Wed. Oct 20th, 2021

Letter updates

The outgoing head of the NHS, Simon Stevens, was expected to be good value (Lunch with the FT, FT weekend, 24/25 July). No one is in a better position than him to be aware of the consequences of the NHS’s long-term undercutting in terms of staff, facilities and bed numbers. All this makes the achievements of the NHS during the pandemic, and before, all the more remarkable.

Stevens acknowledges the transition that the health systems of other industrialized countries are undergoing in the transition from ‘reactive’ to ‘prior’ care.

As a consultant gastroenterologist who retired from the NHS in 2004, I have had the privilege of assisting during the pandemic, conducting a waiting list triage exercise, and conducting telephonic clinics remotely. The dedication of the staff and the gratitude of patients remain unchanged. However, it is disappointingly clear that the NHS system of care has shifted from one to a doctor-patient relationship to a transactional one. Continuity of care by the same doctor occurs much less frequently than in the past. Many factors contributed to this, including the launch of targets along with sanctions for failure, inadequate staffing levels and a cracking infrastructure.

We all know that the cost of care increases with our aging population. No government administration has the honesty to acknowledge this and that we need another way to fund the NHS and social care. Unfortunately, political short-term will always prevent realistic recognition of this. The increasingly obvious failures of our current Prime Minister and the largely weak team with which he surrounds himself exacerbate this problem. The pandemic, as a magnifying glass of inequality, further exacerbated the situation.

I suspect that when Stevens is in the main house, unrestricted by his NHS role, he will be a force for change to be reckoned with.

Dr Stuart R Gould
London N6, UK

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