Tag Archives: cuts

Long waits, cuts and rationing: happy 70th birthday NHS | Zara Aziz

Our National Health Service was founded on the principles that good healthcare should be available to all – free at the point of delivery. Seventy years on, does this still hold true? It is not uncommon for NHS trusts to run their on-call services (for their urgent work) with insufficient junior and senior staff to the point that it becomes unsafe. Many hospitals spend more than their incomes on treating the rising number of patients. GP surgeries close. Waiting times rise. Patients look for alternatives for which they have to pay, such as online providers or private hospitals.

Long waiting times are a big problem for those in physical or emotional distress. It takes around 20 weeks, if not longer, to see an NHS physiotherapist in our area – patients often have acute pain, loss of function, are off work and losing earnings. They can lose faith altogether and disengage from NHS services, or turn to private healthcare. Sometimes they pay for private physiotherapy, but then they start and stop after one or two sessions when the money runs out.

Prescribing is another area with restrictions. Doctors are told by NHS England to not prescribe low-value medications or those that can be purchased over the counter (for instance drugs for diarrhoea, constipation, eczema, hay fever, indigestion, eye symptoms and pain). The price varies from cheap, non-branded painkillers to expensive emollient for eczema. A few years ago my son, who has eczema, was going through a 500g tub of emollient every two weeks prescribed by our GP. This is now £12 or more to buy over the counter, not a small amount, with many eczema sufferers needing many tubs a year. Those who really need treatments are the ones who will suffer from lack of affordability.

Many treatments are now classified as criteria-based or needing individual funding requests (that is, not routinely funded unless a detailed application is submitted by a GP or hospital specialist with evidence such as trials/research of its benefits and especially over any other patient with the same problem). So, for instance, a patient with pain and loss of hand function from a ganglion cyst would need an individual funding request. Clinical commissioning groups have a long list of conditions that need such approval – such as varicose veins, tonsillectomies and hernia surgery. Most of my applications are rejected as almost no one (despite the level of their suffering) is deemed exceptional.

A friend has left hospital medicine, which had been her lifelong passion to pursue a non-clinical career. She described the moment when she woke up one morning not knowing why she was a doctor any more. She said there seemed to be no purpose to what she was doing. She had “perpetual anxiety, an unmanageable workload and a dawning realisation that she could not provide free and safe healthcare for her patients”.

But there is hope, too, if we can equip the NHS to deliver free and world-class healthcare, and if staff believe they make a real difference to people’s lives. And if we can continue the goodwill of those who work within it, which is what oils its wheels. Without this, as it stands now, 70 years on, the NHS will continue its sad path to disintegration and privatisation.​

Zara Aziz is a GP in inner-city Bristol

Hospitals struggling to afford new equipment after NHS budget cuts

Hospitals can no longer afford the most modern scanners and surgical equipment to treat patients who have cancer and other diseases because of multibillion-pound cuts to the NHS’s capital budget, research reveals.

Staff are having to continue using vital diagnostic and treatment technology beyond its natural life because there are insufficient funds to replace it.

For example, radiographers are using out-of-date scanners that produce images so unclear they impede correct diagnosis. In one case, 200 patients had to be rescanned because the images of their lumps, tumours and broken bones were of such poor quality.

Ambulances are breaking down because they have been kept in service for too long, and hospitals are having to continue using archaic IT systems in the wake of repeated government raids on NHS capital funding, the researchers heard. One trust had to scrap plans to bring in electronic scheduling of operations because it could not afford the technology.

Others are unable to expand their A&E units to help them cope with rising patient numbers, while some lack the money to repair rotten windows and leaking roofs in hospital buildings because of the cash squeeze.

The problems are outlined in research conducted at 30 trusts by the health services management centre at Birmingham University and funded by the Health Foundation, a thinktank.

Trust bosses told the academics the lack of money for new equipment and repairs had started to affect the quality and safety of patient care.

“The surroundings that they [patients] are actually being cared for in are appalling and we all know … that those surroundings do impact the recovery rate. So in that respect it is impacting their recovery as well,” one NHS trust finance director said.

