One of the many challenges we are facing after the pandemic and as we enter the winter, is increased pressure on our hospitals and the NHS. Like any large system, when things are working it can deal with the most complex of problems smoothly, but when parts of it break down 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. 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 towards 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.
In Cornwall, pressures on the NHS are always more pronounced because we are a peninsula at the end of the line. It is harder to encourage nursing staff and doctors to move to Cornwall and stay here, it is harder to draw on resources from neighbouring areas to spread the load because we are surrounded by coastline, we have a larger elderly population and the social care system is also struggling to provide enough capacity and recruit enough staff. If hospitals can't discharge patients to a suitable care home, then they can't find beds for those needing admission and if ambulances cannot unload patients at the front door they cannot get back out on the road to attend to new problems.
There is no single solution to help the system work better under the sharp increase in demand but there are a few issues I will be arguing for. Firstly, 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. We need to be far more pragmatic on immigration policy and recognise that we have a chronic shortage of care workers and be willing to welcome people to help fulfil those roles we need different approaches to dealing with mental health challenges recognising that if we give the right pastoral support to people early then we might avoid the need to categorise and treat conditions as medical at a later date. None of this is easy, but we have to make a start to get the system working again.
