How to cure the crisis in the NHS

There have been warnings that the NHS is facing its worst winter ever, thanks to a combination of a particularly virulent flu virus, a sudden drop in temperature, chronic staff shortages and under-investment.

Some predict this could even be the tipping point for the NHS finally to keel over — and part of me wishes it would, because as someone who works on the front line, I know that it really can’t keep on like this.

In a desperate attempt to make resources stretch, we keep cutting services further and further, with the result that now, if I’m honest, the care we provide is all too often not adequate.

It pains me to say this because I am a great advocate of the NHS. All the evidence shows it’s the fairest, most efficient and cost- effective way of delivering healthcare. Of course it could be better, but overall it’s pretty good.

Yet years of political meddling and under-investment have weakened it, and rather than see it limping and stumbling along, mortally wounded, I wish the inevitable end would come. Then we would have no choice but to have a serious, sensible, national discussion about what we want our health service to look like, how we want it run and how much we’re willing to pay for it.

Until it collapses, no politician is going to tackle the subject because no one wants to court controversy. They’ll just keep on talking about improvement and efficiency, occasionally throwing some money in the vague direction of front-line services.

They’ll continue dodging the vital questions we should be debating now to enable us to plan things, rather than adopting crisis management when the crunch comes. The politicians know this is only a matter of time: they’re just hoping it doesn’t die on their watch.

The fact is that health and social care is expensive.

earlier this year, the Office for Budget responsibility warned that the NHS annual budget would need to increase by £88 billion to about £228 billion by 2066-67, in order to keep pace with the rising demand for healthcare. So what do we do? We need an independent review of the NHS which hears from all those involved — politicians, staff and members of the public.

The ideal forum would be a royal Commission, as this is both independent of government and powerful. Such a review will require a considerable amount of debate and soul-searching. But without it, the NHS will flatline.