Helen Martin: The survival of the NHS is now at stake

TWO weeks ago, I received my NHS bowel cancer check kit (considerably easier and less messy than it used to be). I posted it off and just five days later the results came back. Clear, I'm glad to say. Proof that there are at least a few, little parts of the NHS that are still efficient and fast.

Monday, 30th April 2018, 7:00 am
The stressed and stretched NHS is in dire straits

Overall, the stressed and stretched service is in dire straits. Getting a GP appointment, being seen in reasonable time in A&E, bed shortages, waiting times for everything from specialists to physio appointments, are all becoming catastrophic, with many medics even admitting the service is so overloaded that some patients are dying prematurely.

NHS Lothian alone would need £31 million just to return to the service levels “enjoyed” last year. Even then it was under severe pressure.

A perfect solution to this disastrous situation involves everything from care-in-the-community packages (to help reduce bed-blocking) to patient wisdom in knowing when a visit to their local pharmacist is enough. But that’s just tweaking at the fringes. As we all know, at the heart of the problem is under-funding. Without massive increases in public spending, our NHS is doomed.

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The argument to raise taxes in order to increase health service budgets is gathering more and more support from the public as well as politicians.

But even that’s not a Harry Potter magic wand that will easily produce the perfect result. How much more income tax can people afford to pay on top of council tax rises, extra charges for services, higher rents, new tax on home buying, being forced to work in the gig economy, or minimal (if any) annual wage rises?

Governments, both UK and Scottish, and local authorities, also need to take tough decisions to reprioritise spending if the NHS is to survive. We still send £47m a year in foreign aid to China, the second largest economy in the world. The renewal of Trident and dubious military action is also seen by many as a “waste”. Even good and valued local expenses including libraries, swimming pools and sports centres, not to mention trams, cycle lanes and transport developments are all surely lower priority than saving the NHS and rebuilding its excellence?

Even if all that happened, we would still need to pay more tax to do our bit. But where precisely, would that extra taxation go? Would it come with a pledge from both governments that every penny will be ring-fenced and spent only on the NHS? And would they vow that it would all be spent specifically on improving services to the public, and possibly reforming the way the service is run?

Increasing the number of GPs, hospital doctors, nurses and other vital staff is essential. Entering into ill-considered private-finance initiative (PFI) agreements that backfire and cost millions over the years or increasing and offering handsome salary boosts to the army of managers and boards who now suck funding away from the frontline, is not.

Local and national governments always decide where and how to spend taxation, national insurance and any other public money. And yes, we elected them to do so. Unfortunately, such decisions – with little sense of priority – are the cause of the NHS being in crisis today.