Fiona Wallace, Chair-Elect of the ICS Trainee Committee

ICU is under attack, warns Fiona Wallace.  In fact, the whole NHS is under attack.  And the biggest threat couldn’t be clearer: massive underfunding relative to need.

Emergency departments are reporting longer summer waiting times than any winter since 2004,with the exception of last winter.  Social care is in crisis, inpatient beds have been reduced yet demand continues to grow.  The result?  Hospital gridlock.  We have delayed discharges due to lack of timely availability of ward beds and have had to cancel patients on the day of major elective, including cancer surgery, because of lack of critical care beds.  Understaffing means the borderline patient, who I might previously have kept under review on the ward, really needs to come to critical care.

Pay freezes, the bitter junior doctors’ contract dispute and difficult working conditions created by the funding crisis have taken their toll on staff morale.  Critical care colleagues are leaving for more appealing climes, and I very much doubt that Jeremy Hunt’s pledge to mandate graduating medical students to serve four years in the NHS will succeed in reversing the inevitable flow.

The government’s continued insistence that NHS funding is really increasing may mislead the public temporarily but is entirely unconvincing to those of us at the coalface.  Attempts to distract from the funding crisis by stoking xenophobia, for example by supporting one London Trust’s proposal to check identification of women presenting for antenatal care, shame us all.

Depressingly, the narrative that the NHS is unaffordable seems to be gaining ground.  We must counter this rhetoric.  The NHS is not perfect, and of course needs to continue to evolve to meet the changing needs of our patients.  But international comparisons demonstrate relative efficiency and, while we spend significantly less than the EU average, we provide universal healthcare on the basis of need rather than the ability to pay.

We need some honesty.  There won’t be £22 billion in ‘efficiency’ savings.  The pledged extra £10 billion is not really an extra £10 billion.  If we are to maintain standards of care for our patients we need hard cash and quite a lot of it.  It is pretty obvious now that the £350 million we aren’t sending to the EU each week will not be used to fund the NHS.  To paraphrase the occasional political commentator Kevin Bridges “I don’t want to live in a world where you can’t even trust what’s written on the side of a bus…”.


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