No, “ridiculous waste” is not to blame for the NHS crisis

Just because a top surgeon points out a systemic problem doesn’t mean the funding’s fine.

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Great news on the Telegraph’s front page this morning! Apparently, the NHS can be improved “without spending a penny more”. Yes, our health service is in crisis because of waste, not lack of resources.

And you don’t have to take the paper’s word for it – this is the analysis of a top medic: Professor Keith Willett, NHS England’s acute care director.

Professor Willett’s piece, which the Telegraph’s splash is based on, is a specific and level-headed entreaty to “the surgical community” to coordinate with managers and colleagues to try and avoid a lack of beds for patients post-surgery.

This leads to delayed operations, and a waste of time and resources – and surgeons can play their part to try and ease the problem, he reasonably argues.

“To have highly skilled surgeons, anaesthetists and nurses sitting around waiting for patients is clearly a ridiculous waste of resource,” he writes.

Tackling the bed-blocking problem, he suggests, “will take a rearrangement of time and resource but nothing extra – except the willingness and time to think it through with colleagues”.

That “nothing extra” is music to the ears of anyone who wants an argument against spending more on the NHS. But it rings rather hollow when even the Health Secretary Jeremy Hunt,  whose tight-fisted approach is loathed by doctors, is pushing for billions more in funding.

Hunt wants the health budget to rise by 3 per cent, while the NHS chief executive Simon Stevens – who has spoken out about its funding problem, warning that cancer treatment targets will be missed – is urging the Chancellor to boost it by 4 per cent.

And you can see why. The Telegraph’s Panglossian message that doctors basically need to talk more and waste less time comes in the same week that the NHS’s deficit is revealed. Sources close to the service’s financial regulator told the Guardian that hospitals in England ended last year with twice as much overspending as forecasted. We find out the exact figures on Thursday.

The winter crisis in 2017/18 was acknowledged as the “worst ever” by Hunt, with official figures confirming that A&E waiting times were at their highest level on record, and over a thousand patients were left waiting on trolleys for a bed longer than 12 hours. Tens of thousands had their surgery cancelled, including urgent operations and cancer procedures.

A survey by the Society for Acute Medicine found that 75 per cent of acute medicine doctors felt their hospitals were not properly prepared for the winter.

Not that we need figures to measure the NHS crisis. Anyone working, or being treated, in an NHS hospital over the past few years knows that the service is stretched to its limit.

And equally, anyone in need of social care, or who works in local government, will tell you how under-funded that system is.

As Professor Willett points out in his piece, “patients who need simple after care” are unable to be discharged, or end up re-attending hospital, because local providers cannot follow up their care. This is a result of funding cuts, limiting the amount that councils can do for their ageing residents, their chronically ill and those suffering from mental ill health.

No matter how integrated health and social care become, those services cannot help a patient if they haven’t got the resources to do so. And Professor Willett’s pragmatic advice to his fellow surgeons shouldn’t be used by ideologues to obscure that reality.

Anoosh Chakelian is senior writer at the New Statesman.