As doctors gather for their annual conference in Bournemouth, there is a distinct air of uncertainty about the future of the NHS after this month's inconclusive election result and threadbare Queen's Speech. At a time when we should expect newly elected politicians to be responding urgently to the all too obvious crisis in our health and social care system, instead their plans seem as far away and unattainable as the horizon far out at sea. The health service is facing an unprecedented and mounting crisis: and it desperately needs politicians of all parties to address the challenges that are threatening to overwhelm this country's most cherished national asset.
The British Medical Association's survey of the public, published this week paints a stark picture. More than four in five are worried about the future of the NHS with seven out of ten feeling the health service is moving in the wrong direction. Four out of ten are dissatisfied with the NHS' performance and almost half believe a lack of funding is at the heart of the current malaise. Three quarters report getting a GP appointment is becoming more difficult and an even higher number feel waiting times are getting longer.
These findings chime with the experience of doctors on the ground. As a working GP, I am under no illusion that the service is buckling after a decade of underinvestment. Our funding has declined while demand from the public has soared and, most importantly, become more complex. As a direct result of the success of our NHS, more and more people are living longer. There are now 11 million people over the age of 60 and by 2040 one in four will be in this age group. However, this also means more people are living with complex problems and need more care. Increasingly I'm having consultations with people in their 80s, 90s or even older who often have three, four or more conditions to talk about. Problems such as diabetes, arthritis and heart issues, were often dealt with by specialists in hospitals but now patients with these conditions are cared for by GPs and their practice teams. Yet I have to try to manage all this within the confines of a 10 minute consultation. This is simply unsustainable and it's no wonder that so many GPs are burning themselves out trying to cope with the stress of meeting this growing need.
Unfortunately, at every stage the political neglect of the NHS interferes in my treatment. We now have a shortage of GPs which means that while I am treating the person in front of me there are not enough colleagues to start seeing the steady tide of other people filling up the waiting room in my surgery. Services that I want to refer a patient to, like hospitals, mental health services or community nursing colleagues, are overstretched and oversubscribed, meaning that the patient may not get the level of care they deserve.
The most galling aspect of this depressing picture, is that the national political rhetoric seems to be being beamed in from another planet. The government promised an extra 5000 GPs by 2020: a mass recruitment that many at the time felt was a pipe dream at best, given it takes ten years to train a GP. It has proved to be so for the reality is that half way through this time period GP numbers are actually falling. They've also promised more nurses, mental health therapists, and pharmacists to work alongside GPs to help shoulder the growing workload burden, but ask any practice and they'll struggle to identify any of this cavalry coming over the horizon to help rescue the situation, or be able to identify the funding to support this new workforce in a sustainable way.
The BMA called for this election to produce a political consensus built around the need for a long term, fully funded plan that gives the NHS the resources it needs. Unfortunately, the inconclusive result and haziness in all the parties manifestos has left this call unanswered. This uncertainty cannot go on: we need action now before patient services break down completely.