NHS under pressure as winter crisis looms

NHS wars: Nicknamed ‘Death Star’, Glasgow’s new super hospital has already faced controversy.

It is a ‘perfect storm’; it is a ‘national treasure’. It faces ‘the worst financial crisis in a generation’; it is ‘the closest thing the English have to a religion’. Can the NHS be saved?

Blood tests. Physiotherapy. Setting broken bones. All of these services are free in the UK. But a new government scheme hopes to save the NHS £500m a year by charging non-EU patients for care from GPs, paramedics or A&E.

Health Secretary Jeremy Hunt says it will help to ensure that everyone makes a ‘fair contribution’. But Nigel Mathers of the Royal College of GPs warned it would contradict the NHS’s founding principle that healthcare is ‘free at the point of need’. It is ‘imperative’ that GPs are not forced to act as ‘immigration control,’ he added.

And yet, something must be done. As temperatures drop and patient numbers rise, think tanks said last month that a ‘winter crisis’ was ‘inevitable’.

The NHS was founded in 1948, amid a wave of post-war ambition. Before the war, hospitals had been run by charities and local councils. But Labour’s new health minister Aneurin Bevan dreamt of uniting them into a single government service. Care would be free of charge, available for everyone, and entirely funded by taxes. On 5 July 1948, when 13-year-old Sylvia Beckingham was admitted to a hospital with a liver condition, she became the first patient of Britain’s new National Health Service.

But over 60 years have passed, and the patients it treats look very different. Medical advances have eradicated many of the diseases that used to be fatal. Access to better healthcare means that people live longer; the average age of hospital patients is now over 80. More than 70% of the NHS budget is spent on people with long-term conditions like dementia, heart disease, cancer or depression. By the end of the year, the NHS will have overspent by £2bn (almost 2%).

‘The NHS is facing a funding crisis the likes of which we have never seen,’ said the British Medical Association’s Dr Ian Wilson earlier this year.

Doctor, doctor

The NHS has reached its limit, many say. It is time to start thinking about some radical changes. That could mean shifting its focus to prevention rather than cure, as suggested by NICE chairman David Haslam. It could mean introducing an ‘army of volunteers’ to care for vulnerable older people, as suggested by Thomas Hughes-Hallett, Chairman of the Chelsea and Westminster Hospital NHS Foundation Trust. Or, as today’s new consultation suggests, it could mean charging for some of the services which have been free for over half a century.

But some things are more important than money, others insist. The NHS may be expensive, but it is one of the UK’s best-loved institutions — a poll last year found that 52% of people said it was the thing which made them ‘most proud’ to be British. The government must keep finding the money to pay for it, no matter what.

You Decide

  1. The NHS has been called ‘one of the greatest achievements of civilisation’. Do you agree?
  2. Is it time for radical changes to the NHS?


  1. Some people think that the NHS should focus more on preventing conditions which could be avoided through ‘lifestyle’ changes, such as diet and exercise. Design a poster which offers some advice on how to stay healthy.
  2. Choose one of the solutions proposed in the second-to-last paragraph of this article. Split the class into two, and debate its pros and cons.

Some People Say...

“The NHS is a business like any other.”

What do you think?

Q & A

Isn’t the NHS always in crisis?
Sometimes it does feel as though we’ve heard these warnings before — but that doesn’t make them less real, and the long-term nature of the NHS’s problems only makes them harder to solve. But remember, we are not just talking about statistics here. The medical troubles of the ‘ageing population’ could include your grandparents or neighbours. And even if you’re healthy now, one day these doctors might save your life — or maybe you will even become one.
Is this winter going to be worse than last year?
Last year, many patients suffered long waiting times, cancelled operations and ambulance delays — some called the crisis the ‘worst ever’ for the NHS. This year, doctors have warned that many of the problems remain, and that the consequences may well be worse.

Word Watch

Non-EU patients
These patients are already asked to pay a ‘health surcharge’ when they apply to live in the UK for more than six months. Refugees and asylum seekers would be exempt from the rules.
Winter crisis
Icy roads and an increased risk of colds, flu and pneumonia all mean that there is more pressure on hospitals and GPs during the winter months. Over the last few years, tight budgets mean that doctors and nurses have struggled to keep up.
Aneurin Bevan
Often known as Nye Bevan, the Labour politician served as health minister from 1945 to 1951. Bevan once said the NHS would survive ‘as long as there are folk left with the faith to fight for it’.
Over 80
From a study by English health charity The King’s Fund, March 2012.
In January 2014, Dr Martin McShane — England’s national director for people with long-term conditions — said that £77bn of the NHS’s £110bn budget was spent on these conditions, as well as £10.9bn of the £15.5bn spent on social care.
From data by Monitor and the NHS Trust Development Authority, the two organisations which oversee NHS trusts.

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