The NHS in 2019

My favoured mind set is well founded optimism. I prefer to be optimistic. However, I need reasons to be optimistic. In 2019 the evidence for optimism is hard to find. Certainly, there are some reasons for optimism;

  • The pace of research and development is rapid and new treatments are being made available. It is reasonable to expect that many of the “untreatable illnesses” will be treatable either in terms of delaying the progress of disease or providing a cure. AIDs, which took so may lives, is no longer a death sentence if treatment is provided in time. Research into Alzheimers offers hope for the future. Genetic treatments are likely to revolutionise the lives of many.
  • The NHS Long Term Plan is an admirable strategy and it is difficult to disagree with its aims whatever your political views
  • A serious attempt is being made to integrate services provided by Local Authorities, the NHS and the voluntary and community sectors.
  • Workforce issues are being given the priority they deserve after many years of neglect
  • Additional funding has been made available

And yet ….! There are so many difficult issues;

  • The legacy of 10 years of austerity has left the NHS with chronic problems of underfunding. Many NHS Trusts would not be viable without special support and fudges
  • There are serious workforce shortages which threaten the implementation of the Long Term Plan
  • Health inequalities are increasing and increases in life expectancy are slowing down in disadvantaged communities
  • Poverty now engulfs working families as well as those living on benefits
  • Universal Credit seems to be impoverishing the already disadvantaged and causing immense rent arrears
  • Local Authority Services have been decimated by huge cuts
  • Social Care is in crisis
  • Housing is less and less affordable
  • Inflexible pension regulations are leading senior doctors and others to retire early or limit the amount of work that they do
  • A serious shortage of capital is making it almost impossible to replace capital stock which is increasingly threatened by huge amounts of backlog maintenance
  • The growth in demand seems relentless caused by the aging population, new opportunities for treatment and care and increased awareness of mental health issues not least in children and young people

On the 14th of September I will celebrate my 50th anniversary of working with, and for, the NHS as a manager, Non-Executive Chair and consultant. My commitment to the NHS remains as strong as ever. The British people continue to support the NHS much to the frustration of many on the right wing of British politics. However, those of us who love and support the NHS know that we will have to fight for its survival as the storm clouds gather.

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