NHS March: Government must stop burying its head in the sand and save our NHS

Thousands of people will march through central London on Saturday in defence of the NHS. Ministers must listen and get to grips with pressures undermining the health service, warns junior doctor committee chair and GP trainee Dr Jeeves Wijesuriya.

Dr Jeeves Wijesuriya
Dr Jeeves Wijesuriya

This Saturday a wide range of NHS organisations, patients groups and members of the public will join together for a national day of action in London to draw attention to the critical crisis facing the NHS – and it’s time politicians finally listened to their voices.

There is little doubt that our health service is at a crossroads. Thanks to the hard work of GPs, hospital doctors, nurses and other healthcare professionals the NHS is still delivering an outstanding level of care that is the envy of the world.

But it is steadily and corrosively buckling under enormous pressures. Many of these are down to the strong currents of demographic change where we are, like many Western nations, having to cope with a rapidly ageing population.

NHS crisis

There are now 11.6m people over 65 and by 2040 one in four of the population will be in this age group. With this shift there comes a greater demand, especially on general practice, for time-consuming, intensive treatments and consultations from multiple staff for a greater number of patients.

In a few years we will have 1m older people suffering from dementia, while a decade-long increase will see by next year 2.9m suffering from multiple long-term conditions. These are frightening statistics that I am already seeing the reality of as a trainee GP, where more and more of my time is taken up with the workload that inevitably results from this huge change in our society.

But while these forces are uncontrollable, the reaction of the government is not. And so far it is failing to get to grips with the current and future pressures undermining the NHS.

We are told that the NHS is being fully funded – this is a fallacy, as our health service in reality is on the receiving end of a £26bn package of cuts due to political decisions by this and previous governments. Adult and social care is in a parlous state with local councils - on the end of huge reductions in their budgets - being asked with GPs to provide critical services to the most vulnerable residents with no additional help beyond an option to raise council tax by a small amount.

Sustainability plans

We have sustainability and transformation plans (STPs) that are full of impenetrable jargon, and which many fear are cover for another wave of cuts and waste - £2m has been spent on consultants on one London plan for example. And these core issues sit alongside a general workforce crisis. GPs in particular are retiring early and few medical graduates are choosing general practice as a career option.

Who would want to when 300 GP practices are facing closure and 90% of GPs believe unmanageable workload is affecting patient safety? The debacle over the junior doctor contract and sniping from Number 10 at GPs has hardly been a recipe for a motivated workforce.

It is clear that the NHS cannot continue this way. The pressures from an ageing population will only intensify, but the government seems intent on burying its head in the sand. What we need is a proper, open conversation about funding with the public and a commitment to extra resources urgently to cope with this imminent threat to the foundations of the NHS.

But it goes beyond pure financing, we also need a clear strategy for reform: better integration of health services to make them more efficient, an end to wasteful spending on external management consultants and for us to pursue a proper self-care approach that enables patients to be clear where and when it is appropriate to access healthcare.

This protest on Saturday is not just the culmination of frustration; it is also an opportunity for ministers to plot a new course for our health service. And the NHS cannot wait a moment longer for an urgent and radical change of direction to save it from a future of interminable decline.

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