The future of the NHS: Concerns and comparisons

29 March 2018

A recent poll by the Independent Health Professionals Association (IHPA) has shown that nearly a third (32%) of UK residents consider their primary concern to be funding cuts to the NHS, a greater number than were concerned about the threat of terrorism (28%).

It has become almost common place now to hear about the struggles of the NHS. Whether it is under resourcing, under staffing or simply not enough beds, barely a day goes by without a media reference to concerns over the "future of the NHS". It's therefore hardly surprising that, in a recent poll, almost one third of those questioned have stated that they are more concerned about funding cuts to the health service than they are about the threat of terrorism.

For the first time, the Royal College of GPs has produced new recommendations dubbed "three before GP". The recommendations encourage patients to take three steps before visiting their GP, in an attempt to ease the pressure on surgeries. The three steps require patients to ask themselves whether they can: 1) self-care 2) use NHS Choices or another reputable website or resource or 3) seek advice or treatment via a pharmacist. The recommendations follow recent statistics showing that up to one quarter of all GP appointments could, in reality, be avoided, with reports from some GPs of patients attending for issues like indigestion over the Christmas period.

The recommendations have, however, faced criticism for encouraging patients to turn to "Doctor Google", and because of the other risks that this approach to healthcare could have, including a potential delay in diagnosis of serious conditions, and an over reliance on pharmacists who may not be appropriately qualified to respond.

Media reports of the struggles faced by the NHS do prompt the question, what does the future look like? Recent reports suggest that Brexit will place greater pressure on the NHS, with more than 100 elected officials warning that leaving the EU is the "biggest threat of all" to the health service, because of a loss of staff, increased difficulty in importing materials, withdrawal from key EU health agencies and a delay in receiving new medicines and treatments from the European Medicines Agency. Statistics from the Nursing and Midwifery Council already reveal an 89% fall since the Brexit vote in applications from nurses in EU countries to work in the UK.

So, what is the alternative, if the future really is as bleak as we are being led to believe? The NHS has historically been compared to the healthcare system in the US, where the average cost of hospital stays for cancer patients in 2015 was $31,390, around half of the average household income. The prohibitive costs of healthcare in the US have led to an increase in a new form of funding: online donation sites, for example YouCaring, have seen a real expansion, with patients turning to strangers to help foot the bill for their ever increasing medical costs. 

But even in the US there are concerns about this kind of funding, with critics saying that it is undignified to be forced to rely on the financial support of strangers, and that reliance on donations can perpetuate existing inequalities.

The other possibility is, of course, an increase in private healthcare, with a greater focus on private medical insurance and private providers. This isn't necessarily a solution though. Patients will still need to pay for their treatment (through medical insurance or their own pockets) and this could lead to more issues for the NHS, with funding pumped in to the private sector, rather than to support the NHS.

In such an era of uncertainty, and when the alternative has the potential to cause financial difficulty for so many across the UK, it is no surprise that the future of the NHS is a topic of fundamental concern.

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