Major challenges such as Brexit-related staff shortages, rising workloads due to pandemic, essential drug shortages, pay erosion lie ahead for UK healthcare system
LONDON
While the UK’s healthcare system has always had its problems, things have lately taken a turn for the worse amid the fallout of the Russia-Ukraine war, Brexit, and a tightening cost-of-living crisis, reports by unions, universities, independent think tanks show.
The system has been rocked by the biggest nurse walkout in National Health Service (NHS) history, the result of a clear domino effect after a decade of pay erosion, war-driven deterioration in the economy, and piling workloads triggered partially by Brexit and the coronavirus pandemic.
According to a study conducted by the London School of Economics, nurses’ real earnings have lagged behind other lines of work, especially those in the private sector.
“In the private sector, real median earnings fell by 3.2% between 2011 and 2021, while nurses’ median earnings diminished by 6%,” it said.
As nurses’ salaries declined substantially in real terms from 2010-2011 to 2021-2022, the annual rate of departure for nurses increased from 8.5% to 10.9%, the research showed.
The total number of leavers rose from 27,000 to over 38,000 over the period, marking a 42% rise.
The Royal College of Nursing (RCN), the world’s largest nursing union and professional body, has said it was given no choice but to strike after the government dismissed their demand for a 19% pay rise as unaffordable in December.
At the same time, more than 10,000 ambulance workers in England and Wales also went on strikes as well, with the public being warned that patient safety could not be guaranteed during the walkout.
The latest figures from the government on Tuesday showed that a total 9,517 deaths were posted in the week ending Dec. 30, compared to the 1,592 five-year average for this time of year.
“The number of deaths was above the five-year average in private homes (36.9% above, 684 excess deaths), hospitals (14.8% above, 537 excess deaths), care homes (20.4% above; 371 excess deaths) and other settings (0.2% above, 1 excess death),” the Office for National Statistics said in a press release.
Deaths could be avoided
Dr. Martin Carkett, a leading health expert at the London-based Tony Blair Institute, blamed government “inaction and poor decisions” for the massive human cost. “Since the summer (1 Aug), when it became obvious an unprecedented NHS winter crisis was looming, there have been over 25,000 excess deaths,” he said on Twitter.
In a separate statement, the institute said that many of these deaths “could have been avoided” if the government had been better prepared.
The Royal College of Emergency Medicine also said that 300-500 people per week could be dying due to the crisis in emergency rooms.
Patients and their families have also complained of long ambulance waiting times of up to 20 hours, while many have also had to wait to receive care even after arriving at the hospital.
This is despite 24-hour emergency ambulance staff working substantial overtime hours.
The Nuffield Trust, an independent health think tank, have reported that ambulance staff are frustrated at being unable to provide patients adequate services.
“Response times for life-threatening calls take nearly ten minutes on average, against a target of seven minutes,” it said, adding that response time for such conditions as a heart attack or stroke could average waiting times of more than an hour.
Mean earnings of ambulance staff, meanwhile, are now back to levels last observed in 2010-2011.
1 in 10 paramedics quit
The picture for paramedics is no better, with one in 10 quitting their job in the 12 months prior to June. “Some 1 in 4 have said when surveyed that they would leave the role as soon as they could find another job,” according to a study by the Nuffield Trust.
The NHS have had difficulty maintaining the large and diverse body of qualified staff needed to effectively deliver services.
Funding for domestic nurse training has been on the decline since the 1980s, prompting the NHS to fill the gap with health professionals from the Philippines and India.
COVID-19 and its resulting travel restrictions threw a wrench in that bid, however, with many of the more experienced nurses retiring earlier at 55 over the huge workload they were left to shoulder.
Many nurses who came from mainland Europe to work in England also returned to their home countries due to Brexit, while many others from the Philippines began seeking better pay in the US.
Across medicine, nursing, and social care, there has been a decline in recruitment and registration from the EU since the 2016 referendum that resulted in a decision to leave the bloc.
With ongoing shortages in nursing, the UK government has also been heavily criticized for not training enough nurses.
One reason for this is the high costs associated with employing more nurses. Hiring a nurse in Britain costs nearly £30,000-£40,000 (about $36,500-$48,600) annually, while the cost of recruiting a nurse from abroad carries a bill of just £15,000.
There has also been a remarkable increase in drug shortages since the UK left the single EU market in 2021.
“The number of price concessions granted by the government when medicines cannot be found at the usual price has jumped repeatedly since 2016 and has recently soared to record highs,” another report by the Nuffield Trust indicated.
“The latest shifts illustrate how drops in the pound due to Brexit and the September 2022 Fiscal Statement appear to make it difficult for the NHS to obtain medicines under the cost controls it has relied on.”
In December 2022, the government agreed to 198 product price concessions — the biggest on record for the UK, a sign of severe shortage and increased supply prices across the country, according to The Pharmaceutical Journal.
Raj Matharu, chief officer for south London local pharmaceutical committees, told the journal that this was the worst crisis in medicine supply in 36 years.
Government to invest up to £250M in social care
As pressure rises on the government to alleviate the crisis in the NHS, it recently vowed to spend £250 million to buy thousands of extra care home beds to discharge patients, easing the strain on hospitals.
Health Secretary Steve Barclay also announced an additional £50 million in funding for hospitals.
“I and the government regret the experience for some patients and staff in emergency care has not been acceptable in recent weeks,” he said.
Deaths could be avoided
