As the ambulances queue for hours because of full beds and stretched staff let us work together to define a new type of NHS which prevents more illnesses and keeps people healthier for longer.
The fact that I am suggesting that the NHS needs to change is not on attack on it, its principles or its staff but a recognition of the fact that the money that we put into the NHS and social care is not always being spent on the right things.
If we look at people in hospitals we can see that 30%+ of them need not be there if we had spent money differently over the years.
10+ of patients are in hospital because of obesity. 14 different medical conditions are exacerbated or caused by obesity most of which is preventable. 3% of our 11 years olds are clinically obese and will have poor outcomes for the whole of their lives another 27% of 11-year-olds are obese and will not recover from it. This rises to 60% of adults being obese.
Yet so much more could be done to keep this from happening. Public health budgets have been cut. Legislation which could control the selling of sugary drinks and fatty foods has been watered down or abandoned. This is not me saying that bad food and drink should be banned but it should be reduced and people should be shown the harm that it causes to their bodies.
10%+ of patients are in hospital because of their addictions. In the case of tobacco this is considerably less than it used to be but as cancers etc caused by smoking decline, problems caused by drugs has increased.
Yet budgets to help control drug use and support at an early stage those becoming addicted have been cut and the availability of support for addicts in the community which is cheaper and more effective has been reduced by cuts in council budgets.
10%+ of patients are hospital because they are medically fit but cannot be discharged. They do not want to be in hospital but they have to be kept their either because there is insufficient support for them which would enable them to go or because their home is unhealthy and damp and draughty.
Yet the number of people in poor housing is increasing. Facilities to assist people leaving hospital to transition from a fully supported environment to their own home by a targeted support aimed at their specific problems is reducing.
The NHS is suffering not just from under investment but investment in the wrong things.
Investing upstream in preventative services saves a fortune and would provide better lives and longer lives in a healthy condition for millions. Yet Governments and the NHS itself talks about hospitals and acute services and not these preventative and support services. Of course if I was seriously ill I want and ambulance and a hospital or specialist treatment. Too often, though, the need for such services has been brought about by a failure of health policy to target the root causes of health inequality.
Poor food, poor housing, poor environments all of which can be summed up with one word, poverty, are the reasons that the NHS is so stressed.
But even inside what could be considered the mainstream NHS there is resistance to change. Our Governors and their acute professionals are trained to think that the latest building, machine or drug will be what saves lives. In extremis that is undoubtedly true. However, that means that the NHS corporate brain and its actions are looking for most of the time at what can be done to alleviate conditions and not prevent them.
Take my own small example. In the summer of 2021 I had a stomach problem. I rang my GP practice at 9.30 and received a call back from a doctor at 11.00 who gave a diagnosis, sent a prescription to my local chemists and told me that if the problem persisted, I would be physically seen. At 11.45 I picked up the tablets and swallowed the first two.
I think that this was a much better service than previously where I might have had to go to a waiting room, the next day unless I had phoned early, and sit in a waiting room with a lot of sick people! It also meant that the GPs spent less time with me which meant that they could spend more time with people who had a serious illness.
I consistently call for the Council and the NHS to start a dialogue with the people of Liverpool about new ways in which the NHS can work with the community. This would mean some changes in the NHS for example putting more pharmacies in the High Street and giving those pharmacies more to do.
Government must reassess their immigration policy. The NHS is currently flying in people from around the world to provide support to health and care providers. More than 200,000 people are needed to replace the people from the EU who were forced to leave because of BREXIT. That is the staggering number of vacancies in the NHS and social care that exists and which puts such acute pressure on our remaining staff.
It would mean putting a greater resource into groups such as carers groups who do so much to keep people with medical conditions safe and as healthy as possible. People who both as family and friends provide support for people with a wide range of medical issues such as Alzheimer’s and Dementia provide loving care for their friends and relatives and save the Government a fortune.
These were the services that were cut first by the Government who could not understand that spending small amounts on this proactive work would actually save a lot of money up stream.
In the long-term we must also change our ways. We will need to be more accepting of new techniques including triaging our conditions by phone or Zoom. Do we really need to see a GP when we can get a lot of advice from our local chemist who are trained to understand and treat a range of minor conditions?
We could all keep ourselves healthier and those not creating a demand on health services by eating better, not smoking, drinking less and taking more exercise.
Can we just go to bed with some proprietary brand such as Night Nurse or a warm drink and some paracetamol? That’s easier for some than others. If we live in a house with someone else, we can take turns to be the nurse or patient. For people who live by themselves it’s trickier.
The NHS workforce has been run almost into the ground and is being kept going by people who are getting to the end of their levels of endurance. It’s your job and mine to support them and thank them, not slag them off. I will very publicly thank them. If you really care about the NHS you can do something to help it by taking more responsibility for your own health.
But what does Richard Kemp think? 