The government deliberately presents the public with out-of-context spending figures
Official health statistics released yesterday reveal that the NHS is officially in crisis — one that exposes a shortage of funding and staff, and a crisis that the public have noticed despite denials from the Health Secretary Jeremy Hunt.
During 2016, as reported by the Guardian, only 86 per cent of Accident & Emergency patients were treated and admitted, transferred or discharged within four hours, the lowest for more than ten years.
Ambulances crews were able to respond to just two thirds of top priority calls within the eight minute target and only 59 per cent of second priority calls.
More than 25,000 people during 2016 had to wait more than the maximum of two months after referral by their GPs to start urgent cancer treatment — a rise of 92 per cent since 2010.
Patients receiving hospital treatment within 18 weeks has also fallen below 90 per cent for the first time since 2011.
And the number of hospital bed days taken up by patients who are fit to go home but can’t because of care issues — so-called ‘bed-blockers’ — climbed to an all-time record of more than 195,000.
That the crisis is one of funding is confirmed by the health think-tank the King’s Fund:
“The increase in spending announced in the 2015 Spending Review will see the NHS budget increase to £133.1 billion by 2020/21…This means that between 2009/10 and 2020/21, spending on the NHS in England will rise by nearly £35 billion in cash terms – an increase of 35 per cent.
But much of this increase will be swallowed up by rising prices. In fact, around £24 billion will be absorbed by inflation, leaving a real increase of just £11 billion (a 10 per cent rise over eleven years; equivalent to an average annual increase of just 0.9 per cent)”.
Yesterday, Sky News ran a major all-day feature on this crisis. The Sky package was comprehensive, and provided a number of perspectives, including a poll that showed recognition of the crisis and that public back tax rises to fix it.
Yet one problem with the Sky coverage was a rolling NHS expenditure total at the bottom of viewers’ screens, which by the end of the day showed many hundreds of millions of pounds being spent.
These figures often frighten people and the impression given, reinforced by questions from interviewers, is that NHS spending is sucked into a ‘black hole’ so that raising expenditure, by implication, will be ineffective.
The problem in using figures in this way is they lack any contextual comparisons with previous time, as a proportion of Gross Domestic Product or population, and with other health care systems.
The King’s Fund analysis underscores that the NHS is being starved of funding in comparison with the massive expansion under New Labour. And by 2020, NHS spending as a proportion of GDP, at a time of rapid population growth, is likely to be the lowest since the 1950s, and way below the 9 per cent achieved after sustained investment between 1997 and 2009.
On international comparisons, the UK’s healthcare spending by GDP ranks 13th of the major industrialised countries, behind the United States, Switzerland, Japan, Germany, Sweden, France, Netherlands, Denmark, Belgium, Austria, Canada and Norway.
Yet, the NHS is consistently shown to be one of the most cost-effective in the world when analysing health outcomes for given expenditure.
The implicit agenda in not using such contexts to illustrate the effectiveness of the NHS when properly funded, and by quoting startling and raw spending figures, is that the NHS is unaffordable so must be privatised.
As any cursory analysis of the US healthcare system shows, Americans spend twice as much as the UK, while one in five Americans are uncovered by health insurance and the country has healthcare outcomes that are only usually seen in many poorer countries.
The conclusion is that, despite its faults, the NHS is worth defending on economic, societal and equity, as well as health grounds.
Kevin Gulliver is Director of Birmingham-based research charity the Human City Institute, writing in a personal capacity. Follow him on Twitter @kevingulliver
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