Dissatisfied with the health service? Don’t blame the NHS, blame the government

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Let’s get a few things straight. The NHS isn’t failing; it’s being failed, and being failed in a big way. The results of the latest annual British Social Attitudes survey of nearly 3000 people undertaken by think tanks The Kings Fund and The Nuffield Trust between July and October last year are in and they reveal that only 53% of respondents are satisfied with the NHS, (down from 70% in 2010). However, the results also reveal that respondents aren’t dissatisfied with the service doctors and nurses provide (or even with much-scapegoated NHS managers) but with the long-term effects of government mismanagement on their patient experience.

Too long a wait

The ability to access appointments and treatment at all stages from GPs to hospitals ranked as a key factor. Satisfaction with GPs is now at the lowest level since records began in 1983 and double the amount of people (24%) were dissatisfied compared to 2009. Patients are struggling every day to get a GP appointment because there is a chronic shortage of doctors, around 6000 in fact, due to a sustained lack of investment in primary care.

Dissatisfaction with waiting for treatment is unsurprisingly a major factor cited in terms of unhappiness with the health service, whether that is waiting for an operation or to be seen in an emergency department. Britain is one of the richest countries in the world, but judging by some frankly alarming statistics, you wouldn’t think so.

In terms of accessing hospital treatment, the surgical waiting list is the highest it has ever been (at over 4 million), not because hospitals are poorly managed but due to a lack of staff and beds. Beds incidentally, that have been taken away by the last two governments to the tune of 15,000. The number of people waiting over 4 hours for treatment in A&E is the highest in 15 years. In the three months up to March 2010, just over 100,000 patients waited over four hours for treatment. In the first quarter of 2017, that figure stood at just under 700,000 – a rise of nearly 600%

Passing the buck

This figure highlights a massive failing of senior governance.  Blame cannot be explained purely by poor staff or local management performance, it is now endemic nationally. This figure isn’t one that paints the government in a good light, and they are well aware of it. Apparently, the way to ensure better PR isn’t to increase resource to improve the figures, but simply to scrap the target altogether. People will still continue to suffer, but at least the numbers won’t hit the headlines; crucially it won’t overtly be seen as a failure of governance and the buck can more easily be passed to trust managers and healthcare staff; in short public accountability decreases.

Poor lifestyle choices and an ageing population are still continually cited (blamed) by this government as the reason for increasing NHS pressures. It is far easier to lay blame at the door of the individual patient or trust than to admit that government policy is purposefully neglecting our proudest institution.

Yet proper funding to return to the satisfaction the NHS enjoyed eleven years ago isn’t some unobtainable Utopia; it’s a political choice. This government know very well that a well-funded health system reaps far wider economic benefits by ensuring a healthy and productive population, but they are fundamentally opposed to the democratic model the NHS provides.

The impact on morale

Reported levels of dissatisfaction add insult to our already injured healthcare staff. Levels of stress, burnout and mental ill-health are at an unprecedented level as the recently published NHS staff survey testifies to, and media reports of the lowest public satisfaction in eleven years only serve to deplete morale even further. But take heart: although not making the headlines, the reasons respondents gave for valuing the NHS were ‘the quality of care; the fact that the NHS is free at the point of use; the range of services and treatments available; and the attitudes and behaviour of NHS staff.‘ Respondents are in no way oblivious as to the underlying reasons for deterioration of service and cite a lack of funding as one of their principal concerns.

The promised ‘birthday present’ funding of £20bn has been heralded by this government as the answer to all the NHS’s problems. If this were ‘extra’ cash now, it could indeed provide a real solution to the now year-round NHS crisis. However, this funding over five years is yet to be seen, the extent promised does not match need and even if it fully materialises it will do little more than keep the lights on when taken against a backdrop of 9 years of systemic under-funding. The NHS Long Term Plan relies on IT and app gimmicks to address waiting times and fails to address the “national emergency” caused by a lack of 100,000 NHS staff – arguably the principal cause of dissatisfaction amongst the public. In short there is no fix planned – quick or otherwise.

The government’s motives in question

Philosopher Noam Chomsky’s ‘standard technique of privatisation’ enjoys a lot of publicity these days, and for good reason. It is particularly relevant here as he maintains:

“…the standard technique of privatisation [is to] defund, make sure things don’t work, people get angry, you hand it over to private capital.”

This survey shows there are increasing numbers of people currently at stage three – angry at government neglect of their NHS and not supporting privatisation. Stage four is a spectre that looms large. Campaigners around the country must guard against renewed cries that the NHS has failed and continue to point the finger of blame at the government. We must fight, lobby and protest, we must continue to stand on our soapbox until the NHS is returned to proper funding and staffing levels, until the waste of privatisation has ended, until the service can once again boast record levels of public satisfaction and until staff feel valued and respected by not just the public but the government as well. Prompt access once again to a safe and effective health service we all use and contribute to is surely no more than we all deserve.

Samantha Wathen, Press and Media Officer for Keep Our NHS Public

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