THE NHS across the entire UK is facing one of its worst crises in its 75 year history. A perfect storm of Covid and flu, respiratory illnesses, and strep A infections have combined with the usual stresses of winter and 13 years of Conservative austerity to bring the entire health service to its knees.
On Monday, the First Minister has revealed that Scotland's hospitals are almost completely full. Measures are being put into place to ensure that patients who are medically fit for discharge can be sent home, with extra funding for local health and social care partnerships to assist hospitals to book beds in care home beds for vulnerable patients with care needs in order to allow them to be given "interim care" while a more permanent care package is put in place.
So why are things so bad right now? The opposition parties love to put the blame entirely on the shoulders of the Scottish Government and the SNP given that health is a devolved issue, but this is a crisis which is also having a devastating effect on the NHS in England, where it is ultimately under the control of the Conservatives at Westminster, and in Wales where the Labour party is in charge. Arguably the crisis is worse in England and Wales, but that is little comfort to patients in Scotland who are left waiting for hours in over stretched A&E departments, or who cannot get a much-needed appointment in a timely fashion.
READ MORE: First Minister says Scotland's hospitals are 'almost completely full'
One reason for the current crisis is that the UK as a whole, and Scotland in particular, has an ageing population, the 2021 census for England and Wales showed that 18.6% of the population was aged 65 or over, figures for Scotland will be released next year but the percentage of people over the age of 65 in Scotland is expected to be higher. In the 1980s just 15% of the population of the UK was aged 65 or over. Due to advances in health care and standards of living, the number of older old people is also rising.
However, these advances in health care come at a cost. New medicines and new technology must be paid for, and the cost of these new treatments must come out of budgets which are already stretched.
There are now 3.2 million people aged 80 or over in the UK, and almost 600,000 of these are aged 90 or over. Older people typically have greater health needs, putting more demand on health services. Around 40% of people over the age of 60 have a limiting long-term illness or disability, and the more old people there are in the population, the higher the demand becomes.
This older population is also suffering the effects of 13 years of Conservative austerity policies which have fallen hardest on the poorest and most vulnerable households, decreased incomes, poor housing, poor nutrition, the pervasive stress of living in poverty, and social isolation, all play a role in exacerbating health problems which then feed into a greater burden on the NHS as more people suffer serious illnesses requiring hospital treatment.
The cumulative effect of Conservative austerity and the decade long squeeze on social security together with cuts to vital public services has been to cause a reduction in life expectancy which has been felt worst in the poorest communities. This austerity-driven attack on social security has left low-income households unable to cope with the current dramatic increase in the cost of living. This is a crisis of the UK Government’s making, and the problems thus created ultimately express themselves in health emergencies which necessitate medical intervention.
However, this increasing demand is being borne by a health service which is itself suffering from the effects of decades of under-funding, an under-funding decided in Westminster which feeds through to Scotland and Wales in terms of lower block grants to the devolved governments.
The devolved governments have only a limited ability to protect health budgets, something which they can only do by cutting spending in other areas.
In order to help the NHS fund the increased costs of advances in medical treatment and the increasing demands put on it by an ageing population, NHS budgets traditionally rose by an average of 4% above inflation every year.
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However, since 2010 the average annual rate of increase has been half that, so although NHS budgets have still been increasing, they have not been rising enough to cope with the greater demands placed on the service.
This thirteen years long under funding has resulted in fewer available beds and reduced numbers of staff whose pay has not kept pace with the rising cost of living or the greater responsibilities they must cope with. Currently around one in 10 NHS posts are vacant across the UK, leaving the UK with fewer doctors and nurses than many of its Western European countries.
This lack of staff means that fewer health sector workers are having to take on ever greater responsibilities, so we end up with unhappy and underpaid staff who take industrial action.
This is a crisis which is over a decade in the making, the ultimate responsibility for which lies with Conservative austerity.
This piece is an extract from today’s REAL Scottish Politics newsletter, which is emailed out at 7pm every weekday with a round-up of the day's top stories and exclusive analysis from the Wee Ginger Dug.
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