have been a direct failure of Government, than please read this.

I don’t mean to over-analyse or dwell for too long on Government errors and inaction. I simply wish to highlight that over the past decade, the Government have failed in their duty to care for the NHS. We should not be glorifying the fact that a 99-year-old war veteran is having to walk endless laps of his garden to help raise money for what’s supposed to be a tax-funded public service. Whilst I salute this admirable 99-year old and wholeheartedly congratulate his tremendous achievement, I simultaneously feel the need to voice that it’s both obscene and questionable that such urgency for donations in the region of £27 million exists. If our health service was prioritised and adequately funded in the first place, the general public would not need to be reaching into their pockets to compensate for the failings of a Government through Mr Moore. The NHS is devoted to caring for us, but those responsible for caring for the NHS have failed it.

Image: Captain Tom Moore completing his recent fundraising effort (Vickie Flores / EPA-EFE)