There are a panoply of problems with the NHS, with the most acute being waiting lists. In July, the British Medical Association reported that the number of those on NHS waiting lists was 6.84 million, a 2 million increase from the pre-pandemic peak. More than 350,000 of those people had been waiting over a year and 2.4 million had been waiting over 18 weeks for consultant-led care, numbers that would have been inconceivable in 2019.
Large waiting lists are precipitated by staff shortages and these figures should catalyse recruitment. The Guardian reported that the acceptance rate for medicine applicants was down four percent since last year, suggesting we have a huge surplus of capable students. Where medical schools are nervous about offering more seats due to the government capping them at pre-Covid numbers, The Royal College of Physicians is asking for an extra 7,500 seats. This would cost around £1.85 billion. Our new prime minister, Liz Truss, could easily provide this money if she was not preoccupied with futile political measures such as increasing defence spending to 3% of GDP by 2030. My advice to her is to stop being so fatuous and give this money to the services that need it the most.
Recruitment would fill some of the vacancies, currently 50,000 doctors and 40,000 nurses, but the NHS also needs to, as Truss has said, ‘arrest’ the exodus of doctors from the service. In between repeating that she would cut taxes, rhetoric that became as familiar to observers of the Tory leadership contest as the ‘our father’ to a devout Catholic, Truss pledged to get rid of the ‘red tape’ for retirees wanting to return, and change ‘punitive’ pensions causing many to retire early. She is right to identify retention as a problem, but the idea that it is simply red tape disincentivising doctors to return, and cupidity that is causing them to leave, is balderdash. In 2021, an article in the British Medical Journal stated that over 50% of NHS staff had self-reported problems with stress, anxiety and or burnout. This formed the ballast of the argument that NHS staff are treated poorly. This, alongside insolent offers of pay increases that represent a pay cut in real terms, is perhaps more explanatory as to why we need up to 50,000 more doctors and 40,000 more nurses. Thus one suggests, if she has any interest in remedying this problem, that Truss focuses on providing a comprehensive pay package to NHS staff which represents a real-terms increase.
Waiting lists since 2010 have grown by over 4 million, a grotesque figure. This has everything to do with the fact that figures such as David Cameron, George Osbourne, Theresa May and Boris Johnson, grotesque in their own ways, have been responsible for stewardship of the NHS since 2010. Since the Conservatives were returned to power, health spending as a percentage of GDP has plateaued, and spending on the NHS has slumped in real terms. That is why I am more than slightly rueful regarding Truss’ ascension to Downing Street. Somebody who operated within this malign government as an agent of each of the three premiers, cannot be expected to heal a laceration that she bears some responsibility for. The NHS needs a proper investment plan. Ms Truss has persistently preached and proclaimed growth will be achieved, and we will achieve everything with this growth. It is unlikely that growth will make any more than a meagre contribution to NHS regeneration, as Ms Truss would not commit to a plan as radical as is necessary.
In order to fund NHS regeneration, a wealth tax should be implemented on individuals who have over £500,000. In research carried out by the LSE and Warwick University it was concluded that the wealth tax that I propose could raise £260 billion over five years. This would allow the government to increase the current health budget by up to 30%. This increase should initially be used to build new hospitals in areas such as Leicester, Coventry, Bradford, Bedford and Barnsley. Support should be targeted, as the main blockade to accessing care in such areas is simply the unavailability of services. Johnson’s brittle plan to deliver forty ‘new’ hospitals should be repurposed into a delivery of forty new hospitals from scratch, in the areas that need them, alongside upgrades to facilities across the country. Nine in ten primary care centres stated they have been underfunded in the ten years prior to the pandemic. This has led to needless referrals to A&E and delays in referrals to consultant-led care. Fixing both the availability and quality of care damaged by the Conservatives will undoubtedly bring waiting lists down. If the NHS is cared for as benevolently by us, via investment, as it does for us, prospective staff will be encouraged to enter the industry and remain more readily than they do at the moment.
In summary, we need to train, retain, and spend. The fact that these points are rather facile is exactly the point. The main cause of readers’ consternation should be that if given the chance, the government would misnomer them as superfluous. Truss should take the problem of the NHS as seriously as she will have to take other crises such as energy and cost of living. However, these crises represent a break from the usual. The NHS being in ‘crisis’ is now as normal as the sun going down at night.