2020 was an extraordinary year for health services in the UK. As well as all the long-term challenges that the system faces, there was the introduction of a new, global health emergency, in the form of the COVID-19 pandemic. As well as the direct consequences of the virus, there have been indirect ones, too – often stemming from the lockdown.
Let’s look at some of the problems faced by the NHS, for which solutions will need to be found.
NHS clinical negligence claims cost the health service big money. An estimate in 2019 put the figure for outstanding claims at £83bn. When you consider that the total annual budget for the NHS England is £129bn, you get a sense of how colossal this burden is.
A Growing Population
As the population increases, whether it’s as a result of migration or of birth rates exceeding death rates, the capacity of the healthcare infrastructure will need to expand accordingly. Immigration actually alleviates pressure on the NHS, since recruitment is heavily reliant on overseas workers. Immigrants, according to a statement from the Health Foundation, “contribute through tax, tend to use fewer health services compared to others, and provide vital services through working in the NHS.”
Immigrants also tend to be young, which means they’re less likely to put pressure on the health service.
An Ageing Population
Age correlates with a range of health problems. Osteoarthritis, diabetes, and dementia are all more common among older people. The population of the UK is ageing. According to the ONS, there were 11.8 million people over 65 in 2016. This is projected to increase to 20.5 million in 2066. The fastest increases will be seen in those over 85 – whose healthcare needs are even more pressing.
Diabetes and Obesity
Obesity puts enormous, and avoidable pressure on the NHS. It correlates with diabetes, heart disease, cancer and stroke. NHS data reports that the majority of people in the UK are overweight, and that 26% of men and 29% of women are obese. 20% of year 6 children were obese, and this rises sharply in children from deprived backgrounds. This provides a rationale in favour of providing free school meals to children from these backgrounds; not only is it a nice thing to do, but the investment may pay for itself in terms of avoided obesity and avoided burden on the NHS.
New treatments and technologies cost money, especially if they rely on sophisticated and complex equipment. The average MRI machine can cost hundreds of thousands of pounds. Even more consequential is the cost of consumable medication. The NHS spends around £16 billion on drugs every year. It’s for this reason that the cost of potential drugs is given so much attention – cheaper drugs can save more lives than expensive ones. Certain rare conditions require rare and expensive drugs, however, and part of the point of the NHS is that these people are given the help they need.