Independent inquiry needed to save NHS

I would like to congratulate Bill Butterworth (Letters,November 14) on his analysis of the problems besetting the NHS. However, I wish to point out that these problems have been building up over a number of years; but the Covid pandemic may prove to be the final straw that broke the camel’s back.

Ever since the birth of the NHS in 1948, the demands on it have exceeded what it could supply.

The people who designed and produced it grossly underestimated the number of people who were suffering from diseases but had been unable to afford to see a doctor.

As soon as the free service came in, they flocked to be treated. There were not enough doctors or nurses (either in GP or hospital) to meet their demands – and, so, the waiting list was born.

The cost to the Exchequer was also much higher than was forecast; so, in 1952 (just four years after its birth) the prescription charge was introduced – which breached the principle of free at the point of delivery and brought the resignation of Nye Bevan, its founding father and Harold Wilson, then a junior minister.

Back in those days, the average age of the population was younger than it is today. Few people lived into their 80s; now many live into their 90s. And older people et more diseases than those who are younger.

In the early days of the NHS, most of the diseases it had to treat were life-threatening - infections, especially tuberculosis, heart disease, lung problems such as chronic bronchitis and cancer.

Most of the drugs available were relatively ineffective – but they were inexpensive; and surgery was simple. Today, many of the conditions treated are life-enhancing. The drugs are very effective but expensive and surgery can be complex.

The solutions to the problems are simple in principle. Either we have to decrease demand or increase supply – or a mixture of both.

Increasing supply means more doctors, nurses and other professional front-line staff who actually treat patients, and reducing the number of bureaucrats, both locally and centrally, who push paper around, study statistics, and issue inappropriate guidelines, protocols and ‘patient pathways’ – which usually obstruct the efficient care of the patient.

Decreasing demand means deciding what the NHS will treat, and what it will not. There also needs to be a reappraisal of what constitutes negligence to reduce the enormous cost of litigation.

Both of these solutions are politically hot potatoes so, no political party dare suggest them. So, we need a truly independent inquiry to look at the purpose of the NHS, its management structure, and its system of financing. No other country has copied our NHS – patients have to pay something at some point of their treatment, or for certain conditions.

If this does not happen soon, I fear we will witness the death of our, rightly, loved NHS.

Malcolm Morrison

Retired Surgeon

Prospect Hill

Root and branch reform required

I am sure every Swindon resident would like to solve the problems of the NHS.

Sadly, this is not going to be possible without root and branch reform, a situation which even Labour's health spokesman acknowledges.

Des Morgan

Caraway Drive

Swindon

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