Like many people I’m grateful for the NHS. It hasn’t always been perfect, but I’ll never cease to be grateful for the treatment and care I’ve had. It’s enabled me to focus solely on my own health, without anxiety, fear or stress about payment.
But in all the celebration of the NHS, there’s a danger that we overlook its flaws. One of the sources of these flaws is that it’s still based on a model for providing acute care. Our population and needs are different to those of 70 years ago. If we don’t change now, the NHS won’t last another 70 years.
You may say it simply needs more funding. For sure, we all know that’s true. It’s hard for even the most frugal to deny that, and it’s why the Conservative government has agreed to a so-called ‘Brexit dividend’.
We’d be unwise, however, to think that simply injecting cash will make the NHS sustainable for the future. There needs to be a radical change in thinking – amongst NHS executives, professionals and the public.
The brilliant advancements in medicine and technology in recent decades have enabled us to live longer. But with longer lives we have a growing population and people are living with more long-term conditions. We need to adapt for that.
How? Firstly, we all need to get away from seeing the NHS as hospital-centred. Emotionally, most of us are attached to hospitals. They’re where people have given birth and had life-saving treatment and surgery. But hospitals aren’t the right place for all care. They’re often not the best place for someone in their last few days of life who wants to be in a more homely environment with people who love them. Nor are they usually the best place for someone needing long-term care for a condition like dementia.
We need to invest more in community care – professionals like GPs, community nurses and crucially social workers. They provide people with the support they need in their own homes, instead of a stressful (and expensive) hospital stay. The great thing about this is, not only does it allow people to be more comfortable, but it actually saves hospitals money in the long-run – long hospital stays aren’t cheap. If Jeremy Hunt’s new(ish) title of Health and Social Care secretary is more than lip service, he needs to invest in social care and community health care.
But there’s also a challenge for all of us. If more people are going to be cared for at home, we all need to play our part. This means being willing to share responsibility for caring for those we love when we feel able to do so. Sometimes this isn’t feasible with our jobs – which is why employers need to get much better at supporting people who are caring for someone they love. Informal carers need rights such as working from home and flexible hours. Employers need to shift their attitudes and become much more flexible about this.
For that to work, there needs to be a bigger culture change across the NHS and society. We need to see the people who care for their loved ones as experts in their care. Professionals may have the medical and practical expertise, but carers are experts in the people they support – their needs, preferences and concerns. And people are experts in their own experiences. No one should ever feel that professionals are making decisions on their behalf without their involvement or consultation. Professionals need to stop treating their patients as passive recipients of care, and patients and carers must not allow them to do so.
If we remain stubborn and unwilling to change, the consequences will be drastic. The NHS simply won’t be fit for the future, and we’ll lose it. But if everyone – government, NHS staff and the public – is willing to work together, change our attitudes and play our part, we can sustain the NHS. Beyond that, we can enable it to flourish and thrive for another 70 years and beyond.