Great Britain : what does the future hold for the NHS?

Julette Perrot, translated by Joanna Davies
24 Février 2015

The National Health Service (NHS) saw some difficult moments during the festive period at the end of last year. We take a look at the malfunction of the public health system in Britain.

Crédit DR
Crédit DR
At the end of December and the beginning of January, numerous incidents took place in the British emergency services. Interminable waiting times, cancelled operations and a lack of beds gave rhythm to the everyday lives of the health workers. Around 21 000 people waited for more than 12 hours on stretchers before being seen to. A veritable atmosphere of chaos reigned in A & E (accident and emergency), with some patients vomiting in the waiting room and others not daring to enter for fear of contracting an infection. Faced with this situation, doctors and nurses showed their distress; they notably denounced the pressure weighing down on their shoulders, with the patients and their cases to be treated being very different from each other. It is therefore difficult to manage everything at the same time. During the festive period, calls were made in many of the emergency services to the doctors and nurses on their time off. Certain hospitals went as far as to use social networks such as twitter to mobilise the maximum number of members of the nursing staff. 

How can this dysfunction be explained?

In Great Britain, the emergency services and the hospitals are not overflowing solely during the festive periods. The country faces a genuine public health problem, largely linked to the ageing population. The elderly are in fact the most susceptible to falling ill, to needing care and intensive medical monitoring. They also constitute the majority of the ‘bedblockers’, the name given to patients who stay in the hospital and therefore block the beds when they could return home. They generally need regular monitoring and generous care several times a day, and it’s therefore more advantageous to keep them on site. As for specialised establishments, they are oversubscribed and therefore very few patients are sent to them. Today around 10 % of the beds are thus ‘blocked’ in British hospitals, a phenomenon that is getting worse owing to the budget cuts which have taken place in the country and which reduce the possibility for the patients to take care of themselves at home. 
Crédit The Guardian
Crédit The Guardian

Beyond the problem of an ageing population

Going directly to see a doctor is a step that the sick are taking less and less, and this is because of the waiting times necessary to obtain an appointment. Many people therefore go straight to A&E, which has led many hospitals to mobilise doctors from the entrance doors so that they can perform an initial screening of the patients. Some specialists also explain that we are more and more inclined to go see a doctor for the slightest pain, without it always being justified. Everyone finally agrees on the fact that one of the major reasons that the public health system is dysfunctional is linked to the way in which it is organised. 

Of the million people who dial the NHS emergency number (111) every month, 17% lead to an ambulance being sent out or are informed that they should go to A&E. This important figure- disproportionate to what it should be in reality- is explained by the fact that the employees who answer the telephone follow a guide that indicates precisely what to do depending on the declared symptoms, sometimes in spite of common sense. Employees of the NHS information service are in fact in no way linked to the medical world and follow a training programme of only a few weeks before taking up their positions. In the era of the old information service, NHS Direct, nurses were in charge of answering the telephone. NHS 111 seems, however, to have been put in place for economic reasons as employees without training are paid less than the nurses were. Among the patients, there are complaints of calls which remain unanswered, waiting times and a continued struggle to obtain the correct information. 

As for the employees, they denounce a job that is frustrating and far from being always efficient. In the absence of real medical knowledge, an ambulance can thus be sent to a patient experiencing chest pains, when it’s possible that in reality he is suffering only from muscle pains or heartburn; a diagnosis that a nurse would have had little difficulty in establishing by posing the correct questions by phone. 

Presenting innumerable weaknesses and dysfunctions, the British public health system is today on the point of implosion. Patients, doctors, nurses and employees of the NHS all agree on the fact that changes are necessary. It remains to be seen if this will influence the different British political parties, as the general elections will take place in the country this year.

Still, the surprisingly modern works of Seneca, Epictetus or Marcus Aurelius are a perfect extension of this article for those who are the most interested in stoicism.