In the grand scheme of things I haven’t been a doctor long. There are consultants who qualified as doctors before my parents even met. I have however seen my fair share of patients, and working with some of the sickest groups in the hospital, I’ve seen plenty of deaths as well.
Most very unwell and terminal patients will die in similar ways. As with any large and very complex machine, there are usually predictable stages. The first signs are the subtlest and most varied-the kidneys might slow down, the peripheral vessels might close down, the brain might become forgetful or sleepy. Then slowly more parts of the whole stop working- each has a knock on effect to the next, with predictable decline. It’s possible to intervene of course- modern medicine can breathe for you, be your kidneys, even pump your heart if needs be. But sometimes we cannot fix what is wrong, and it’s not always right to do so.
Once one major organ fails, another shortly will, and then the next. Beyond this point the damage is usually irreparable. Things deteriorate slowly, until suddenly, whatever spark of life that keeps you laughing, crying, loving and moving, the spark that makes you YOU, is gone.
Why all the morbid tales you may ask?
Because for months and years the NHS has been in slow decline.
Because the end of the NHS isn’t in five or ten years time, it’s staring you in the face, right now. Today.
To the experienced eye, the signs have always been there.
First- the disease. Diagnosis is always difficult. The same pressures of increasing complexity, increasing possibility and increasing age of the population haven’t really changed. Healthcare inflation is well recognised. But the increased work load has been met by starvation, and waste. Austerity, massive reorganisation and criminally expensive private finance deals have smothered the system. Deprived of funds, the NHS began to wobble.
Subtly at first, waiting times crept up and A&E and maternities began to close. NHS finances dipped, a pay freeze hit staff, a mild winter spared us, and the NHS limped on.
But now the organs are failing. Waiting times in A&E have reached a record high, and today this happened. Lancashire Teaching Hospitals Trust A&E, due to being unable to recruit sufficient staff in a combination of lack of retention and capped locum rates, is left with either closing their A&E or calling in the army.
Let me just reiterate that- an NHS A&E is considering calling in the army to prop up services. Calling in the army. This is what a state of emergency looks like.
This is what a dying NHS looks like.
The other organs are rapidly declining as well. Due to threatened nursing bursary cuts and immigration law, the life blood of the NHS, our nurses, are failing. We are bleeding out losing experienced staff and failing to recruit sufficient numbers to replace them.
The ‘backbone’ of the NHS, the junior doctors, is being crushed – by rota gaps, by overwhelming pressures and by rock bottom morale. Is this the time to introduce a toxic, unmodelled and unsafe contract? We are trying to hold up the service like everyone else, but we can’t do it anymore.
The NHS needs urgent intervention, we need funding and we need politicians who value the service, not butchers to carve up the carcass to private companies.
If you don’t believe the Tories would destroy the NHS it’s time to face reality. It’s happening right now. The NHS is critically unwell, and whether it’s deliberate or not, death’s door is open.
Don’t stand by and watch it die.
juniordoctorblog.com 
So true and so scary
Let us be completely open about this, it’s not just “the tories” because New Labour wasted millions on “suits” and other advisers and got Senior Consultants so tangled up in meetings that they only had limited time for patients.
Then there is the other aspect, the one everyone is avoiding. The NHS is going to die because demographically it is unaffordable. This is the one the cretins in The Commons avoid, simply put there are not enough people of a working age in the UK to pay sufficient tax at any REASONABLE rate to maintain the NHS. There are too many old people draining it, technology is massively expensive and there are not enough babies being born to produce the tax payers of tomorrow. That is it – it doesnt matter which party is in power the NHS is shot.
get used to it.
This is rubbish. It is NOT unaffordable. Firstly if we received something actually approaching the western societies average level of funding we could slowly begin to redress the damage of years of underfunding. Secondly I have worked in a part of the country where the number of over 65s was approaching 25% of the population. With good pragmatic care in the community, primary care and the DGH we were in a lot better condition than many other trusts struggling to cope now with overspecialised, rapid transit emergency care.
There is a cure for our malnourished and deconditioned health service, to use the analogy in the article. It will take clear vision and radical reversal of some policies – explored in previous articles in this blog. Examples include abandoning irrelevant targets and linked funding, scrapping 111, proper resourcing of all aspects of social and health care, breaking down the barriers between different specialties especially mental and physical health and making personal care a true calling, taught in schools and recognized in qualifications and pay structure.
Health is one of the pillars of a modern civilization, keeping the workforce strong and respecting the needs of the frail and elderly, it needs to be reliably good wherever it is accessed and not preyed upon by the hawks of private corporations.
The NHS is most certainly affordable. If you compare expenditure from different developed countries http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS
you will see that the UK spends about 9% of GDP on healthcare, compared with the 11% or thereabouts spent by France, Germany, Belgium, Holland, Canada or Japan, or the astonishing 17% spent by the US, which still fails to deliver basic healthcare to its poorest 20%.
I won’t repeat the excellent points made by Glen Harper but a lot could be done by a reform of social care. Increasing expenditure by expecting the consumer to pay will work, of course, but only for those who are able to pay, and will lead to an increasingly divided society. The USA has lower life expectancy, higher levels of unhappiness, and perinatal and maternal mortality rates that would shame many countries, including Cuba and Estonia, both of which have significantly higher levels of poverty.
People need to benchmark across nations much more, if they did they would find that given the funding it receives the NHS delivers astonishing quality.
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