The NHS in England is a hugely complex area and there’s now a need for a grown-up, truthful discussion about how we move forward here in Greater Manchester. I think we may have to conclude that, in the next five years, the NHS will become economically unfeasible in its current form.
The problems we face are many, but here are just a few of the major ones.
As medicines and operating techniques become increasingly advanced, the inevitable result is more treatments coming under the NHS umbrella. For example, hip replacements have become a significant budgetary cost over the last 20 years. The number of operations carried out is rising year on year – to the tune of £10,000 per hip.
2. Ageing population
The NHS is focused on prolonging life. As people live longer, the drain on resources will grow.
3. Doctors and nurses
Supply and demand means remuneration and rewards are higher in the private sector. As a result, more talent is moving into private hands, despite having trained in the NHS.
4. Growing population
It’s likely that our city will grow in numbers by up to half a million over the next 20 years or so, if economic growth takes off as predicted here in Manchester. This means more people will demand more NHS services.
5. Economies and diseconomies of scale
This is the key question on the administration side. Would a single Greater Manchester Trust, with each hospital specialising in certain areas, work better than the current situation of duplication?
I don’t know the answer to any of these problems, so I only have two policies to offer here.
1. Depoliticisation of the NHS
Every time politicians meddle in the NHS, they get it wrong. The constant changing of systems and organisational structures is causing increased job insecurity and confusion around the task in hand.
We therefore need to stand back, take stock and organise a 20-year plan that focuses on keeping the population healthy, but doesn’t shy away from difficult, long term stability questions. By taking the NHS out of the of the political sphere and handing its management over to the clinicians (who are, after all, the experts), we stand a chance of long term success.
2. Individual responsibility
This is where our schools come in to create a culture of good health, fitness and diet. Too many people are falling ill – and draining NHS finances – because of poor lifestyle choices or not looking after themselves properly. Better health education could lead to huge cost savings. Prevention rather than cure is always the best way to proceed, and a fitter population will always consume fewer health resources.