Yes, there is a staffing crisis in the NHS and it could well be the worst in history, but that is not the whole story.
Over the years the NHS has had to overcome many problems and maybe not overcome them completely for one is ‘Successive Governments’ interference for virtually every Government there has been since 1948 has interfered in the NHS to some extent, reorganisations here and there, in many instances with no or relative communications with the NHS, but interference for political motives.
Then there is fund of the lack of it or the right funding. As currently there is an issue of pay in virtually every sector of the NHS, but when Hospitals or Foundation Trusts form their budgets they will write in a pay percentage increase, but this will be well before the actual pay percentage has been agreed and in many instances really thought of. So a pay percentage increase is eventually agreed, but the budgets will only have included a fraction of the actual percentage. While the pay increase is directed by the Government, they will not, in most instances provide further money to increase the original budgets, so the balance of the [ay increase will have to be found from other areas in the budget, so some areas will not receive the amount of funding they expected and will have to provide the forecasted service with much less money available. This is not the fault of the NHS or the hospitals, but the hospitals will still receive the blame, when the blame should firmly rest with the Government.
Then we have targets created by the Government, which in many instances are not met and meeting these targets, could, in some instances release slightly more funding. So, the targets tend not to be realistic for many reasons, some mentioned above. What is the point in having unrealistic targets in fact, why have targets at all. Well targets are used as a measuring tool to define quality and quantity care
Another problem is the pricing of equipment and other resources from associated organisations, many of whom will be the central NHS recognised suppliers, but are these suppliers still competitive or have they over the years increased their pricing more than they needed, so in effect imposed a NHS Surcharge because they know they will get it.
But another major factor is the state of Social Care, which has been in crisis for as long as the NHS and maybe even longer, and while the NHS has been regularly funding, albeit, not to the required levels, social care has not been, in fact over the last 12 years or more as had its funding drastically reduced as social care is funded by local authorities. (LAs) who receive most of their funding from Government for all the services they provide and over these last 12 years have been subjected to extreme austerity cuts. This has required that the quantity of social care has had to be reduced and in doing so some of the quality has also been reduced. You also need to be aware that social care is not just for the elderly in care and nursing homes, for it includes home care, supported living, respite for all children and adults.
So, when patients are due to be discharged, bit are not sufficiently able to look after themselves at home and will require some social care input, due to the lack of social care available this required input may not be available, hence the patient can’t be discharged. This means beds in hospitals which should be available for new patients are not available so this causes problems in A&E and thereby they become overcrowded and eventually can’t admit more persons into A&E.
This causes problems for to be patients to be admitted to A&E and they are retained on ambulances, thereby causing ambulances to be waiting outside A&E and so are not available to attend new patients. This in turn affects the set targets for ambulances, who are then blamed for not meeting their targets.
There is also a lack of suitable social housing and in fact good quality social housing, which in turn creates more health issues, which could well add to the problems for the NHS. Now social hosing is either the responsibility of LAs or Housing Associations, who may well be funded by LAs, which brings us back to the extreme underfunding of LAs by Governments.
In all of this the respective organisations are blamed, while the Government escapes all or most of the blame, when in many instances they are totally to blame. But Governments and especially Government Ministers are not held accountable, when they should be. Unfortunately politics has much to be blamed for and in many respects the Treasury is behind the lack of funding policies, so the responsibility and accountability should be placed not only on the respective department ministers, but also the Prime Minister and certainly the Chancellor of the Exchequer.
The current policy to not fund social care and for many previous years is such a major factor in the current crisis in the NHS. But Social care is not on the Government agenda and if it is mentioned it is not to sufficient degree and urgency.
Yes, there was or is, to some extent the £5.1 billion to be funded by the 1.25% increase in NI contributions, but this falls way short when looking at Social Care. It was also and still is, if the NI contribution was the best way to fund it, when there would be other means available, the surcharge on Energy companies, no pay rises for MPs and Ministers and other means.
Until Social Care becomes the major priority for this or any Government, then funding for the NHS will never be sufficient. The NHS and Social Care have to work together, for one can’t exist without the other and this Government and others need to take this on board and do it urgently.
Source: NHS / Worst staffing crisis in history putting patients at serious risk, MPs warn | The Guardian