What is the Future of the NHS?

Like many other sectors, the NHS has been hit hard by the pandemic. With the National Health Service under greater strain than ever before, the government has been scrambling to bring in new and innovative measures to reduce the pressure.

The NHS is currently being underfunded, and on top of the lack of funding, the social and welfare cuts have really impacted services within the community, leading to growing pressure on hospitals and GP surgeries. The current conservative government is proposing the lowest budget rise of all political parties and has historically underfunded the NHS. Of course, all sectors have taken a cut during the recession, but the NHS is impacted by cuts in other areas too, such as in the social care system or in the benefits system.

The future of the NHS really must be discussed in conjunction with the future of the population. It is no secret that the population is aging, and that old age often comes with several health issues. It is a great thing that medical advances have meant that many illnesses that were previously a death sentence are now treatable, but this does change the future of the NHS. People are living with long-term health conditions that not only require long-term care, but long-term support. On average, it costs the NHS 2.5 times more to treat the average 65 year old than the average 30 year old, and it can cost up to 7 times as much to treat the average 90 year old. The aging population will mean that the cost to the NHS will continue to grow in the future. On top of this, the obesity problem (a third of adults are risking their health due to their weight) is also costing the NHS more year on year.

Despite this dim picture for the future of the NHS, the UK is continuing to spend less than some other EU countries. Germany spends more than the UK and has almost twice as many nurses. On top of the lack of spending, the NHS is suffering from a large number of vacancies within the service.

Paying for infrastructure is another element of the NHS that has fallen to the wayside over the last few years. Although the cost to clear maintenance backlogs is growing, the government has increased the budget for it quite significantly, meaning the future of the NHS may be less crumbling buildings and leaky roofs, and more clean and safe architecture.

Society has changed significantly since the NHS was first created, however the NHS itself has not changed a lot. Although the government is adding funds and trying to grow the budget, the whole system of social care needs reform in order for that money to make a real difference. Particularly among the oldest people in the community, there is not enough support and this leads to increased pressure on the hospitals. The future of the NHS will be bleak if we continue to do nothing and just push money into the system without critically analysing all aspects of the system and thinking about what kind of NHS we need today and into the future.

“The NHS’ aim is to move to a ‘digital-first’ model of care within the next 10 years, so by 2030, the vast majority of people are likely to be accessing healthcare via apps and technology. “Providing access to healthcare via technology will hugely increase how effective the NHS will be in delivering care.

Caroline Molloy argued earlier that former NHS secretary,  Matt Hancock plans to legislate in the first half of 2021, as promised in Johnson’s first Queen’s Speech, and looks set to hand most of the NHS’s cash to new “Integrated Care Organisations”. Their remit is to tightly control spending on frontline healthcare – but also to tear down lines of division between public money and private companies, between who controls the purse strings and who gets a cut, and between health and social care budgets.

Stevens, who is also a former vice-president of the US private healthcare giant UnitedHealth Group, says that these new organisations are to be overseen by a “system partnership board with NHS, local councils and other partners represented”. “Other partners” is, as I pointed out last year, a euphemism for private companies. Now running most of social care, private ‘partners’ also already provide a substantial percentage of health services – from ambulances to district nurses – in local areas.

Andrew Fisher stated earlier that the NHS is being privatised by stealth under the cover of a pandemic. As Sir David King, a former chief scientific adviser, and the special representative for climate change under Boris Johnson when he was foreign secretary, recently told the Guardian, the government is slipping through plans to “effectively privatise the NHS by stealth” in “the name of a pandemic”. This story of privatisation is not one of wholesale transfer, such as the sell-off of British Gas or Royal Mail, but rather of a gradual hollowing out, a process that has been further accelerated by the pandemic and will continue under the Johnson government. In 2010, for example, the NHS spent £4.1bn on private sector contracts; by 2019, this had more than doubled to £9.2bn.



Beth Malcolm

Beth Malcolm is Scottish based Journalist at Heriot-Watt University studying French and British Sign Language. She is originally from the north west of England but is living in Edinburgh to complete her studies.