In recent days, two of my friends have had little mishaps and have connected with local health services. Neither went well.
There are times when trying to make sense of things, there can be great clarity and there are times, such as this, where clarity hides behind the dark clouds of confusion and uncertainty. In this case, the latter rules.
Let’s just get one piece of clarity out of the way – the NHS is a complex organisation but its beating heart is made up of many, many, dedicated and committed people: Doctors, nursing staff, porters, cleaners, ambulance crew, front line admin staff, caterers, etc etc.
But where the very evident issues come from, is really beyond my very small, feline, brain to comprehend.
Both my friends went to a minor injuries unit deciding, rightly, that it was beyond the local chemist, an urgent doctor appointment was not merited and neither was clogging up A&E.
They weren’t in any danger, but the injuries were painful and needed sorting. One waited almost all day and when it became clear they wouldn’t be seen that day, was asked to come back in the morning.
In the other case, the minor injuries unit decided the issue was one that should be at A&E, so my friend trudged along there and waited seven hours to be seen.
Now, both are on the road to recovery, but it begs the question, why is the NHS on its knees?
Well, many will claim it is staff shortages, linked to a lack of investment while others will claim that the service is still affected by COVID, both in terms of rebuilding capacity and with ongoing COVID-related admissions being very up and down.
However, the issues of the NHS and far more complex and way beyond the scope of my Saturday piece to unravel but here are some random thoughts to start a debate:
Since 1948 and the inception of the NHS, the people of this country have realised how lucky they are to have a service that is free at the point of delivery, something which takes away the worry about being ill. This translates to a sense of ownership which is all very well but troublesome when we feel able to DEMAND to be seen.
Too many times the belief that I must be seen before people who may be much more in immediate need than me, gets in the way of objectivity where A&E staff have to make challenging decisions about who to see next.
Of course, not all NHS services are free. We pay for many, or they are means tested so the majority contribute towards the cost – dentistry and prescription eyewear spring to mind. Is it in the spirit of the NHS, paid for by taxation, that those who can contribute to some services should? After all, those who have paid the most taxes are both more likely to be those asked to contribute at the point of delivery or be able to self-fund private health care. And, believe me, my vets bills aren’t cheap!
Let’s also consider Brexit. Since we left the EC and abandoned free movement of labour, we have struggled to fill low paid vacancies in agriculture, transport, and health and social care. This is significant, especially with social care as hospitals can’t discharge a patient, however well they may be, if there is no one to care for them in the community.
This directly leads to bed blocking and the inability at the other end of the service to admit patients meaning long waits in ambulances which are then unavailable to meet the next emergency. Recruiting to social care posts, usually at or just above the minimum wage and often on precarious, often zero hours, contracts, will always be a challenge until their worth is recognised and rewarded.
What about the challenges of primary care? If you still know and can see your named GP, you are lucky. Not enough GPs are coming into the service – many prefer to work in secondary car – and those that do find the burn rate so high they opt for part-time working, which in the case of one local GP I know, means working three days a week as a clinician which equates to more than 40 hours a week and then spend time on the admin of running a GP practice.
Indeed, recent challenges in recruiting to a practice in Ambleside, posed the question – “If you can’t recruit a doctor to work in one of the most beautiful places on earth, what chance Aspatria, Barrow or Carlisle?”
And, no, because immigration is seen as a dirty word by so many these days, we can’t just go abroad to recruit and when we do are we just stripping other, less wealthy countries of their medical staff?
We could go on and look at the cost of drugs and try and balance a healthy return on investment and research for the manufacturer with a value for money model for purchasing. If only we had done this with many of the eyewatering PPE contracts that were flung around during the pandemic.
Then there is the condition of the hospital estate. A recent Prime Minister promised 40 new hospitals by 2030 and, in Carlisle we have one – the Northern Centre for Cancer Care, a facility that is already transforming the treatment of cancer in North Cumbria. But how many hospitals or doctors’ surgeries are not fit for purpose?
These are just random thoughts on a very complex issue. I haven’t mentioned Andrew Lansley and his reforms in 2012, or Jeremy Hunt and his spat with junior doctors.
And I have bitten my tongue when it comes to Therese Coffey who thought she could make appear, as if by magic, increases in GP appointments without any additional GPs. Hopefully, Steve Barclay can fight the NHS corner as we face increased taxation and lower public spending.
So, what do you think?
About Cumbria Cat
Born in Cumberland and, from 2023, will be back living in Cumberland, having spent most of the past 50 years in some place called Cumbria, this cat has used up all nine lives as well as a few others.
Always happy to curl up on a friendly lap, the preference is for a local lap and not a lap that wants to descend on the county to change it into something it isn’t. After all, you might think Cumbria/Cumberland/Westmorland is a land forged by nature – the glaciers, the rivers, breaking down the volcanic rocks or the sedimentary layers – but, in reality, the Cumbria we know today was forged by generations of local people, farmers, miners, quarriers, and foresters.
This cat is a local moggy, not a Burmese, Ocicat or Persian, and although I have been around the block a few times, whenever I jump, I end up on my feet back in my home county. I am passionate about the area, its people, past, present and future, and those who come to admire what we hold dear, be it lakes and mountains, wild sea shores, vibrant communities or the history as rich and diverse as anywhere in the world.
