NHS: Under-funding is main threat

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Aidan Ruff thinks that health tourism will cause the NHS to sink, (Northumberland Gazette, January 26). I believe the Government is causing that to happen on its own without the help of such tourists.

Yes, health tourism is an issue which needs to be addressed, but it is a very small problem for the health service. At the highest estimate it is less than 0.069 per cent of the total budget.

The major problem is the Government’s attitude and spending on public services. Moral panics about health tourists and other abusers of public services, particularly if they are foreign, distract from the real underlying problems.

This and the previous Government have chosen to see spending on public services as a problem – your and my money for your and my services – and that such spending should be reduced as a percentage of GDP. The UK spends 9.1 per cent of GDP on health. The EU countries’ average is 10 per cent (France 11.5 per cent, Germany 11.3 per cent); Japan spends 10.2 per cent. There is much room for improvement in the UK.

These decisions are political and ideological; they are not inevitable or necessary. Money, time and effort is wasted by NHS staff responding to repeated restructuring to fit some notion of a business model. Ministers should be dealing with the real issue of properly funding this public service.

The other Government-imposed problem is arbitrary targets. Hospitals are punished, fined thousands of pounds, for failing to meet waiting time targets. Presumably these fines come from already overspent budgets.

These ‘failures’ are caused by lack of bed spaces beyond the control of hospitals. Some hospitals outsource to private hospital beds. If private hospitals can do it, why can’t the NHS build in spare capacity?

The number of available hospital beds in England has more than halved since the late 1980s, with the decreases greater in beds for people with learning disabilities, mental illness and for longer-term care of older people. Some 4,093 operations were cancelled last year, largely due to bed shortages, particularly in intensive care or high dependency units caused by move-on bed blockage elsewhere.

In addition, cuts to local government budgets prevent adequate social care in the community.

Rather than spend time highlighting the issue of health tourists, which hospitals are addressing, we need a national debate on the proper funding of the NHS and social care. This needs to include how and where taxation is raised and used. The Government gives tax breaks and subsidies to large corporations, businesses, and landowners that do not benefit the community. Do they need these benefits?

We also need to stop the notion that paying tax and spending taxpayers’ money for the common good is bad and to be avoided. Paying tax pays for the services we want. Paying tax for the NHS is good for your health.

It is often said that the first duty of Government is to protect the population. The greatest threat to the health of the population is an underfunded health service.

The NHS is not coping or just about managing, it is sinking.

Geoff Hoskin,