WRIGHT ANGLE
Stephen Wright’s monthly take on nursing in the news
Beware those who claim our NHS is unaffordable
There is no getting away from it – there are more demands than ever on the NHS, and a £30 billion ‘black hole’ in its finances is expected by 2020, according to NHS England. This frightening figure is used to support arguments that the NHS is unaffordable and/or must be exposed to more competition and privatisation. But talk of £10 charges to visit your GP or creating an NHS tax are red herrings in a deeper and wider debate. Let us face a few facts. The NHS remains the most popular of all our publicly funded services. It is good value for money. It is more cost-effective than other systems worldwide. So beware the siren voices that suggest we must privatise it because we cannot afford it. The UK remains one of the wealthiest nations in the world. We can meet NHS costs by much better health promotion (see story, bottom right), which includes tackling the sugar and drug lobbies, and the addictions and illnesses that they cause. We can look at a more imaginative – and fair – system of taxation to tackle the widening inequality gap. A bad diet and inequality make us sick. We are now heading for Dickensian levels of inequality. The richest 1 per cent of our population controls 55 per cent of the country’s wealth. In 1910, Britain’s richest 1 per cent owned 70 per cent of the wealth. By 1970, this latter figure had dropped to 20 per cent. Now it is back up again.
Is Stephen right? Whether you agree or disagree with Stephen Wright, you can tell him what you think by writing to [email protected] 16 june 18 :: vol 28 no 42 :: 2014
Inequality and health are closely linked, and policies of tax and redistribution funded the NHS and better health outcomes in the late 20th century. This progress risks being reversed. Nurses experience the effects directly, in their pay packets and in job insecurity. They also see it in the worsening health of patients. States that attend to the common good, in the way that the post-war government did in Britain, can level
THE NHS IS MORE COST-EFFECTIVE THAN OTHER HEALTH SYSTEMS WORLDWIDE inequality and produce better health for all. They just need the courage to pursue policies of redistribution and stand up to the powerful, such as the sugar lobby. Perhaps we can look at tackling tax avoidance to pay for the NHS – it is currently estimated to cost the UK £130 billion a year. The NHS costs £100 billion year to run. That is not to say the NHS does not need constant transformation. It does. We are not facing up to the challenges of an ageing population, for example, and many long-term conditions, such as diabetes and depression, are being treated with high-tech interventions that have limited impact. More imaginative programmes that seek to address these problems, such as the WEL programme in Glasgow, are now thankfully gaining attention. They arise not from constant reorganisation, privatisation and competition, but from collaboration and integration.
MIDWIFERY AND MEDICINE NEED TO DO SOME TALKING
Giving birth has become so medicalised that only 2 per cent of UK births take place at home each year. In revised guidance, the National Institute for Health and Care Excellence (NICE) has suggested that more midwives should have greater scope for home births and there should be more midwife-led units. The Royal College of Midwives and parenting charity the National Childbirth Trust are supportive. The Royal College of Obstetricians and Gynaecologists warned of the need to ensure transport to hospital is available in the event of complications. The revised NICE guidance comes at a time when the long-standing tension and rivalry between medicine and midwifery over their approaches to childbirth persists. Perhaps the guidance needs to be backed by a deeper conversation and collaborative support between the two professions.
Why keep us well if illness is big business? An article on statins in the British Medical Journal last month revealed that 7 million people in the UK are taking them. What a figure – and yet another example of the how pill-popping has become the standard response to lifestyle-related illnesses. No wonder two of the biggest drugs companies – Pfizer and AstraZeneca – got into an almighty multibillion dollar takeover spat last month. The causes of health problems remain largely unchallenged by a government in hock to drug, food and tobacco industries. Why tackle the causes of ill health when there is so much money to be made from sickness?
NURSING STANDARD
Downloaded from RCNi.com by ${individualUser.displayName} on Jul 03, 2016. For personal use only. No other uses without permission. Copyright © 2016 RCNi Ltd. All rights reserved.
