While much of the NHS is working well, some parts are slowly deteriorating. Why is this and what can we do about it?
There are more elderly people as many are not dying early of preventable disease. But older people suffer more from chronic disease, requiring more doctors, time, medecines, operations and tests.
Modern medicine offers new and improved treatments and medications, which typically cost more.
Currently over half of new medical students are female, who at some point may wish to work part-time to balance work and family commitments. Increasingly some male doctors also want part-time work to share in child-rearing. To get the same number of 'whole-time equivalents' requires training more doctors.
Hospitals are expensive to run so with over half of surgery is carried out as day case, managers have closed beds to keep within budgets. Unfortunately, an increasing number of elderly patients cannot return to their homes, or only with significant community support, and stay in hospital when they no longer need medical care.
All solutions to the above involve significant amounts of money. Politicians play distraction games; an example is blaming doctors for the 'weekend effect' when those doctors who found the effect very specifically state that cannot explain what it is due to.
Rationing is not honestly discussed but already happens by default. Long waiting lists will, in some cases, result in poorer outcomes and even death before diagnosis and treatment. GP appointments used to be very short to keep up with demand; today longer appointments mean longer waits to see a GP and more people visit Casualty departments, increasing pressure there.
Various sources
