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Opinion | The UK’s National Health Service is exhausted

On December 15th the nurse went out and biggest nurse strike In the history of the UK National Health Service. They were protesting against working conditions and lower wages that left them burnt out and emaciated, jeopardizing patient safety. last 10 years practically. Paramedics joined them.this week, thousands of junior doctor We went on strike for three days in a row.

“I can come to work and see patients waiting eight hours to see a doctor. I see you told the BBC on Monday.

But you don’t have to work in a hospital to know that the UK’s NHS is in the deepest crisis in its history. You just get hurt or sick.thousands people are presumed dead Last year, because ambulances and emergency services were overwhelmed.there is 7.2 million people In the UK, more than 10 percent of the population, is on the waiting list for treatments such as hip and knee replacements, back surgery and cataract surgery. And hundreds of thousands have been denied doctor referrals for outpatient treatment in hospitals. Available Appointments — they are simply brought back to the doctor to restart the process.

This state of affairs for a major health service in one of the richest countries in the world is shocking, but not without explanation. Decades of marketization, a decade of Conservative austerity and a pandemic have hollowed out the NHS, leaving more and more people who can and cannot afford health care.

A two-tiered system that is increasingly common with American healthcare is forming. It’s not working and it will soon be too late.

Damage to the NHS occurred mainly in three waves.

Introduced by the Conservative government in the late 1980s and early 1990s inside market and closed long-stay hospitals under the euphemistic banner of “community care.” Equity investor-backed private nursing homes have taken over services for the elderly, and care has become fee-based and means-tested. Medicaid “Running Out” rule.

In the late 1990s and early 2000s, Labor, under Tony Blair, built dozens of new hospitals funded in partnership with private investors.the new hospital was saddled with repayment of huge debts and interest — About $60 billion is still outstanding.

In 2010 the Conservative Party returned to power alongside the Liberal Democrats until 2015, decade of austerityA government-commissioned report published last year identified the period 2010-2020 as the NHSten years of negligence

The cumulative impact has been devastating: in the 30 years preceding the pandemic, the number of NHS beds was Less than half of EnglandThe shortage of beds, ventilators and intensive care specialists in early 2020 was not unique to the UK, which had fewer beds per capita than comparable countries. There was a palpable sense of panic about how the UK and its health services would be managed.

Britain managed. And it’s all thanks to the dedication of those who work in the NHS and the retired staff who have come to their aid after retirement.Brits know this: Spring 2022 survey shows British citizens still overwhelmingly Support the founding principles of the NHStheir satisfaction with it has fallen to its lowest level in decades. most Public support for all workers who went on strike in the UK this winter.

But people are either sick of waiting or they can’t wait, and more and more people are paying for personal therapy.

35% more people to choose. self-funded care Between 2019 and 2021, “Growth that outperforms the market” It has been reported in the out-of-pocket market since the COVID-19 pandemic.Number of out-of-pocket surgeries such as hip replacements and knee replacements more than 2 times.

Also, there are indications that some people who pay for folk remedies do so not because they can afford it. they can’t afford to wait: From 2019 to 2021, due to an increase in own funds, the number of people Decrease in private insurance payments; people Reportedly taking out loans to pay for operating expenses And while it’s a development familiar to Americans, it’s completely new to Britain, with more and more people Look to GoFundMe to collect medical expenses.

Governments have done a lot to facilitate this transition: in 2012, the Conservative Party raised the cap to 49% on what percentage of NHS hospital revenues can come from treating individual patients.

Survey by The Guardian in January some NHS hospitals It was working with the private sector to promote copays for people who “didn’t want to wait for an NHS referral”, while warning NHS patients that the service was “very busy”. And doctors working in the public and private sectors conflict of interest You can also manipulate the system to tell patients that they have to wait a few months for one week to get NHS treatment, and then treat them privately the next week.

More private patients are believed to mean more costs for services.But the researchers weren’t able to do that because the profit margin on income from private patients would be treated as confidential. verify Whether private patient units generate more money for NHS patients, whether they are making a profit or even losing money.

What we do know is that it is becoming increasingly difficult for Britons who want to use the NHS. It doesn’t have to be, but change is not easy.

In the short term, the NHS will need to stop treating private patients and use public funds to increase the number of beds and staff. And sooner or later, doctors should have to choose between working in the public sector or in the private sector.

Since 2015, there have been four attempts in the House of Commons to introduce legislation to revive the NHS as the UK’s planned system of universal public health care, four times unsuccessfully. The last he is one time. 2018The outlook for future attempts will depend on the next government.

On Thursday, the government increased salaries for nurses and paramedics after months of strikes. Three of the largest health unions agreed to recommend this proposal to their members. The junior doctor has returned to work, but their dispute is not over yet.

The NHS as Brits know it is accessible, always free and cherished, but it is becoming something else. But it’s never too late to save it as long as there are people willing to fight for it.

Alison Pollock is a clinical professor of public health at the University of Newcastle. Peter Roderick is a senior researcher and attorney at the University of Newcastle.

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https://www.nytimes.com/2023/03/17/opinion/nhs-britain-privatization.html Opinion | The UK’s National Health Service is exhausted

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