On Wednesday Budget must deliver for our broken NHS
STAND by for some bad news tomorrow that will impact on your family finances. How do we know that’s what is coming, in advance of the Chancellor’s financial statement? It’s because he and the Prime Minister have been softening us up for the past couple of weeks for a painful budget statement. It has been the political equivalent of the garage mechanic who opens the bonnet of your old banger and does a swift intake of breath, followed by a worried shake of the head. You know it’s going to be costly.
The question we most want answered, however, is not so much how much, but will it be worth it? And in one area in particular we desperately need to see a decent return on the investment we are going to be asked to make in the form of higher taxes.
There is much talk at the moment of a crisis in the NHS. But, in truth, we don’t have a crisis in the NHS – we have a crisis in social care. A report this week revealed the shocking truth that one in every three patients in hospital at the moment is well enough to be discharged.
They continue to occupy a precious NHS hospital bed, however, because there is no social care provision and no one in their family to care for them.
In the past few weeks I must have spoken to half a dozen people with recent experience of hospitals (it must be my age). None of them had a positive story to tell. Delays measured in days, not hours, waiting for a bed were commonplace. Ambulances that took hours – in some cases many, many hours – to turn up. Overstretched services, stressed out staff... it has been alarming to hear. My elderly parents are, thankfully and touching wood, both still independent and living in their own home. I despair, however, of the time – which is bound to come – when they need to go to hospital in an emergency. It is no surprise that those who can afford to are turning to private medical services in the event they need treatment fast.
However, like so many issues we are facing at the moment, cataloguing the scale of the problem is easy – finding solutions is much more difficult. Hints emerged yesterday that
Chancellor Jeremy Hunt is looking at giving local councils more power to hike council tax so the money can be used to bolster their social care services.
That sounds like a reasonable idea – but the promise of cash from the Department of Health and Social Care to speed up the discharge of hospital patients, pledged three prime ministers ago by Boris Johnson, has yet to materialise. £500 million was promised as far back as September. None of it has so far been allocated, according to a report in The Guardian.
A spokesman told the newspaper: “The NHS discharge taskforce has been working directly with the NHS trusts facing the greatest discharge delays to ensure best practice is being implemented.” But phrases like “best practice” are meaningless if there are essentially no facilities that can take in the elderly and infirm, who no longer need hospital treatment, but must have care.
In the descriptive phrase of one commentator, our hospitals have become lobster pots – easy to get into, hard to get out of. Anyone with a serious health condition in need of treatment might argue with the “easy to get into” bit – but the point is a fair one. Once you have got across the threshold and are in a bed, you might, if you have nowhere to go for care, find it difficult to leave.
It is not even as if those essentially trapped in hospital are getting the care they need. Medical staff are trained to get people treated, make them better and move them on. Anyone left in a hospital bed for longer than necessary is at risk of a number of conditions – from declining mental health to a loss of muscle tone and bone density.
If Jeremy Hunt is as honest with his budget as he has been with his warnings, we need to hear – in the specific area of easing the pressure on our health service – two assurances: Yes, it’s going to cost – but, yes, it is going to work. Tomorrow’s statement will be a double-edged sword of public spending cuts and higher taxes. But the cuts cannot – must not – come in health and social care. Mr Hunt’s job isn’t just about mollifying the money markets. It’s about tackling an urgent crisis, too.
‘Any spending cuts cannot – must not – come in health and social care’