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February, 2018 >>

Humanitarian crisis in the National Health Service of United Kingdom

Shabih Zaidi  ( Private Practitioner, London )

Abstract

Red Cross is a globally respected non-governmental organisation (NGO). It has stood the test of time in peace as in wars. It may be called the Red crescent in some nations or Red Cross in others, but its role remains the same. It identifies human disasters and rushes to rescue the mankind from such catastrophes. So early in January 2017, when the British public was warned by the Red Cross that the much beloved NHS is facing a 'humanitarian crisis' the whole nation shook up.1 Instant denials by the health secretary, MPs, even the prime minister, as well as multiple interviews by the competent authorities on the TV and radio inundated the media.2,3 NHS, obviously denied such charges,4 though citizens as well as the leaders of family practices and health services, all but seconded the observations made by the savants and sages. The autumn crisis brought about by junior doctors' strike against the decisions made by the government was still fresh in their memories.

So what is the truth?

Well, National Health Service was created by the Attlee's Labour government in 1948.5 In a country reeling with human disaster, calamity, disease, famine and rationing, post war Britain needed something substantial. Aneurin Bevan was the founding health secretary, a Welshman who hailed from a working-class family. The nation suffered with hunger, filth, fear and death.6 He had seen it in the coal miners of Rhonda valley rather closely. So, he embarked upon giving a national health plan to the nation. He did it; despite a strong opposition by the doctors!
Post war Britain had lost its wealth, colonies and industries. So funds were short. When the NHS was launched in 1948, it had a budget of £437 million (roughly £15 billion at today's value). For 2015/16, the overall NHS budget was around £116.4 billion. NHS England was managing £101.3 billion in April of 2016.7 The cost of health and social care is perpetually rising. Sky is the limit!
NHS is a perfect example of service to mankind based upon the egalitarian principles of equity and fair play. The service is given to one and all based on who needs it rather than who can afford it. It is a perfect example of distributive justice as people are given their dues as their rights.
NHS was introduced to treat the sick. In the post war Britain TB, Malaria, Dysentery, infectious diseases, so widespread in many parts of the developing nations, even in the first quarter of the 21st century, were prevalent. Many people succumbed to them.

Those killers are now totally eradicated. Now a days people do not die of infectious diseases but trauma, coronary artery disease, and cancer, which may in some cases be declared a chronic disease. Many more are now living with chronic illnesses, posing a burden of financial commitments on the health providers.
Longevity of life is a blessing, but also a liability on the families and the states. Lesser number of working age population and increasing load of greying pensioners in many Western countries is arguably one of the reasons behind granting asylum to the young and healthy immigrants!
It is not a rocket science, that much damage is resulting from people consuming more sugars, tobacco, stimulating drinks, and many other harmful elements. Besides, public conveyances have made walking almost an obsolete entity; at least in the West. Physical exercise protects health. Lack of time and space are not so conducive to follow a routine. The term 'couch potato' is a commonly used term for many such people who spend all their time watching sports on TV, munching potato crisps and drinking sodas.
Obesity is a major issue in both US and UK. US is worse. Some states like Pennsylvania are notorious for hunks of human beings crawling the streets of Philly, munching large quantities of fast foods, and growing fatter by the day. Fast food may be a necessity in the West due to paucity of time or lack of family support etc, but sadly has become a symbol of affluence in the subcontinent: a practice deserving to be condemned. Obesity in children is another major issue. Asian children are no exception and their elders are either hypertensive or diabetic or both. Global Burden of Disease is perpetually rising due to affluence, abuse of wealth and power, as indeed deprivation of the rest of the world suffering with poverty, famine, hunger and death.
NHS was designed to provide medical care to the sick. Over the years, expectations have changed. Winter months are always harsh on the elderly. So just as the first snow fall hits these lands, the older folks hit the A & E departments with cold, cough, chest infections etc. In the first week of January this year, although the temperature had not fallen exceedingly below zero, the A & E departments became flooded with the elderly. Usually the week between 9-13 January is the busiest time for the A & E in England and Wales.
The ambulance service in the UK is next to none, but they simply could not cope with the rush of calls. The excessive demand resulted in a couple of tragedies. The British Red Cross was called to assist. The media, as always, exploited the situation showing queues of elderly waiting on trolleys to be accommodated in the hospital beds. Some reportedly stayed in the trolleys for over 24 hours.
Shortage of hospital beds is always an issue; particularly in the winter months.
The British as indeed most of the Western societies have moved away from larger family units to single or nuclear family setup, so no family support is available to many elderly, when they need it most. The fact of the matter is that the demand for health and social care is changing every day and the competent authorities are engaging with the issues, albeit slowly .
The major difference in the texture between the Eastern and the Western societies is known to all. The former is like a well knitted tapestry; each fibre neatly warped, knitted and intertwined with the next one, called tana bana. So in an hour of need many family members would come forward to share the burden of responsibility. Same cannot be said for the Western society, although there are exceptions.
Just like other services, even the social services are struggling due to shortage of funds. The financial crisis faced by the NHS and its allied services is brought about by the rising costs of personnel and services, energy and oil prices, technological advancements, research and development, and a larger force of manpower to cater to the needs of the people.7
Rising costs and falling resources has also resulted in rationing of service: an ethical dilemma in its own right.
So ,all in all it is a picture of gloom. Unless the government can find funding up to a tune of several billion in a few years, to develop appropriate health and social care models to match the changing demographic and society needs, the NHS may succumb to profiteers. They are ready to privatize the health services aka the neighbours across the pond. And that would be a disaster.

References

1.  NHS faces 'humanitarian crisis' as demand rises, British Red Cross warns. The Guardian 2017 Feb 6.
2.  Red Cross description of NHS 'irresponsible and overblown', says PM. Jan 11, 2017 - The Telegraph. [Online] [Cited 2017 Jan 7]. Available from: URL:  https://www.theguardian.com › Society › NHS.
3.  NHS denies Red Cross claims there is a 'humanitarian crisis' in UK. [Online] [Cited 2017 Jan 7]. Available from URL: www.telegraph.co.uk ›News.  
4.  NHS rejects claims of 'humanitarian crisis' in England's hospitals. [Online] [Cited 2017 Jan 7]. Available from URL: www.bbc.com/news/ health-385386375.
5.  Why was the NHS created in 1948. [Online] [Cited 2017 Aug 5]. Available from URL: //www.nursingtimes.net/the-birth-of-the-nhs-july-5th-1948/441954.article 
6.  Newstatesman Life before the NHS: hunger, filth, fear, death - Public Reading Rooms. [Online] [Cited 2017 Feb 27]. Available from URL: www.newstatesman.com/politics/.../hunger-filth-fear-and-death-remembering-life-nhs.
7.  About the National Health Service (NHS) in England - NHS Choices. [Online] [Cited 2017 Feb 27]. Available from URL: www.nhs.uk/NHSEngland/thenhs/about/Pages/overview.aspx


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