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The BMJ: “secure the NHS’s future”

The BMJ, the prestigious British Medical Journal, today calls on the next Health Secretary to “secure the NHS’s future”.

England’s NHS is stretched close to breaking point, say the BMJ editors.

The BMJ today calls on the next Secretary of State for Health to “secure the NHS’s future as the best and fairest health service in the world.”

In an open letter, Editor in chief, Dr Fiona Godlee, and colleagues say England’s NHS is stretched close to breaking point - and they set down what they believe is needed to heal the NHS.

They point to current problems, such as virtually flat-line funding in real terms since 2010, the growing demands of an aging population, and extreme cuts to social care, that have “exacerbated the pressures, causing knock-on effects across the service.”

As a result, waiting times for treatment are the longest for many years, while staff morale in many parts of the service is at rock bottom because of real terms pay cuts and the relentless workload, they write.

Patient safety is now also at risk, they warn, with 13 NHS trusts currently in special measures because of concerns about the quality of care being delivered - and eighty per cent of acute trusts are now in deficit.

They explain that in his five year plan, NHS England’s chief executive, Simon Stevens, demands savings of £22bn over the next five years. But say this level of saving “will still require efficiency gains never before achieved by the NHS, and a further £8bn is needed from government by 2020 just to stand still.”

And they point out that additional election promises - seven day working, guaranteed shorter access times, and more GPs and nurses - have been described by Mark Porter, the BMA’s chairman,  as “outlandish and unachievable.”

Against this background, the editors ask the Secretary of State to give “an unshakable commitment” to providing a publicly funded national health service, free at the point of need, and to resist the temptation to undertake further major top-down reorganisation.

They call for a focus on collaboration not competition and marketisation, for public health budgets to be ring fenced to protect vital services, and for “good transparent governance and less political interference.”

Finally, they urge the government “to properly fund England’s health service.”

They point out that the UK spends the joint lowest of any G7 country on healthcare as a proportion of gross domestic product, and the NHS is widely acknowledged to provide the most cost effective care of any developed nation. The NHS is not unaffordable, they say, but if it is deprived of the funds it needs to meet demand effectively, it could become so.

“History will not forgive another health secretary whose actions contribute to its decline,” they warn. “Let this be the five years that secure the NHS’s future as the best and fairest health service in the world.”

Responding to the BMJ's call for the next health secretary to 'secure the NHS's future', Dr Mark Porter, the Chair of the doctors organisation, the British Medical Association (BMA), said:

“The BMJ’s call for urgent action to secure the future of the NHS echoes those made by the BMA for a number of years. While staff have done as much as they can to protect and improve patient care, they are battling rising demand and years of underfunding that have left the NHS close to breaking point. This has been compounded by the costly and unnecessary reorganisation that distracted attention from the real issues and wasted millions of public money.

"Doctors on the ground are seeing first-hand how the pressures on the system are affecting the delivery of care across the NHS and the impact this is having on patients. The BMA's latest research has highlighted how 29 per cent of doctors have experienced a 'black alert' in their hospital and 48 per cent experiencing breaches in A&E targets. While our largest ever survey of GPs has shown that a third are considering retiring from general practice in the next five years at a time when politicians of all parties are trying to outbid each other on the number of new GPs they can magically produce in the next parliament.

“If we are to secure the NHS in the next parliament urgent action is needed to address the years of underfunding, the damaging marketisation of the NHS, the increasing recruitment and retention crisis and the health inequalities and major public health issues in our society.

"As part of the BMA’s ongoing No More Games campaign we have been calling for an end to the political game playing and the unrealistic pledges that have been a feature of this year’s election. Whoever holds the keys to No 10 after polling day has a duty to commit to having an open and honest public debate on the future of the NHS and how they expect to pay for it.”



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