Save the Health Service!

Another day, another text trying to inveigle me into baring my arm for a third time. I think it’s the fifth I’ve ignored in the last two weeks. You think they’d get the hint wouldn’t you? Keep sending out texts that get ignored, maybe the recipient isn’t interested? Next time I’m blocking them. this is getting silly.

I’m getting a more than a little impatient over all this COVID nonsense. As I have said many times, we never locked down or wore masks everywhere for colds and flu, so WTF are we doing over a bug that has morphed into something analogous to a bad head cold? Especially as the “OHMYGAWD!” variant seems to infect both vaccinated and not equally, regardless of being ‘boosted’ or not.

In addition, we keep on hearing that we, the general public have to “Save our health service” In the UK this is the ‘wonderful’ National Health Service fetishised by so many despite it’s many flaws. So, having a bit of time on my hands on site between waiting for estate agents, technicians and builders to turn up on site, I did a bit of Interweb searching and found the following;

In the UK, the ‘wonderful’ NHS which people are constantly exhorted to ‘save’ is shrinking. It has been in decline as far as bed capacity is concerned since at least the year 2000. In the year 2000 there were approximately 240,000 beds, almost a quarter of a million beds serving a population of just under 59 million people. That’s about one bed for every 246 people.

By 2020, the NHS had a capacity of approximately 167,000 beds serving a population of around 68 million. That is one bed for every 407 people. If you want to check the percentages, knock yourself out.

Now pardon my arithmetic, but that sounds rather like an institution in decline. Go back to the mid 1970’s and the total bed count was 400,000 for a population of just over 56 million. One bed for 140 people. How do I know? this site has done all the heavy lifting. All right, ‘care in the community’ hadn’t happened yet and the UK still had large mental hospitals, but still, that’s a hell of a step change.

By the mid 1980’s the bed count had shrunk to 151,000, but grew again to 299,000 (!) by 1986/7, with the majority of spaces being in acute and emergency care. Read the full story here.

However, I would call one thing into question; The articles quoted population figures. See quoted paragraph below:

As bed numbers have fallen, England’s population has grown, from around 47.3 million in 1987 to approximately 56.6 million in 2020. As a result, the number of beds per capita has fallen faster than the absolute reduction in number of beds. Over this period, the number of older people in England – who are more likely to spend time in hospital – has also increased.”

43.7 million in 1987? World bank and ONS figures give the UK’s population as just under 57 million for that year. In 2020 the overall population figure is over 10 million higher at a shade under 67 million, putting even greater stress on the fewer beds available.

I’d tend to concur about the increasingly elderly in secondary health facilities like nursing homes. But memory is waving a hand here and is reminding me that this was a problem even as far back as the early 1980’s. Space in the public waiting rooms for God has always been at a premium.

I can recall some breakfast TV talking head using the ‘Oldies are hogging all the resources’ kind of rhetoric before 1990, coining terms like ‘bed blocking’, as if older people like getting ill and taking up bed space. If my family is any guide, they generally hate being in hospital, because there is always the suspicion that they might not come out breathing. This was a widely held belief at least back to the 1970’s.

One of the other factors currently putting even more pressure on hospital beds has been less reliance on primary health care sources like GP’s practices, with more shifting directly onto hospital A & E departments. Especially with undocumented newcomers who are not even registered with a GP. They bypass the buffer of GP’s and end up inflating the A & E queues. There is also a breed of Doctors receptionists who have not helped this situation by deflecting would be patients and forcing them to seek help in the only other place available. Other countries get around this, Canada and the USA being examples, by having ‘walk in’ clinics where anyone can go in off the street and get relatively affordable health interventions, no matter who they are.

Anecdote: I was in for major chest surgery in a UK midlands hospital in the mid 90’s (Cancer with a small c) and in the High Dependency Thoracic Unit I spent 3 days in there were 12 beds. Four of which were occupied by ethnic north Europeans, one of whom was myself. Six of the remaining 8 beds were occupied by elderly non-Europeans from the Indian subcontinent. Which at the time surprised me somewhat. Over 15 years before, during my time working on the wards, non-European patients were a rarity. Non-Europeans were commonplace among the staff, but not the patients.

And you can’t even blame it on any particular political party. The largest growth of NHS beds since the mid 1970’s occurred under the premiership of (gasp) that awful public health hating Margaret Thatcher, topping out at the end of her tenure as Prime Monster of the UK at 299,000 beds and thereafter declining throughout the Major, Blair and Brown administrations. Said decline continuing under Cameron, May and Johnson. This is the story the raw data tells.

Before that, during the late 1970’s, NHS capacity dropped 50,000 beds under the Callaghan Labour government, before Thatcher came to power. I mean, this is the Labour party that allegedly just Luuurrves socialised health care, right? Yet the biggest decline in NHS beds happened on whose watch?

Personally, having actually worked in the UK’s National Health Service, I think that there’s been a lot of political cheese paring over the years, trying to ‘cut costs’ and ‘improve’ the management of said organisation, but only ending up with a huge bureaucratic monstrosity chewing it’s way through everyone’s wage packet.

Of course this could have been mitigated by implementing a French style system where there is a basic service with additional top up, either by insurance or cash. Yet the propaganda soundbite machine has always been opposed to a ‘two tier NHS’, and so here the UK is, with a bureaucratic behemoth that is failing it’s original purpose.

As one who keeps his ear to the ground, I hear constant leaks from the health service front lines about management interference in clinical decisions. Just little trickles and dabs of information, but when viewed as a whole like an impressionist painting, these snippets paint a comprehensive picture which does not imbue one with a sense of confidence. Far from the utopian vision that brought about one size fits all care’s naissance.

For a little light relief, see the trailer for the satire ‘The National Health, or Nurse Norton’s affair’ below.

Yes I have seen Lindsay Anderson’s ‘Britannia Hospital’ – didn’t like it much, although some of the characters were awfully familiar.

What is that whirring sound? Oh, it’s only the political father of the NHS. Aneurin Bevan, spinning in his grave. As a semi serious aside, if we could harness all his rotational energy, maybe we could solve the unfolding energy crisis?

Talking of crises, I have to get back to packing my life away ready for the move. Next time some other bugger can have the pleasure.

Update: Just as a matter of interest; Canada has undergone a similar decline in hospital bed capacity since the 1970’s. In 1976 there were 6.92 beds per 1000 population. Now it’s 2.52. No wonder the politicians and their ‘experts’ are panicking.