Facing Up To Crisis Britain

The 48-hour NHS consultants’ strike in England this week provides further evidence of a service that has lost faith in itself.

In Scotland, we hear the sound of SNP back-slapping due to the fact that, here, doctors have so far declined to walk out. It follows a two year 17.5% pay offer by the Scottish Government. That’s all very well in the short term – and gives the SNP another stick with which to beat the Tories – but given the huge sums such deals require, it only worsens the longer-term financial picture. Other public services in Scotland will now face even higher cuts to pay for the hundreds of millions of pounds spend on higher salaries.

In short, the “Scotland Good/England Bad” framing of the current NHS crisis as promulgated by SNP MPs like Philippa Whitford in the House of Commons this week is head-bangingly superficial. It is the equivalent of passengers at the stern of the Titanic congratulating themselves on their forethought as they watch the bow disappear beneath the waves. It entirely ignores the now glaringly obvious fact that without concerted action, we’re all going down to the bottom of the sea.

Is it possible, I ask, that we might focus a little deeper?

The background to the NHS crisis is the hole the UK currently finds itself in. We need to face up the bottom line: we can’t afford nice things just now. This week, everyone is talking about this post by Sam Bowman which makes the point that Britain is a lot poorer than it ought to be, and needs to start thinking of itself as a developing nation: we are a lot more like Poland than the United States. The mess the UK finds itself in was also the starting point of the Future of Britain Conference held by the Tony Blair Institute for Global Change earlier this week. So much for “things can only get better”, Sir Tony began the conference by declaring that the UK’s position just now was “grim”. It’s well worth watching his appraisal. We have created, he said, “an unsustainable state”. Spending on public services will soon head past 50% of GDP, well above our capacity to pay for it. “The actions of the state have not kept pace with what’s happening in the real world,” said Sir Tony. No wonder the public is also deeply pessimistic: according to polling by the New Britain Project, 58% of people agree with the statement “nothing in Britain works anymore”, compared to 17% who agree. In Scotland, the figure is 66%. Depressingly 84% of Scots also think things in Britain are worse now than in the past.

This is the reality. It’s hardly surprising therefore that, when combined with the equally grim prognosis for our planet’s very survival, many people have decided that spray-painting walls with orange paint is the only course of action or, at the other extreme, that it’s best just to ignore it all by going to watch the new Barbie movie or, in Scotland, that we should jack in the whole shit show and plump for independence.

Ah yes, Scotland. Here, the Unionist side, trapped by the binary simplicities of the independence debate, has long had a tendency to ignore Britain’s reality for fear of feeding the Nationalist beast. Won’t acknowledging the hole we’re in be used by our opponents to add to their case? Best to look the other way and talk up the genius of Britain, two World Wars, the greatness of the aforementioned NHS, etc, etc. 

Let’s go back to the NHS. Among the many speakers at the Future of Britain conference this week was Sir John Bell, the emeritus professor of medicine at Oxford University. Again, his eight minute presentation is well worth watching. He was brutal about the failings of the NHS as it stands. To paraphrase, we have created a system which pays little interest in people until they turn up at the front door of a hospital chronically ill or half-dead. Our wonderful NHS then spends billions of pounds badly managing their passage into the next life while telling people at the front gate of hospitals than they have to wait until the turn of the next millennium to get their hip joints looked at.

But there are solutions. The problem, said Sir John, is that the NHS is a technology averse system. Britain spend way less money on new drugs than our peers. We are also bottom of the international league table when it comes to the availability of MRI and CT scanners, both so crucial to early diagnosis. Worst area of all, said Sir John, is Britain’s failure to use digital technology and healthcare data to understand what causes disease and who can most benefit from interventions. Britain’s medical tech funding fell to £1bn this year, out of a total healthcare spend of £180 billion – a figure which is, Sir John said, “pretty outrageous”.

So let’s get to it. Rewiring the NHS for the Google Age isn’t as appealing as buying bricks and mortar for a new hospital but the potential benefits for is all are immense. For example, thanks to advances in genetics, it’s possible to predict which disease we are likely to succumb to. Kate Bingham, the vaccine tsar, has raised the prospect of getting a cancer test at Boots and then being prescribed a vaccine for tumours we may be susceptible towards later in life (indeed, cancer vaccines are already happening). In a few years’ time, we may all be using wearables that can track our health data. Many of us already signed up to an NHS App which could offer personalised health advice to us on a daily basis, based on our own unique circumstances. We could all have a GP in our pocket.

The potential for health data is the subject of Our Future Health – the UK’s biggest research programme – which is recruiting up to 5 million people from across the UK who will offer up their personal details and a blood sample (I signed up after listening to Sir John). Researchers will use this data to identify more effective ways of tackling disease. It’s hoped the programme – which brings all the UK health services together – could lead to the introduction of earlier treatment, better screening, and more accurate predictions about who is at risk of disease. This leads to happier lives and billions and billions of pounds of savings.

This is the future of the NHS. Working across the UK, using our national expertise in AI and digital tech, we can modernise the NHS for everybody, improve healthcare and free up the cash to afford to pay doctors and nurses enough to deter them from the threat of strike action.

It won’t happen overnight but then nothing important ever does. But if we’re going to respond properly to the crisis Britain finds itself in, these solutions are the ones we all need to focus on.