This week the Prime Minister set out a speech on the NHS as it enters a difficult period of winter pressures. Rishi Sunak’s father was a GP, and his mother ran the local pharmacy where he grew up, so he knows a bit about the NHS and the challenges it faces, alongside the economic challenges, dealing with the pressures on the NHS is at the top of his priorities.
Winter pressures have always been a feature that the NHS has had to contend with. The spike in colds and flu during the winter leads to increased admissions to hospitals and more pressure. However, this year things are particularly difficult. Like any large system, when things are working the NHS can deal with the most complex of problems smoothly but when parts of it break down then there are knock-on consequences for the whole system.
The NHS is the one area of government spending that has increased relentlessly year after year. In 2010, the annual spending on the NHS was around £120 billion. Last year that had risen to £190 billion. Spending increased every year during the coalition government even as other departments saw spending reduced. A few years ago, it was given a new increased funding settlement to last a decade and there have been further increases since to deal with specific pressures. However, despite huge injections of additional funding, the system is stretched and there are a number of complex factors contributing to this including difficulties recruiting staff, a surge in demand in the aftermath of the pandemic, and a lack of capacity in the nursing care sector.
During the pandemic, as the NHS focused on dealing with Covid, other conditions received less attention so there is a backlog. People were anxious during the lockdown so avoided going to see their GPs with problems or found their GP surgery reluctant to do face-to-face appointments, so things were put off. There has been a huge surge in people suffering from mental health problems up by about a third.
Although a huge amount of effort has gone into recruiting and training new doctors, many are also leaving so there are constant problems recruiting and retaining staff and there has been a trend toward more GPs seeking to work part-time. If an organisation is short-staffed and more pressure falls on fewer people, then it is only a matter of time before they too find that they cannot cope.
This week we saw the Prime Minister pledge some new interventions to deal with the current challenge but there are longer-term issues that we need to address. In my view, the government must do everything in its power to create incentives to retain doctors, to get them all working full-time, and to focus efforts on recruiting medical staff where gaps exist. I take a different view to my own party on immigration policy. I think we should have a visa policy based on need where staff shortages exist, not a so-called “skills-based” policy that only allows people in who are on high incomes. We all know there is not a direct correlation between salaries paid and the value of work. Many of those on the highest incomes were able to stay at home during the pandemic and no one noticed. The key workers in sectors like care or the food supply chain kept going because their jobs were more important. We need to be far more pragmatic and recognise that we have a chronic shortage of care workers, that they perform one of the most valuable jobs of all and we need to leave no stone unturned in helping the sector recruit more staff.
Cornwall recognised in New Year’s Honours:
It was great to see individuals from Cornwall recognised in the New Year’s honours list this year. There were several names from Cornwall that were featured for services to their communities such as David Geoffrey Hall-Davies (CEO of Cornwall YMCA) and Ian Jones (CEO of Volunteer Cornwall) as well as Sue Sayer founder and director of The Seal Research Trust who was given an MBE. I have met Sue many times through the nationally recognised work she has done on Sue on seal conservation and the group of volunteers she leads has done some great work rescuing injured seals and raising awareness of the importance of avoiding disturbance. My congratulations to all of those and the volunteers who work with them who were recognised this year.
