Last week I wrote in the Mail Online about Lionel and Ellen who have been together for 82 years! That this couple are alive is a testament to the success of modern medicine and their channel of communication is a witness to how technology has transformed our lives. In the year they were born, 1911, life expectancy for women was 54 years and for men 50 years; today it is 82.2 and 76.7 years respectively. In 1911 there were no fridges, few cars and the radio was still eight years off.
We have been hugely successful at increasing our longevity and the NHS has been central to delivering this achievement. Easy access to medicine has had a huge impact on our society and we are rightly proud of every life saved, injury healed and body restored.
Yet it is precisely because of our success at medicine and innovation that demands on the NHS as it is currently run have become a ticking time-bomb. The rising demand falls into three categories.
Firstly our wonderful but ageing population means that there are fewer people to pay tax to fund the NHS, just when demand for medical care is rising. At present there are more than five people working for every person over the age of 70 years; in under 18 years time there will be 3.7 people working to support everyone over the age of 70, because with people living longer, the population of 70 year olds will have increased by over 50% (6.2million in 2010 to 9.6 million in 2030). If we continue to rely on taxes as the sole source of funding for the NHS, the burden on the working population will be crippling.
Secondly we British are super-innovators. Our technological advances mean that we can do much more to keep people alive and improve their quality of life. I am not aware that anyone has stopped to cost what some of the advances that are beginning to emerge from the pipeline, such as stem-cell therapies, bio-sensing implants, pre-implantation genetic diagnosis etc. But I am sure that to expect the tax payer to fund them all is economic suicide.
And thirdly we refuse to grasp the nettle of broader treatment coverage – or “diagnostic drift”. The NHS was brought in so that everyone could have access to necessary medical and emergency care. People now expect it to sort out every part of their body with which they are dissatisfied. We cannot afford the NHS to continue to be expected to be in charge of happiness, and we need a frank, open debate about this to manage the public’s expectations.
I have heard no opponent to the Health Bill address just how they would transform the NHS to be fit for purpose in the 21st century. Last week I also wrote about the economic reality of a rising public sector burden on the economy – no one came up with any realistic alternative solution. We urgently need to tackle funding; we must face up to unsustainable demands, and next time I’ll address the third time-bomb of dependence.