Those of you who have had the misfortune to be in need of hospital treatment in the UK would be pleased that the service we get, although not always what it could be, is free in so far as we don’t pay extra other than taxes and National Insurance to fund it. People in other countries are not so fortunate. So is the National Health Service (NHS) the way forward for the future healthcare in the UK?
(The figures quoted below can be found on the TheKingsFund website)
Our NHS service, whilst not the best or worst healthcare service in the world, is free for anyone from any walk of life to use. Because of the resources needed to run this behemoth, it is fair to say that it takes it toll on the buildings, staff and patients. Staff availability isn’t what it could be. In fact a lot of staff in our hospitals in the UK tend to come from other countries. This is because the wages they can earn here are attractive compared to their home countries. Even with that, our hospitals are severely understaffed. There are 1.2 million FTE (full time equavalent) NHS staff. Of that, about 325,000 are nursing staff.
They are also severely under-funded. Money to fund the NHS comes from the government coffers. It is estimated that it will cost £120 billion to fund the NHS in 2017. By 2021 this is forecast to be £133 billion. 98.8% of this is paid for by taxes and National Insurance contributions.The other 1.2% is from patient charges.
There there is the bed space.There are around 125,000 hospital beds available in the NHS. The beds roughly have someone in them 90% of the time. Almost at breaking point.
So, although not ideal and almost at breaking point, it works. You get ill, you wait, you get repaired. The quality of care in most cases is excellent, but there are some exceptions. Personally, I’m very grateful for our NHS service. Yes it has it’s problems, but it is free at the point of need. Is it the way forward for the future? No. I don’t think so.
The NHS has a Five Year Forward View (pdf) that was published in October 2014 and sets out a new shared vision for the future of the NHS. Patient groups, clinicians and independent experts have also provided their advice to create a collective view of how the health service needs to change over the next five years if it is to close the widening gaps in the health of the population, quality of care and the funding of services.
All well and good, but how is this going to be funded you may ask. There are many ideas about how it will be funded, but most agree it will not be entirely by the taxpayer as it is now. Funding through insurances which we all pay is a possibility. Private healthcare is another option. Some people are already fortunate enough to have this. Things like BUPA, AXA PPP, Aviva and PruHealth are the big four companies involved in this accounting for almost 90% of the market. This would of course rule out those less well off. There would need to be some thought into how those people access healthcare without insurance provision. For the less well off, emergency care would be free, as it would for anyone. Anything beyond emergency care would need assessment and then could be funded if needed based on assessed medical need and impact on life to the patient, not unlike today.
Healthcare itself may also change substantially. Going to the supermarket for a checkup may not be an uncommon thing in the future. Doctors, or machines could do this. As technology improves there may be less need to have staff. Things like blood pressures and weight checks can already be done without the need for staff intervention.
What does all this mean? Well, the NHS as we know it and the way it is funded may change dramatically. This could help to improve an ailing system that is over 50 years old. Healthcare of the future may require less staff, but as the population ages, healthcare needs change. We are a long way off robots being able to support or care for the elderly. This will still require staff and these must be paid for somehow.