It was good to see my friend Kitty Sparkes from Chippenham for lunch over Christmas, fit and bright as ever, belying that she is over 100 years of age. Yet the statistics indicate that more and more of us will follow her example and achieve our centenary. In 1917, a year after Kitty was born, King George V started the tradition of sending out 100th birthday telegrams. He sent 24 cards that year. Since the beginning of her reign, the Queen has so far sent 110,000 birthday greetings. And in 25 years’ time it is estimated that the Monarch will be sending 250 such cards per day, or 100,000 every year. 550,000 Britons are now aged 90 or more (compared to 190,000 in 1984), and life expectancy for all of us has risen dramatically in recent years.
So is it really any surprise that our beloved NHS, committed to providing the best of healthcare from cradle to grave, is creaking a bit at the seams? The NHS employs 1.7 million people (making it the fifth largest employer in the world, and by far the largest in the UK), delivers services at over 7,000 sites, costs £121 Billion a year (£2000 per head of the population); it deals with 1 million patients every 36 hours, (85% of whom are thoroughly pleased with their treatment), including 10 million operations (up from 7 million in 2005), and 16 million hospital admissions, 28% more than a decade ago.
The fact is that as we live longer and longer, and have higher and higher expectations with regard to healthcare, it becomes less and less affordable. The Government has increased spending on the NHS by more than inflation; but the costs are sky-rocketing. And developments in medical science mean that this trend will become worse and worse over the next 20 years unless we do something pretty radical about it.
There are cleverer minds than mine tussling with this huge problem. But here are a few ideas for them. The only important thing about our NHS is that it is excellent and that it is free. The way in which that is achieved should not really matter to us. So, for example, does the Government really need to own all 7,000 sites? Could we make better use of the private sector in one way or another? Are there ways to save money? For example, I was astonished when I visited my excellent GP’s surgery in Yatton Keynell to collect my regular repeat prescription (painkillers for a minor affliction) a few days after my 60th birthday. ‘No charge’, said the nice pharmacist, ‘now that you have turned 60’. But why should it be? My income is the same as it was when I was 59. Between July and November 2016, more than 31,000 GP, nurse and healthcare assistant appointments were missed across Wiltshire’s 55 GP Practices – the equivalent of over 1,033 days of general practitioner time. In Wiltshire, this boils down to a potential 6,000 patients missing out on an opportunity to be seen each month.
It’s no use using health as some kind of political football. Nor is spending more and more necessarily the right answer. We could spend the whole of the national wealth on it and it would still not be enough. No. As a society we need to get together and quietly and reasonably work out how we can provide outstandingly world-renowned excellence in our healthcare, but do so in a way which is affordable to the nation in the 100 years that lie ahead. We can’t go on as we are, so let’s get that Great British brain to work on the problem, and come up with a long-term solution, not just short-term sound bytes.