The NHS is undergoing radical changes. With a constrained budget and a massive shake-up to the way services are commissioned, it is also trying to recover from a number of high-profile scandals which have thrown doubt on the quality of patient care. As the health service undergoes these changes, there are five crucial issues the government and the health service needs to address.
Can the NHS tighten its budget without reducing services?
The Conservative party came to power promising to “Cut the deficit, not the NHS.” In real terms, the health service is having to make £20bn of savings by 2015, to keep up with the rising costs of healthcare. Politicians claim that this can be achieved without significant cuts to services, through “efficiency savings.” But healthcare managers responsible for implementing these changes say this may not be possible. After significant cuts to services already – including hospital and ward closures (sorry, efficiencies) – healthcare managers say more service reductions are inevitable. “We will have to trade off in terms of quality of services,” said one manager surveyed by the King’s Trust.
Can hospitals improve step up their patient care?
Kane Gorny, 22, went into St George’s hospital in Tooting for a routine hip operation and ended up dying of thirst. Instances of patient neglect of worryingly frequent in NHS hospitals, with patient care shown to be hampered by a lack of empathy in staff and a focus on meeting targets and ticking boxes over caring for patients. The majority of patients get a fantastic service in the NHS, but the government needs to address the problem of an alarming number of people admitted to hospital, who end up being left to suffer and die.
Will whistleblowers be protected?
The reason so many cases of patient neglect have been allowed to continue is because many staff who see it happening are afraid to speak out. In the past people who have spoken out have had their complaints hushed up and even dismissed, to avoid confronting these problems. Doctors, nurses and care workers who speak out in the public interest ought to be protected (and applauded), because the standard of patient care is more important than the reputations of clinicians.
Can the commissioning shake-up improve services?
In theory it shouldn’t matter who commissions services, providing they are delivered to the patients who need them. But the Conservative government has taken this power away from Primary Care Trusts and given them to groups of GPs. In theory this is supposed to give patients – and the people who know their health needs best – the power to commission the services they need. It could indeed lead to a ‘revolution in patient care’, with local services tailored to people’s needs. It’s an idea the British Medical Association has been recommending for many years, but there is still anxiety over putting GPs at the heart of ‘rationing’ services.
Will the ‘privatisation’ of many NHS services affect patient care?
The 2012 Health and Social Care Act also effectively opens up NHS services to much more privatization. GPs and commissioning boards are now duty bound to hear bids from private companies. While the government and NHS bosses claim that quality won’t be sacrificed, and competition will lead to greater efficiency, the potential for corruption and insider dealing between health boards and private interests is huge. Many of the companies bidding for NHS services include G4S and Serco, which have shown themselves to be incompetent in the provision of security and other services.