What caused the winter crisis in the NHS?
BMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7177.145 (Published 16 January 1999) Cite this as: BMJ 1999;318:145
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Dear Sir,
Our culture is replete with locum doctors, bank nurses and teachers. Many
nurses are leaving the NHS without any exit questionnaire being completed.
The traditional British solution is being deployed, namely sending out the
banana boats to foreign climes, to tide us over this 'temporary crisis'.
Who cares? All those new nurses and doctors who are going to qualify in
the next 5-7 years will be working in a substantially unchanged
environment. Creating 'super' nurses will only affect a small percentage,
the majority will still feel the sting of staged pay awards.
If the people in this country had woken up over night to the current
situation in the NHS, there would have been a national outcry. In spite of
the 'new' Labour notion that the majority do not want a tax increase, many
are arguing for a hypothecated tax system. Do we not have the right to
chose whether our money goes to bomb the Iraquis, rather than pay for our
own healthcare?
The plain fact is that we are being means-tested by attrition. The system
is being squeezed and squeezed until those who can afford to pay give up
and pursue the private route. I cannot think of a better way to do it
cheaply. Doing it overtly would be hugely expensive. The Government with a
huge majority will just tough it out for a few years. In 10 years time the
NHS will exist solely as a health care system offering emergency care to
all those who go privately (because they will probably still be paying tax
and National Insurance) and acute and long-term care to those who cannot
afford such a route.
Pouring more money into the NHS cannot be the only answer anyway. The real
issue is the reduction of 'learned helplessness' and ridiculous
expectations of a nation that is led by unelected Murdochs and Mandarins.
One solution is to move people away from system-dependence and hanging on
the every word of so-called 'experts'. This however takes time and space;
for the average GP, both are now in scant supply.
It is now that we are really paying the price for the beliefs of a person
who felt that there was no such thing as society.
Yours Faithfully
Chris Manning
Competing interests: No competing interests
Winter crisis: don't the past
A whole range of reasons has been put forward for the present winter
crisis in the NHS but I have seen little mention of the underlying
historical reasons. The internal market and the last government's so-
called efficiency savings year on year resulted in large numbers of bed
closures and loss of nursing posts. The drive towards increasing case
throughput, high occupancy levels and reducing numbers of acute hospital
beds were bound to lead eventually to insufficient bed capacity to deal
with winter needs. Many Trusts made financial savings by not filling
vacant posts which were then often lost to establishment.
Competing interests: No competing interests