Inspiration

Inspire-NHS Part 2:News Has Significance Part 2

NHS, the title was not chosen by chance but to show how the NHS was the topic for many newspaper articles recently.

I wonder if you have ready my previous article.  It seems that this was “right on message”- to coin a political soundbite.  Inspire-NHS:News Has Significance.

The topic has become the subject of more headlines today in the coverage of the election Here are links to articles on the subject on both the BBC and the Telegraph

https://www.bbc.co.uk/news/health-50351861

https://www.telegraph.co.uk/politics/2019/11/08/boris-johnson-pledges-extra-6000-gps-deliver-millions-appointments/

My original article highlighted that the real issue was getting staff.

It is pleasing to see that the politicians are pledging to appoint 6000 more GP’s.  However there was a previous pledge made by Jeremy Hunt in 2015 to appoint 5000.  From the BBC article it seems that the actual number appointed was 272 between 2015 and 2018. A questionable level of progress.

It is worth recalling that on 18 July 2018 Mr Johnson promised to sort  the NHS pensions crisis which is leading to staff leaving the service early.  

https://www.ft.com/content/5398331a-a491-11e9-974c-ad1c6ab5efd1

Although it  could be said that he has had quite a bit to deal with in the interim, the issue is still there and unchanged.

The commentators are already stating that urgent action is needed to avert an even worse winter crisis than normal

https://www.theguardian.com/society/2019/nov/02/tories-act-to-prevent-nhs-crisis-hitting-election-hopes

https://www.telegraph.co.uk/news/2019/11/07/hospitals-must-boost-doctors-pay-urgently-avoid-winter-crisis/

As ever the result is that the politicians and managers try and solve a long term problem by throwing money at it – for a quick fix

https://www.telegraph.co.uk/news/2019/10/11/hospitals-paying-locum-doctors-record-sums-4000-per-shift/

However  he real long term solution takes time and commitment.  It takes a new student 5 years to get through medical school and a minimum of 4-6 years to become a GP.  So this problem is not going to be solved in time for an election on 12/12/2019. Despite the soundbite and headline grabbing promises.

One also must question the ethics of the UK Government to seek to recruit 3000 doctors from the UK and a further 3000 from abroad.  Do we not have enough students of our own? What about those countries who loose their doctors to the UK.  We have a double standard on this as some time ago the proposal was floated that all doctors were expected to commit to the NHS for a certain period after qualification.  A pay back the debt so to speak (conveniently forgetting the student loans and lower pay whilst in training)

The statistics from UCAS showed that in 2019 up to 96,770 applications were made for medicine of which 77,200 were from UK domiciled school leavers.  In 2016/2017 the GMC released figures to show the total number of students across all 5 years was 39,994 ie about 7999 on average per year.   So despite the need from more to study medicine the number of places which the 96,770 applicants are fighting for is still quite low

There are also sadly several disincentives to study medicine as the new graduate is estimated to have a dept of £43,700 upon graduation (BMA Survey).  The system of short term posts often of only 6 months duration combined with the potential need to move every 1st August and 1 February to fit these start dates do not encourage new doctors.

https://www.bma.org.uk/-/media/files/pdfs/collective%20voice/committees/msc/medical-student-finance-survey-2018.pdf?la=en

Little surprise therefore that BMJ reported that 9000 newly qualified doctors left the NHS entirely and the number progressing to specialist training had decreased from 71.3% in 2011, to 50.4%in 2016 and a further decrease to 42.6% in 2018.   So much for trying to grow you workforce.!

https://blogs.bmj.com/bmj/2019/01/25/why-are-so-many-doctors-quitting-the-nhs-its-time-to-ask-the-right-questions/

The NHS leaders have asked that the NHS is not made a political weapon in the December 2019 General Election https://www.bbc.co.uk/news/election-2019-50282333. 

The competing candidates however find it a topic too good to ignore.  They promise the earth whilst sadly overlooking inconvenient facts and past performance.

Although it was meant as humour to finish the last blog, the BBC comedy Yes Minister  about the hospital completed but with no medical staff or patients may well become all too true.  Perhaps this a case of the Empty Promises from Prospective Ministers

Sadly as the system currently functions the patients are all waiting in ambulances outside Accident and Emergency to get into the Hospital.

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