Since 2014 Jeremy Hunt, the health and social care secretary, has taken £4.3bn from the NHS in England’s capital budget and used it to help pay for day-to-day running costs, in response to its deepening financial crisis. In 2016-17 alone he removed £1.2bn, a fifth of the entire capital budget.

“This has left the NHS between a rock and a hard place, postponing and cutting vital capital investment to fund day-to-day running costs,” said Anita Charlesworth, the Health Foundation’s director of research and economics. “It’s clear that shortfalls in NHS capital spending are starting to hurt: spending on new equipment such as medical scanners has more than halved over the last four years.”

NHS Providers, which represents NHS trusts, said the shortage of capital funding was so acute that hospitals could not afford to replace outmoded machines that deliver radiotherapy to cancer patients.

“Just in the last few days one trust leader told us of frustrating delays in funding needed to improve an emergency department. Another spoke of her worries about being able to replace linear accelerators. But as we see in this report, this is also a major problem for mental health, community and ambulance services as well,” said Phillippa Hentsch, the organisation’s head of analysis.

A separate analysis of NHS finances by the Health Foundation found that capital spending for healthcare, such as for hospitals and equipment, in the UK was low compared with other OECD countries, at 0.3% of GDP compared with an average of 0.5%.

Increasing the percentage spent in the UK to the OECD average would mean the NHS had another £3bn a year for such projects, it said.

Charlesworth said: “The maintenance backlog for hospitals is now over £5bn. Most worryingly, £2.8bn of this backlog is high or significant risk, related to clinical services and safety.” She said cutting capital spending was “a false economy” that made hospitals inefficient and prevented them from improving patient care.

One trust boss said £40m of “priority one high-risk” urgent repairs were needed in one year, but only £11m was available for them.

On Wednesday Labour will use parliamentary procedure to try to force ministers to disclose documents that reveal what elements of the Health and Social Care Act 2012 they want to scrap.

There have been reports that Theresa May is keen to repeal some sections of the legislation to help pave the way for an overhaul of how the service works, tied to a big increase in NHS funding planned to mark its 70th birthday on 5 July.

NHS cuts and privatisation have brought no benefits | Letters

GPs have taken the unprecedented step of urging patients to write to their MPs about the funding crisis in the NHS (Complain to your MPs, top doctor tells patients amid worst ever A&E figures, 9 March). This situation, and the crisis in public services that has left councils at the point of bankruptcy, did not need to happen. Many of the cuts are a false economy that do not lead to savings.

A report from Policy in Practice showed that in Croydon the benefit cap, which was supposed to save the taxpayer money, led to evictions, and it calculated the cost of just one homeless application to the council to be around £8,000.

Private finance initiatives in the NHS will cost us approximately £199bn right through to the 2040s, despite the National Audit Office confirming that in London “the costs of services, like cleaning, are higher under PFI contracts”.

I’m also fed up of not seeing my wife until late at night because another of the supposedly efficient private sector trains she gets to London fails to show up.

Austerity overall has failed – it costs lives as well as taxpayer money.
Mark Murton
Wallington, Surrey

So ministers are set to offer NHS staff a 6.5% pay rise (Report, 9 March) on condition they give up a day’s holiday in return. Pay for MPs has risen by over 15% since 2014 (without any conditions). Pay for nurses, over the same period, has risen by 3%, and public sector workers have suffered a pay freeze.

Is the government unaware of how much we owe to the dedication and hard work of NHS staff, who are working under increasingly difficult conditions, and often work extra hours with no extra pay? To require them to give up a day’s holiday is petty and mean.
Angela Crum Ewing
Reading

Now that NHS workers have been offered a long overdue rise, will we see other employers dig deep and pay decent wages in other sectors in which there are staff shortages? Isn’t it strange that the money is found as the exploited low-paid eastern Europeans vote with their feet?
Jane Ghosh
Bristol

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

NHS cuts and privatisation have brought no benefits | Letters

GPs have taken the unprecedented step of urging patients to write to their MPs about the funding crisis in the NHS (Complain to your MPs, top doctor tells patients amid worst ever A&E figures, 9 March). This situation, and the crisis in public services that has left councils at the point of bankruptcy, did not need to happen. Many of the cuts are a false economy that do not lead to savings.