Stephen Wright’s monthly take on nursing in the news
Beware those who claim our NHS is unaffordable
There is no getting away from it – there are more demands than ever on the NHS, and a £30 billion ‘black hole’ in its finances is expected by 2020, according to NHS England. This frightening figure is used to support arguments that the NHS is unaffordable and/or must be exposed to more competition and privatisation. But talk of £10 charges to visit your GP or creating an NHS tax are red herrings in a deeper and wider debate. Let us face a few facts. The NHS remains the most popular of all our publicly funded services. It is good value for money. It is more cost-effective than other systems worldwide. So beware the siren voices that suggest we must privatise it because we cannot afford it. The UK remains one of the wealthiest nations in the world. We can meet NHS costs by much better health promotion (see story, bottom right), which includes tackling the sugar and drug lobbies, and the addictions and illnesses that they cause. We can look at a more imaginative – and fair – system of taxation to tackle the widening inequality gap. A bad diet and inequality make us sick. We are now heading for Dickensian levels of inequality. The richest 1 per cent of our population controls 55 per cent of the country’s wealth. In 1910, Britain’s richest 1 per cent owned 70 per cent of the wealth. By 1970, this latter figure had dropped to 20 per cent. Now it is back up again.
Is Stephen right? Whether you agree or disagree with Stephen Wright, you can tell him what you think by writing to [email protected] 16 june 18 :: vol 28 no 42 :: 2014
Inequality and health are closely linked, and policies of tax and redistribution funded the NHS and better health outcomes in the late 20th century. This progress risks being reversed. Nurses experience the effects directly, in their pay packets and in job insecurity. They also see it in the worsening health of patients. States that attend to the common good, in the way that the post-war government did in Britain, can level
THE NHS IS MORE COST-EFFECTIVE THAN OTHER HEALTH SYSTEMS WORLDWIDE inequality and produce better health for all. They just need the courage to pursue policies of redistribution and stand up to the powerful, such as the sugar lobby. Perhaps we can look at tackling tax avoidance to pay for the NHS – it is currently estimated to cost the UK £130 billion a year. The NHS costs £100 billion year to run. That is not to say the NHS does not need constant transformation. It does. We are not facing up to the challenges of an ageing population, for example, and many long-term conditions, such as diabetes and depression, are being treated with high-tech interventions that have limited impact. More imaginative programmes that seek to address these problems, such as the WEL programme in Glasgow, are now thankfully gaining attention. They arise not from constant reorganisation, privatisation and competition, but from collaboration and integration.
MIDWIFERY AND MEDICINE NEED TO DO SOME TALKING
Giving birth has become so medicalised that only 2 per cent of UK births take place at home each year. In revised guidance, the National Institute for Health and Care Excellence (NICE) has suggested that more midwives should have greater scope for home births and there should be more midwife-led units. The Royal College of Midwives and parenting charity the National Childbirth Trust are supportive. The Royal College of Obstetricians and Gynaecologists warned of the need to ensure transport to hospital is available in the event of complications. The revised NICE guidance comes at a time when the long-standing tension and rivalry between medicine and midwifery over their approaches to childbirth persists. Perhaps the guidance needs to be backed by a deeper conversation and collaborative support between the two professions.
Why keep us well if illness is big business? An article on statins in the British Medical Journal last month revealed that 7 million people in the UK are taking them. What a figure – and yet another example of the how pill-popping has become the standard response to lifestyle-related illnesses. No wonder two of the biggest drugs companies – Pfizer and AstraZeneca – got into an almighty multibillion dollar takeover spat last month. The causes of health problems remain largely unchallenged by a government in hock to drug, food and tobacco industries. Why tackle the causes of ill health when there is so much money to be made from sickness?
NURSING STANDARD
Downloaded from RCNi.com by ${individualUser.displayName} on Jul 03, 2016. For personal use only. No other uses without permission. Copyright © 2016 RCNi Ltd. All rights reserved.
