UK Government Finances And The NHS

Channel 4's Dispatches programme last night gave some insights into the pressures facing nurses and doctors in severely short-staffed hospitals that have even more cuts to look forward to.  Some parts were very tough to watch: one elderly lady dreaded eating because the nurse feeding her was so rushed off her feet that she made her swallow faster than she could handle, hurting her in the process; another wet herself several times before someone could attend to her.  The key problem was that there simply weren't enough health professionals to handle the volume of patients. 

The reality we face is that UK Government debt has shot up sharply since 2007, when the credit crunch hit.  The Maastricht Treaty, which was signed in 1992 and was one of the key milestones in forming a single monetary union in the EU set the ideal level of national-debt-to-GDP as less than or equal to 60% and an optimal deficit-to-GDP ratio of 3% or under.  Gordon Brown went further and set in place a self-imposed limit of debt:GDP of 40%, the so-called "Golden Rule".  All these rules have since been blown out the water.  

The deficit to GDP ratio stands at 10.2% (Office of National Statistics, ONS, website) and debt to GDP is just shy of 80% according to the ONS or in the region of 150% using Timetric's methodology (graph below)!  If Britain's financial position is not brought under control we could face a ratings downgraded, thereby increasing our cost of funding (amongst many things) and making an already bad situation a lot, lot worse.

I will not opine on where the cuts should come from but one observation from the Dispatchesdocumentary that struck a chord with me is the limited amount of family involvement that I saw.  If we cannot avoid the pending cuts to the NHS, could family be more involved so as to alleviate the current pressures on health staff?

I will use my own country as an example.  In Malawi, the hospitals are not only full of patients but also carers.  Nurses and doctors are primarily involved in diagnosing, prescribing and monitoring patients and a member of the family takes care of feeding, bathing and minute-by-minute care for the patient.  Whenever someone has to go to hospital one of the first questions asked is, "who will be there with them?"  Family will even sleep at the hospital, under the bed or on a chair to ensure someone is always waiting on the patient.

Of course, many in Britain cannot afford to have a relative to hand 24/7 but I think there could be a part  solution within the Malawi model.  Perhaps, a template could be drawn up outlining all the ways in which family could get involved with patient care, ways that would not get in the way of nurse and doctors, then on a case-by-case basis doctors and nurses can determine what services relatives will take care of versus what the doctors/nurses will do.  This information can form part of the notes kept for the patient.  Currently, the duty to ensure patients are fed and bathed falls on nurses and other hospital staff but this is not really a task that one has to qualify for, if close family (and even friends) can commit time they could take care of such things.

The problem we would likely come up against is that a) "health and safety" (don't even get me started on that one) and b) no one wants to make such a commitment, most people claim not to have even enough time for themselves let alone time to help out with sick relatives and friends.  Perhaps it's time to take stock of how individualistic society has become and roll back.