A report from Policy in Practice showed that in Croydon the benefit cap, which was supposed to save the taxpayer money, led to evictions, and it calculated the cost of just one homeless application to the council to be around £8,000.

Private finance initiatives in the NHS will cost us approximately £199bn right through to the 2040s, despite the National Audit Office confirming that in London “the costs of services, like cleaning, are higher under PFI contracts”.

I’m also fed up of not seeing my wife until late at night because another of the supposedly efficient private sector trains she gets to London fails to show up.

Austerity overall has failed – it costs lives as well as taxpayer money.
Mark Murton
Wallington, Surrey

So ministers are set to offer NHS staff a 6.5% pay rise (Report, 9 March) on condition they give up a day’s holiday in return. Pay for MPs has risen by over 15% since 2014 (without any conditions). Pay for nurses, over the same period, has risen by 3%, and public sector workers have suffered a pay freeze.

Is the government unaware of how much we owe to the dedication and hard work of NHS staff, who are working under increasingly difficult conditions, and often work extra hours with no extra pay? To require them to give up a day’s holiday is petty and mean.
Angela Crum Ewing
Reading

Now that NHS workers have been offered a long overdue rise, will we see other employers dig deep and pay decent wages in other sectors in which there are staff shortages? Isn’t it strange that the money is found as the exploited low-paid eastern Europeans vote with their feet?
Jane Ghosh
Bristol

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

NHS cuts and privatisation have brought no benefits | Letters

GPs have taken the unprecedented step of urging patients to write to their MPs about the funding crisis in the NHS (Complain to your MPs, top doctor tells patients amid worst ever A&E figures, 9 March). This situation, and the crisis in public services that has left councils at the point of bankruptcy, did not need to happen. Many of the cuts are a false economy that do not lead to savings.

A report from Policy in Practice showed that in Croydon the benefit cap, which was supposed to save the taxpayer money, led to evictions, and it calculated the cost of just one homeless application to the council to be around £8,000.

Private finance initiatives in the NHS will cost us approximately £199bn right through to the 2040s, despite the National Audit Office confirming that in London “the costs of services, like cleaning, are higher under PFI contracts”.

I’m also fed up of not seeing my wife until late at night because another of the supposedly efficient private sector trains she gets to London fails to show up.

Austerity overall has failed – it costs lives as well as taxpayer money.
Mark Murton
Wallington, Surrey

So ministers are set to offer NHS staff a 6.5% pay rise (Report, 9 March) on condition they give up a day’s holiday in return. Pay for MPs has risen by over 15% since 2014 (without any conditions). Pay for nurses, over the same period, has risen by 3%, and public sector workers have suffered a pay freeze.

Is the government unaware of how much we owe to the dedication and hard work of NHS staff, who are working under increasingly difficult conditions, and often work extra hours with no extra pay? To require them to give up a day’s holiday is petty and mean.
Angela Crum Ewing
Reading

Now that NHS workers have been offered a long overdue rise, will we see other employers dig deep and pay decent wages in other sectors in which there are staff shortages? Isn’t it strange that the money is found as the exploited low-paid eastern Europeans vote with their feet?
Jane Ghosh
Bristol

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

NHS cuts and privatisation have brought no benefits | Letters

GPs have taken the unprecedented step of urging patients to write to their MPs about the funding crisis in the NHS (Complain to your MPs, top doctor tells patients amid worst ever A&E figures, 9 March). This situation, and the crisis in public services that has left councils at the point of bankruptcy, did not need to happen. Many of the cuts are a false economy that do not lead to savings.

A report from Policy in Practice showed that in Croydon the benefit cap, which was supposed to save the taxpayer money, led to evictions, and it calculated the cost of just one homeless application to the council to be around £8,000.

Private finance initiatives in the NHS will cost us approximately £199bn right through to the 2040s, despite the National Audit Office confirming that in London “the costs of services, like cleaning, are higher under PFI contracts”.

