The ongoing NHS fiascos

I am deeply concerned about the NHS-partly because a few of my colleagues work there, and partly because it is “crumbling” due to a mix of political apathy, bureaucratic slumber and apathy. Ultimately, it is the people who will suffer from lack of access. A few links (from Financial Times).

Cracks in the NHS go deeper than Truss and Sunak think | Financial Times

There is nothing new about the NHS’s dependence on foreign workers, with about one in seven staff identifying as non-British. But the shift away from EU states and the UK to non-EU states is stark. BBC analysis of NHS Digital data showed that 34 per cent of doctors who joined the health service last year came from overseas, a rise from 18 per cent in 2014. The share of UK recruits has fallen from 69 per cent in 2015 to 58 per cent last year.

Growth in NHS recruits from abroad prompts concern about over-reliance – BBC News

A total of 39,558 domestically trained doctors and nurses joined the NHS in 2020-21, which is just over 3,200 more than in 2014-15.

But UK medics have been occupying a decreasing proportion of the overall 1.35 million workforce during that period. The share of doctors recruited from outside of the UK and the EU rose from 18% to 34% while the share of nurses rose from 7% to 34%

The NHS will make or break the next prime minister | Financial Times

Politicians are always tempted to tinker, and the NHS has a maddening profusion of titles, regulators, committees and acronyms. But hard-pressed staff cannot bear another restructure. What they need is fewer targets, better pay and an immediate focus on removing the obstacles that make their jobs increasingly frustrating. This is a colossal management failure. While other professionals eat in office canteens, clinicians and nurses are often left with a run to Costa or a midnight vending machine. Charity workers have modern IT; a district nurse is lucky if the software works at all. Multinationals look after senior staff; experienced doctors who don’t want to retire are downing tools to avoid losing money to pension taxation. These things dent productivity and demonstrate a total lack of respect for the people on whom our health depends.

So these are structural problems; over reliance on immigration (with often “stringent rules” and requiring “clearing of standards”) won’t help their cause.

Something that I had covered earlier:

The NHS is being squeezed in a vice | Financial Times

During June of this year, 102,000 people waited 12 or more hours in A&E, almost four times the pre-pandemic average for the same month. A further 441,000 waited between four and 12 hours, double the typical number. By my calculations, June’s waiting times alone are likely to have resulted in more than 2,000 additional deaths during the following days and weeks due to the significantly elevated mortality risk associated with waiting so long for urgent care or admission. The total number of additional A&E-linked deaths since waiting times rocketed is an almost perfect match for the missing 12,000.

A little more perspective on what needs to be “fixed”:

None of these proposals are much more than a sticking plaster. And some progress is being made: on diagnostic hubs which will provide more scans, for example, on electronic patient records and better use of data. But while these develop, staff must also be taken seriously and shown that their conditions can get better, even as they treat an increasingly frail population through a grim winter.

I’ll keep an eye on the developments.

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