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by andyjohnson0 1292 days ago
You're blaming the wrong things. Its a system problem.

Waiting lists for elective treatment are high because hospitals are full of mostly elderly people who can't be safely discharged because the social care system is broken - largely due to lack of capacity due to underfunding. And the government recently cancelled the national insurance rate rise that was supposed to fund improvements in social care.

Accident and emergency departments, as well as intensive care, can't move patients into regular and high dependency hospital areas because of the problem above. Which is why ambulances have to wait for so long outside hospitals. Which is why ambulance waiting times are seriously dangerously high.

The NHS generally has a lot of burnt-out people who are quitting or retiring faster than they can be replaced. Part of the problem is low pay (arguably partly due to under-funding of the service) and perception of that NHS roles are high-stress. The same is true for GPs (who generally aren't NHS employees) although the shortage of people wanting to become GPs is less about pay and more about the stressful nature of the job. The stress of dealing with the pandemic also substantially contributed to burn-out.

Ultimately, the UK isn't willing to fund public services properly. Health, education, social care, police, military - they're all grinding to a halt after running hot for too long with not enough people or funding.

If you want to take the argument further - we're looking at the economic damage caused by 14 years of austerity topped-off by brexit. The UK economy can no longer fund the expected activities of the state at the level that people expect.

1 comments

It is - like everything else, our response to Covid has just accelerated anything that was already in decline. The best we can hope for is a well-managed transition to a hybrid healthcare system that all of the other sensible countries use.

>the social care system is broken

Here, you are talking about social care for old folks. The relevant question here is - why has it got worse over the past 2 years? What we had before wasn't great - old folks basically sold everything they had so minimum-wage staff could care for them in their dying last few years, and needed constant attention from NHS-provided services. Which part of that is now properly broken, and why?

Other thing that happened in the last two years: Brexit.

A post about this from two years ago: https://www.ageuk.org.uk/our-impact/campaigning/care-in-cris...

Paying cheap imported labour to care for isolated elderly people certainly was an "already broken" system.
> Which part of that is now properly broken, and why?

Residential social care (primarily for elderly people, but also for younger people with specific issues) is mostly provided by the private sector and part-funded by the state. The amount that the state will pay care businesses to provide that care hasn't kept pace with their costs, and private care homes are increasingly ejecting loss-making residents and/or closing-down completely. This has been going on since at least 2017 and is starting to accelerate as energy costs increase. The state has very little residential care capacity left.

Home-based care is also a mess - again due to lack of funding. Salaries don't compensate for the job stress, and people still working in the sector are over stretched and burning out. So people who might have been able to live semi-independently in their own homes are pushed into the residential care system which (except at the high-end) is crumbling.

Again, its a system/coordination problem. I'd argue that part of the problem is inherent complexity, but a bigger part is that the politicians who are setting policy are ill-equipped to deal with these types of problem because very many of them believe in market-only solutions. When a system gridlocks like this, they don't know what to do.