I’m also fed up of not seeing my wife until late at night because another of the supposedly efficient private sector trains she gets to London fails to show up.

Austerity overall has failed – it costs lives as well as taxpayer money.
Mark Murton
Wallington, Surrey

So ministers are set to offer NHS staff a 6.5% pay rise (Report, 9 March) on condition they give up a day’s holiday in return. Pay for MPs has risen by over 15% since 2014 (without any conditions). Pay for nurses, over the same period, has risen by 3%, and public sector workers have suffered a pay freeze.

Is the government unaware of how much we owe to the dedication and hard work of NHS staff, who are working under increasingly difficult conditions, and often work extra hours with no extra pay? To require them to give up a day’s holiday is petty and mean.
Angela Crum Ewing
Reading

Now that NHS workers have been offered a long overdue rise, will we see other employers dig deep and pay decent wages in other sectors in which there are staff shortages? Isn’t it strange that the money is found as the exploited low-paid eastern Europeans vote with their feet?
Jane Ghosh
Bristol

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

NHS cuts and privatisation have brought no benefits | Letters

GPs have taken the unprecedented step of urging patients to write to their MPs about the funding crisis in the NHS (Complain to your MPs, top doctor tells patients amid worst ever A&E figures, 9 March). This situation, and the crisis in public services that has left councils at the point of bankruptcy, did not need to happen. Many of the cuts are a false economy that do not lead to savings.

A report from Policy in Practice showed that in Croydon the benefit cap, which was supposed to save the taxpayer money, led to evictions, and it calculated the cost of just one homeless application to the council to be around £8,000.

Private finance initiatives in the NHS will cost us approximately £199bn right through to the 2040s, despite the National Audit Office confirming that in London “the costs of services, like cleaning, are higher under PFI contracts”.

I’m also fed up of not seeing my wife until late at night because another of the supposedly efficient private sector trains she gets to London fails to show up.

Austerity overall has failed – it costs lives as well as taxpayer money.
Mark Murton
Wallington, Surrey

So ministers are set to offer NHS staff a 6.5% pay rise (Report, 9 March) on condition they give up a day’s holiday in return. Pay for MPs has risen by over 15% since 2014 (without any conditions). Pay for nurses, over the same period, has risen by 3%, and public sector workers have suffered a pay freeze.

Is the government unaware of how much we owe to the dedication and hard work of NHS staff, who are working under increasingly difficult conditions, and often work extra hours with no extra pay? To require them to give up a day’s holiday is petty and mean.
Angela Crum Ewing
Reading

Now that NHS workers have been offered a long overdue rise, will we see other employers dig deep and pay decent wages in other sectors in which there are staff shortages? Isn’t it strange that the money is found as the exploited low-paid eastern Europeans vote with their feet?
Jane Ghosh
Bristol

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

NHS cuts and privatisation have brought no benefits | Letters

GPs have taken the unprecedented step of urging patients to write to their MPs about the funding crisis in the NHS (Complain to your MPs, top doctor tells patients amid worst ever A&E figures, 9 March). This situation, and the crisis in public services that has left councils at the point of bankruptcy, did not need to happen. Many of the cuts are a false economy that do not lead to savings.

A report from Policy in Practice showed that in Croydon the benefit cap, which was supposed to save the taxpayer money, led to evictions, and it calculated the cost of just one homeless application to the council to be around £8,000.

Private finance initiatives in the NHS will cost us approximately £199bn right through to the 2040s, despite the National Audit Office confirming that in London “the costs of services, like cleaning, are higher under PFI contracts”.

I’m also fed up of not seeing my wife until late at night because another of the supposedly efficient private sector trains she gets to London fails to show up.

Austerity overall has failed – it costs lives as well as taxpayer money.
Mark Murton
Wallington, Surrey

So ministers are set to offer NHS staff a 6.5% pay rise (Report, 9 March) on condition they give up a day’s holiday in return. Pay for MPs has risen by over 15% since 2014 (without any conditions). Pay for nurses, over the same period, has risen by 3%, and public sector workers have suffered a pay freeze.

