The NHS needs less money, not more

Rachel Reeves is about to throw another £20bn at the problem, but there’s a real risk it will go to waste in the name of inclusion

Across the NHS, celebrations for Black History Month have just reached a crescendo. At Walsall Healthcare NHS Trust in the West Midlands this year’s theme was “Reclaiming Narratives”. According to the local hospital website, the aim was to “correct historical inaccuracies, showcase success stories, and highlight the full complexity of black heritage”. To that end, staff were encouraged to read e-books about black culture while patients and visitors browsed market stalls offering “ethnic jewellery, hair and beauty products”. At one point, there was a “Caribbean vibe” with music from a famous steel pan drummer called the Mighty Jamma.
Angela Cope, the trust’s equality, diversity and inclusion manager, believes all this is vital to “educate people” and “create a more respectful and anti-racist society”.
Really? Or would patients prefer her hospital to focus on making sick people better? As Chancellor Rachel Reeves prepares to throw another £20bn at the NHS, the danger is that yet more cash will be squandered on this guff.
Such initiatives might just be forgivable if trusts like Walsall were doing a brilliant job of caring for patients. That, after all, ought to be their core offer. With depressing predictability however, the trust officially “requires improvement”, having failed to impress care quality inspectors on almost all measures (including “use of resources”). Against this backdrop, why is any time and money being devoted to the black history agenda?
Throughout October, almost all hospitals went through the same Black History Month routine. Over at North Bristol NHS Trust, they marked the occasion with a “Yes You Can” campaign designed to “celebrate the diverse journeys” of black, Asian and ethnic minority staff. Again, “use of resources” at this trust officially “requires improvement”. No wonder! Having drifted so far from its primary purpose, the NHS is eating itself. Swamped by a ballooning population with ever more complex needs, and endlessly diverted by unnecessary activities, the bitter truth is that it is terminally ill.
Of course, almost nobody wants to admit it – least of all cowardly political leaders, who will continue to throw money at last-ditch treatments to help it stagger on. The question is how much will be frittered away. Across the entire system, scandalous waste abounds. Having spent the best part of two years investigating the good, the bad and the ugly of the NHS, I continue to receive shocking illustrations of woeful misuse of funds. These tales of woe cover almost every single aspect of the provision of healthcare and hospital services. In the last few days alone, the messages I have received range from a ridiculous saga over a broken reading light by a hospital bed (nurses were not allowed to change the bulb because of “health and safety”; a specialist “maintenance team” was nowhere to be found; the patient’s husband bought and fitted a new bulb himself) to a truly jaw-dropping litany of failures in the long-term care of a bone marrow transplant patient. (Sadly, his eye-wateringly expensive operation failed, because the donor vanished, meaning the patient was unable to receive vital top up cells.)
Earlier this week, a distinguished oncologist was in touch about the truly appalling treatment of a terminally ill 48-year-old in a central London teaching hospital. The doctor was almost in tears. Apparently the patient has been marooned in intensive care (at a cost of £4,000 a day) for weeks, waiting for a bed on a certain specialist ward. Until one is found, he cannot have the biopsy he urgently needs. Rake thin and increasingly confused as a rare form of cancer eats into his brain, the man (who, with the sort of world-class care the NHS is supposed to offer, might have a bit longer with his family) is just another victim of a slow-motion car crash that damages the lives of countless patients every single day.
At 5pm on the dot, all those equality, diversity and inclusion staff clock off, congratulating themselves on finding ever more creepily creative ways to respect trans women. At weekends, state-of-the-art operating theatres lie vacant while consultants play golf. Meanwhile, neglected patients languish on wards that would not look out of place in a Third World country. That despairing oncologist had initially found the 48-year-old languishing in another totally unsuitable setting: an old fashioned Nightingale ward, with 10 or 12 patients on each side of a long rectangular room.
“I had not been in such a ward for a very long time. I imagined they’d been abolished, to be honest,” he wrote. “The ward was very noisy: loud voices (there must have been 40 or 50 people in total); clattering trolleys; piped oxygen machines and other medical devices. How anyone could get better in such a setting was my preoccupying thought.”
The 48-year-old didn’t, of course – and nor has the severely immuno-compromised bone marrow transplant man, who is continually exposed to potentially fatal hospital-acquired infections in filthy communal toilets. He keeps having to repeat his entire medical history to doctors who can’t see his records and is made to hang around for up to five hours for hopelessly inadequate patient transport services. Blood tests are routinely lost and repeated, faxed referrals go astray, and repeat prescriptions are frequently suspended, only to be put back in place when someone has ticked a box.
When I co-authored a book – Life Support: The state of the NHS in an age of pandemics – on the state of the NHS a few years ago, I thought it was worth saving. Now I fear it is too far gone.