When America Gets a Cold...  
  

Kerry Stott  II 17 JAN 2017


  
With the truly terrifying and rapid changes to health care policy in the USA before Trump has even been sworn into office, the Affordable Care Act (also known as Obamacare) is being dismantled; the world is looking on with horror at one of the world’s largest developed countries stripping away its healthcare for the nation, with figures suggesting that somewhere between 20 and 52 million people will be left without affordable health insurance.1 Is Britain being viewed by the world in the same way?

More and more rhetoric is being spewed from 10 Downing Street. Junior doctors have been vilified and made out to be political radicals, and ‘lazy’ GP’s have recently been ‘ordered’ to work 12 hours per day for 7 days a week in an attempt to alleviate the pressure on A&E departments.2 Breaches of the 4 hours waiting time limit in A&E is down to 82.3% - an all-time low since targets began in 2004 - and patients are being treated on trollies in corridors: a ‘humanitarian crisis’ according to the British Red Cross. 3 This political mud-slinging from all sides leaves patients wondering what is going on, but what is very clear is that the NHS is under pressure and the cracks are beginning to show. The Government repeatedly states that there is more money being spent within the NHS, but the fault lies with doctors and managers, who are simply not doing enough.

However, there are many trusts in the UK who have repayment for PFI, the private finance initiative that was set up in the 1990’s to allow new hospitals to be built by private companies and repaid by the trusts. This allowed the Government to reduce public spending at the time whilst increasing the quality of the environment that people were being treated in. However, by the end of the last financial year, 104 trusts within the UK were having to repay a total of £1.9 billion 4.

Furthermore, there is a public perception that the NHS is a national service. However, from a business perspective, it is lots of different companies with the same branding, similar to buying a franchise such as Pizza Hut. These companies get the branding and the marketing, but unfortunately they also get the debt; any business that starts off with a weighty debt around its neck is going to struggle to stay afloat, and in turn will seek to implement efficiency savings and sweat its assets. Unfortunately, in the case of the NHS, its biggest assets are its people, with the wages of health care professionals have an increase of just 1%.People can only be ‘sweated’ for so long before they become burnt out and leave, or worse.6

This begs the following questions: how is the NHS perceived by the rest of the world? Are we still a shining beacon of clinical excellence and the envy of all? Are we looked upon as the lovable but aging aunt or uncle that people love to have around but only for a short time? Are people outside the UK seeing the asset stripping of the NHS just like they are in America?

Any opinions above are the author's alone. Guidance is based on the best available evidence at the time of writing.  All data is based on externally validated studies unless expressed otherwise. Novel data is representative of sample surveyed. Online recommendation is no substitute for seeing your own doctor and should not be taken as medical advice.

References
Jacobson, L. (2017). What would the impact be if the Affordable Care Act is repealed? Politifact.com. Accessed 16/01/2017 [http://www.politifact.com/truth-o-meter/article/2017/jan/05/what-would-be-impact-if-affordable-care-act-repeal/]
 
Dominiczak, P. and Donnelly, L. (2017). Theresa May to tell GP surgeries to give patients appointments when they want them or face funding cuts. The Telegraph. Accessed 16/01/2017 [http://www.telegraph.co.uk/news/2017/01/13/theresa-may-tell-gp-surgeries-give-patients-appointments-want/]
 
BBC. (2017). NHS England chief contradicts May over spending. Bbc.co.uk Accessed 16/01/2016 [http://www.bbc.co.uk/news/uk-politics-38582285]
 
Mendick, R., Donnelly, L., and Kirk, A. (2015) The PFI hospitals costing the NHS £2bn every year. Telegraph. Accessed 16/01/2017 [http://www.telegraph.co.uk/news/nhs/11748960/The-PFI-hospitals-costing-NHS-2bn-every-year.html]
 
Department of Health (2016). NHS Staff to receive a 1% pay rise. Accessed 16.01.2017 [https://www.gov.uk/government/news/nhs-staff-to-receive-1-pay-rise]
 
The Guardian. (2016). Views from the NHS frontline. Accessed 16/01/2017 [https://www.theguardian.com/healthcare-network/views-from-the-nhs-frontline/2016/jan/05/doctor-suicide-hospital-nhs]