Is the government unaware of how much we owe to the dedication and hard work of NHS staff, who are working under increasingly difficult conditions, and often work extra hours with no extra pay? To require them to give up a day’s holiday is petty and mean.
Angela Crum Ewing
Reading

Now that NHS workers have been offered a long overdue rise, will we see other employers dig deep and pay decent wages in other sectors in which there are staff shortages? Isn’t it strange that the money is found as the exploited low-paid eastern Europeans vote with their feet?
Jane Ghosh
Bristol

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

NHS cuts and privatisation have brought no benefits | Letters

GPs have taken the unprecedented step of urging patients to write to their MPs about the funding crisis in the NHS (Complain to your MPs, top doctor tells patients amid worst ever A&E figures, 9 March). This situation, and the crisis in public services that has left councils at the point of bankruptcy, did not need to happen. Many of the cuts are a false economy that do not lead to savings.

A report from Policy in Practice showed that in Croydon the benefit cap, which was supposed to save the taxpayer money, led to evictions, and it calculated the cost of just one homeless application to the council to be around £8,000.

Private finance initiatives in the NHS will cost us approximately £199bn right through to the 2040s, despite the National Audit Office confirming that in London “the costs of services, like cleaning, are higher under PFI contracts”.

I’m also fed up of not seeing my wife until late at night because another of the supposedly efficient private sector trains she gets to London fails to show up.

Austerity overall has failed – it costs lives as well as taxpayer money.
Mark Murton
Wallington, Surrey

So ministers are set to offer NHS staff a 6.5% pay rise (Report, 9 March) on condition they give up a day’s holiday in return. Pay for MPs has risen by over 15% since 2014 (without any conditions). Pay for nurses, over the same period, has risen by 3%, and public sector workers have suffered a pay freeze.

Is the government unaware of how much we owe to the dedication and hard work of NHS staff, who are working under increasingly difficult conditions, and often work extra hours with no extra pay? To require them to give up a day’s holiday is petty and mean.
Angela Crum Ewing
Reading

Now that NHS workers have been offered a long overdue rise, will we see other employers dig deep and pay decent wages in other sectors in which there are staff shortages? Isn’t it strange that the money is found as the exploited low-paid eastern Europeans vote with their feet?
Jane Ghosh
Bristol

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

NHS cuts and privatisation have brought no benefits | Letters

GPs have taken the unprecedented step of urging patients to write to their MPs about the funding crisis in the NHS (Complain to your MPs, top doctor tells patients amid worst ever A&E figures, 9 March). This situation, and the crisis in public services that has left councils at the point of bankruptcy, did not need to happen. Many of the cuts are a false economy that do not lead to savings.

A report from Policy in Practice showed that in Croydon the benefit cap, which was supposed to save the taxpayer money, led to evictions, and it calculated the cost of just one homeless application to the council to be around £8,000.

Private finance initiatives in the NHS will cost us approximately £199bn right through to the 2040s, despite the National Audit Office confirming that in London “the costs of services, like cleaning, are higher under PFI contracts”.

I’m also fed up of not seeing my wife until late at night because another of the supposedly efficient private sector trains she gets to London fails to show up.

Austerity overall has failed – it costs lives as well as taxpayer money.
Mark Murton
Wallington, Surrey

So ministers are set to offer NHS staff a 6.5% pay rise (Report, 9 March) on condition they give up a day’s holiday in return. Pay for MPs has risen by over 15% since 2014 (without any conditions). Pay for nurses, over the same period, has risen by 3%, and public sector workers have suffered a pay freeze.

Is the government unaware of how much we owe to the dedication and hard work of NHS staff, who are working under increasingly difficult conditions, and often work extra hours with no extra pay? To require them to give up a day’s holiday is petty and mean.
Angela Crum Ewing
Reading

Now that NHS workers have been offered a long overdue rise, will we see other employers dig deep and pay decent wages in other sectors in which there are staff shortages? Isn’t it strange that the money is found as the exploited low-paid eastern Europeans vote with their feet?
Jane Ghosh
Bristol

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters