We’re only a few weeks into the new year, but it’s becoming increasingly hard to feel positive about the future of the NHS. Until recently the discourse was about a system at breaking point, but the conversation has moved on. We’re now talking in the present tense about a system that’s well and truly broken.
Over this winter period people have been advised to stay at home where possible and not engage in behaviour that might put them at risk of needing hospital level treatment. You know that it’s desperate when members of the public are told to adapt their way of living because we can no longer guarantee access to safe healthcare.
Sadly, this isn’t NHS England officials being overly cautious—it reflects the reality on the ground. I hear of patients being examined in cupboards or in the middle of the emergency department floor, with sheets held around them to maintain some degree of privacy and dignity. Extra beds are being created to accommodate patients in overstretched units, without access to appropriate monitoring or call bells, never mind the extra staff required to care for them.
I hear my colleagues now saying that they’re frightened by the thought that they or their families may need the NHS one day. How can you work in a system that you don’t believe in, that you wouldn’t trust to take care of you or a loved one in a time of need? I’m sensing that many doctors are already planning for a future devoid of a national health service—repurposing their careers and making the move to private practice, moving abroad, or leaving medicine altogether.
Healthcare staff are tired of being told to be resilient. It’s reached the point where we can no longer prop up a failing health service and absorb all the risk that comes with that. History tells us that we can’t rely on well meaning words of reassurance from regulators when they say they “understand that we may have to depart from established procedures to care for people” and that “the context we are working in will be taken into consideration” should we be subject to a referral to the General Medical Council.1
It may seem that you’ve heard this all before—that the NHS is understaffed, that it can’t meet demand, that there are patient safety issues wherever you look—but this is unlike anything we’ve lived through before. Is this a failure by politicians to recognise the scale of the problem, or is it wilful inaction?
Either way, I’m not even sure that the situation is salvageable. It feels as though we’ve moved on from debating the survival of the NHS and that it’s now time to call the postmortem.