Analysis

NHS crisis: Politicians are not offering a comprehensive solution on how to fix the health service

This is an intensely political question, given that it is governments who decide how much investment should be put into the health system, sort out the infrastructure and decide how it should be organised. There is a growing discussion in Westminster about how the NHS should be funded.

NHS graphic
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The NHS is in the worst crisis in its 75 years, say health experts.

And you only had to listen to the heart-wrenching stories of the audience during a live Sky News programme on the NHS at Coventry Hospital for the reality of that to be laid bare.

There was James, whose wife died after waiting too long for an ambulance - and Sarah, whose mum died from an infection in hospital after waiting too long to be discharged into community care.

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'NHS can survive if people fight for it'

Stories that provoked gasps of horror and expressions of distress from the audience, as those around them recounted how they lost loved ones in a health system on its knees.

And as the stories of failings were shared, the obvious question that followed was whether the NHS can survive in its current form, or if it needs a radical rethink.

This is of course an intensely political question, given that it is governments that decide how much investment should be put into the health system, sort out the infrastructure, and decide how it should be organised.

There is a growing discussion in Westminster about how the NHS should be funded, with the former health secretary Sajid Javid telling me last year that he doesn't believe the NHS can survive and the country needs an "honest conversation" about how we pay for healthcare.

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He thinks the UK should look to European neighbours that have a mix of private insurance and state provision, where patients pay some money for services. He recently said those who can afford it should also pay to see a GP.

But this wasn't a view shared by our audience, with many shaking their heads when I reflected some of the political discussion back in Westminster around the future of the NHS.

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Sir Rod Stewart calls Sky News

As Phil Brown, a retired children's nurse, said: "As Nye Bevan [the founder of the NHS] put it, the NHS will survive for as long as there are people even now who are prepared to fight for it.

"Give back an elective nurses council, take away the parking charges, give us a four-day week, we will graft... and watch what all NHS staff can do."

The audience reflected wider public sentiment, according to Hugh Alderwick, director of policy at the Health Foundation.

"Polling shows strong support for the core principles of the NHS, including it being free at the point of use, available to all and predominantly funded through tax," he said. "The public want a better health service, rather than a different system and they back additional spending to supply it, with 71% thinking greater government investment in the NHS is necessary."

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Can the NHS survive?

But if the audience seemed to agree with the principle of an NHS free at the point of use and funded through taxation, the politicians are not offering comprehensive solutions to how to end a crisis that was beginning long before the COVID pandemic.

Chronic staff shortages, the need for more investment, a plan to fix adult social care and weak capital investment in buildings, equipment and IT, are some of the big problems facing the NHS but our politicians tend to deal in sticking plasters not real solutions.

The most obvious example being the ditching of Boris Johnson's £12bn-a-year plan to better fund the NHS and social care through a National Insurance tax rise and a cap on individual care costs to protect the elderly from exorbitant costs.

That successive government inaction now hitting home with ambulance delays, bed blocking and high levels of unmet needs.

But on both sides of the political divide, parties are for now unwilling to grasp the nettle.

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Where - and why - there are long waits for emergency care

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'NHS Crisis: Your Say' Highlights

The Conservatives have delayed social care reform until after the next general election. They have promised a plan on improving emergency care, access and workforce to deal with acute staffing shortages, but there is a private admission within government that it is unlikely that patients will feel much improvement in services before an election and there is certainly no talk of increased investment.

Labour too is unwilling to commit to more funding, anxious that they open up a line of attack from the Conservatives if it commits to spending plans for the NHS.

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An NHS hospital under pressure

As deputy leader Angela Rayner put it to me in a recent interview, Labour will focus on reforming the NHS - a big push on changing the way GP surgeries work and increasing preventative medicine - rather than raising taxes to pay for it.

The "retail offer" from Labour is to pay for more doctors and nurses by scrapping non-dom tax status and funnelling the estimated £3.2bn that will raise into extra training places.

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Lord Winston, the IVF pioneer who has worked in the NHS for nearly six decades, told me last week he had never seen it so bad and said he believed more funding would be inevitable. He urged Sir Keir Starmer to show more "courage" when it came to resolving the problems of the NHS.

With an election less than two years away, political leaders are for now playing it safe with difficult decisions delayed. But what was clear from our discussion is that voters want the NHS to survive in its current form. And they will expect their political leaders to deliver it.