Can we afford the NHS?

The cost of healthcare increases every year. ‘NHS Inflation’ means that the cost of providing healthcare increases more than normal inflation; if spending just keeps pace with inflation, it is not enough to maintain services. So how can that be, and why is NHS spending going up much faster than inflation?

Let me illustrate this with a personal story.

Arthur Brunskill, 1911-1979.

In May 1979, as I was about to enter my final year at Medical School, my father Arthur Brunskill died suddenly of a heart attack aged just 68. He didn’t know it, but he almost certainly had an inherited form of heart disease called hypertrophic cardiomyopathy (HCM). This is caused by a genetic mutation, which was undiscovered in his lifetime.  In 2010 I found that I had inherited the same gene.

When my father had his first heart attack in 1977, he was treated according to the current standards and protocols - bed rest, mobilisation, aspirin and a short hospital stay. His care by the standards of the time was exemplary. Today however such management would be regarded inadequate.

If he had suffered his first a heart attack today, he would be given thrombolytic drugs – ‘clot busters’ - to dissolve the blood clot that was obstructing his coronary artery. The next step would have been to restore the blood supply to the heart by cardiac catheterisation and placing stents into his blocked coronary arteries, or possibly performing coronary bypass grafting.  None of this was available in 1977.

Clot busters are expensive, costing thousands of pounds a shot. Cardiac catheterisation and stenting is both intensive and expensive. Coronary bypass surgery which requires a large multidisciplinary team, several hours of surgery and recovery on ICU, is extremely expensive.

Once I was diagnosed with the same gene mutation for HCM, I was investigated before I had a heart attack. After two MRI scans and a cardiac catheter I was advised that I needed to have stents; when this proved impossible during a second catheterisation, I was offered coronary bypass grafts.

I had heart surgery in March 2017 almost 8 years ago.

Surgery was a success. Like many, I was impressed by, and grateful to, the hard working and committed NHS staff at Leeds General Infirmary, who were absolutely superb.

On ICU 28th March 2017, 1 day after coronary bypass surgery.

The management of coronary artery disease has changed massively in 40 years, with major and long-lasting improvements in outcomes. I have benefitted from these advances; my father on the other hand did not. He never saw me graduate, get married, and never met his grandchildren. In October 2022 I passed the age at which he had died. I feel lucky, and each generation gets luckier.

Improvements in outcomes cost money!

The NHS is paid for by all of us through our taxes. Is it worth it? For me, it’s a resounding yes as I would probably not be here otherwise. The cost to the NHS of my cardiac treatment including ongoing medication is probably tens of thousands of pounds, a price I would never have been able to afford.

The cost of the treatment my father received in 1977 was almost insignificant. But there is no point complaining about increasing costs and NHS inflation, unless you are prepared to die before your time from a preventable cause. If we want healthcare like this, we have to be prepared to pay for it.

Finally:

Many of the difficulties faced by NHS staff result from resource limitations. They are aware that they have become less able to provide the standard of care that they would like, and which is necessary. The resulting stress is difficult to handle. Healthcare workers must be supported and equipped to manage the pressures caused by demand exceeding resources. They need help to re-discover what inspired them to join the profession.

There are many experienced and qualified Coaches who work with Healthcare staff. If you think I might be able to help you to work out your own future career path and to deal with the pressures of working in the NHS, please use the link here to book a free discovery call. I will link you to someone else if I am not the right person for you.