The NHS isn’t failing; it’s being failed: A doctor’s take on the latest NHS public satisfaction survey

Public satisfaction with the NHS has plummeted, as anyone trying to book a GP appointment (including me) will tell you. A survey into public satisfaction with the NHS released yesterday shows it is at its lowest level for twenty-five years, with just 36% of the population content with the health service’s performance.

Pretty much any clinician or support staff working in any discipline across the NHS will attest to the damaging effects of privatisation, political meddling and incessant cuts to NHS funding and resources since 2010, year on year. The real effects these savage cuts have on patient care and patient safety has been wilfully ignored by Government – despite academics, clinicians and campaigners having repeatedly raised the alarm.

More public money now is going to waste, as more of it leaks out from the NHS into corporate profits and shareholders’ pockets. The right-wing platformers like the Institute for Economic Affairs will revive their mantra that the NHS has failed, despite the evident truth – that it’s the Government that has failed the NHS.

As a GP in the NHS, I’m genuinely surprised it’s taken so long for the public to feel the pinch. I’ve been feeling uneasy for a few years that systems are becoming less safe, primarily due to the inadequate and falling numbers of qualified GP staff and core resourcing. I’m surprised that we’ve kept things running for this long. But inevitably, something has to give. It means patients’ diagnoses missed, diagnoses late, diagnoses made but unable to get treated in time, or treatment no longer available on the NHS; patients not properly assessed, not listened to, not cared for; impersonal, hurried, harassed attitudes from staff. All of these worrying and potentially harmful aspects of a poor service are built into a system that’s been deliberately reduced beyond its efficient and safe capacity and function. This is the NHS now.

The British Social Attitudes poll has real and biting implications. Whereas such a dramatic decline in public satisfaction should trigger alarm bells for all, it will only result in more hollow talk and false claims from ministers determined to deflect criticism and to take credit for things they haven’t done. Where responsibility is concerned, ministers are notably absent.

When whistleblowers like Dr Chris Day act properly to alert the system that staffing levels are unsafe, the response from NHS senior management and government is to silence the whistleblower, not to deal with the problem. When doctors raise alarms about potential safety concerns, it means that patients may potentially be, or already are, coming to avoidable harm.

With the publication of the Shrewsbury and Telford Maternity report, the NHS needs to prepare for another cynical and rabid reputational onslaught from ministers and the right wing. Both staff and patients were bullied to maintain a high proportion of vaginal births at Telford, and good research was misused in order to please the HR performance metrics for low rates of expensive Caesarean sections.

Maternity scandals occurred not only at Telford, but also at Morecambe Bay, Nottingham, East Kent and Northwick Park hospitals. The avoidable deaths of mothers and babies is deeply affecting for all those concerned. The devastating effects on a mother of losing a baby, or suffering an avoidable birth trauma which results in harm to her or her baby, must not be underestimated. Whether a complaint ensues or not, midwives, doctors and nurses also carry the resonances of these traumas throughout our careers. We do the job because we care, because we want to do right by patients, and because we think we can make a difference.  As patient satisfaction levels now plummet, it may be a sign that I can no longer make that difference.

Trying and failing to get an appointment with my own GP, I’m now faced with a website that advertises dozens of different GP and community services – but they are all pay-for, privately provided services.

Under this government we have seen the actual breakup of the National Health Service under a massive transformation plan – first via the Health and Social Care Act 2012 and now into 42 separate entities under the Health and Care Bill.  This sets the NHS into a commercialised, contract-based and centrally controlled structure, under a government in thrall to corporate America.

More privatisation will result from the growth of the private medical schools and hospitals, centrally-awarded large 15yr outsourced contracts eg £2.25bn for pathology, privately run Rapid Diagnostic Centres, US corporate takeovers of general practice, and chains of hospitals and ‘provider collaboratives’ being ripe fruit for takeover by corporates of the size of the NHS. And more patients will ‘go private’ as the NHS offer deteriorates and waiting lists remain long.

After twelve years of Conservative government and the two largest restructures of the NHS in its history, the national health service is in pieces, while the most basic of all its remediable problems remains unaddressed – where are the midwives, doctors and Nurses? Where are the safe staffing ratios? Where is the per capita funding? Why has the government done nothing? The answer, I believe, is twofold – firstly, as a country we’ve lost the ability to call a duck a duck. Secondly, this government lies and is corrupt. I’ve worked and paid tax all my life. I want my NHS back. And so should you.

Dr Nick Mann is a GP in London, and a member of Keep Our NHS Public