Today the NHS employs over a million people and costing more than £2 billion per week to run. In every year since it started medical inflation has outstripped general inflation and the cost of the service takes an ever greater proportion of national income.
With thousands of UK and international medical charities funding pioneering research, and a national expectation that whatever new treatments are developed will immediately be provided free by the NHS, running costs can only increase further.
A funding crisis is inevitable ‘at some stage’ yet to date no UK political party has been willing to face what is considered almost certain ‘political suicide’ by introducing a policy to formally limit the services provided by the NHS.
This is an argument that cannot be won. Every life is important and the idea of refusing treatment on the grounds of cost goes against Bevan’s founding principles for the NHS – that it meet the needs of everyone; that it be free at the point of delivery and that it be based on clinical need, not ability to pay. However these principles were written when the global population was less than half of what it is today and when UK Life expectancy, according to the ONS, was less than 65 for men and 70 for women.
Having wrestled with the issue for some time the best ‘solution’ I can find is to encourage people to look after themselves. Reducing demand for services will delay the inevitable and allow the money we spend to be targeted on those whose need is greatest, but that is just a delaying tactic. Someone needs to make the call – a decision I wouldn’t like to face….