The Ockenden report into maternity care at Shrewsbury and Telford NHS Trust will undoubtedly elicit concerned sentiments from past and present health secretaries. The brutal fact that hundreds of healthy babies were allowed to die over many years as a direct consequence of inadequate care in an NHS hospital must not be brushed aside.
We have also seen the publication of the 2021 British Social Attitudes (BSA) Survey this week, which found that patient satisfaction with the NHS overall has dramatically fallen to its lowest level in 25 years, with only 36 per cent of the public happy with the health service.
Sajid Javid has been eager to present himself as a believer in the founding principles of the NHS, stating in his recent speech to the Royal College of Physicians this March, “Nye Bevan believed we needed the NHS: a world class health service, free at the point of use. So do I”. Later in the same speech he talked of “reform”, while discussing adjustments to how the service will ultimately deliver the same care, using alternative names and structures. Over and again, the NHS sees itself reinvented, while the underlying fundamental rot remains. What if Javid’s belief in “a world class health service, free at the point of use” is no longer deliverable in the present era?
Our country has an ageing population. Rates of obesity, mental illness, and other comorbidities have steadily risen. Rates of GP consultation are increasing. Patients expect to be able to access medical advice at the click of a button, sometimes at the first sign of a minor, self-limiting illness. All the while, there has been a continued decline in the number of fully-qualified, full-time equivalent GPs in England. This winter has seen record waiting times in emergency departments, with December 2021 being the worst month on record in England according to official figures. As I write this article, on a weekday morning, in my local A&E department there is a 13 hour wait to be seen.
Back to Ockenden. Maternity services, amidst a chronic shortage of midwives and obstetricians, have been known to be in crisis for years. A survey undertaken by the Royal College of Midwives in 2020 revealed that three-quarters of midwives thought staffing levels in their NHS trust or board were unsafe. Let us imagine that a survey had been undertaken to ask how many believed that babies were dying avoidably. At what point might we be stirred into action? How many innocent babies, exactly, will need to die before we acknowledge that the NHS is failing our population?
The failings found in the maternity unit of this district general hospital are certainly not an isolated occurrence. Any UK medic can tell you tales of being on call alone covering dozens of wards and hundreds of patients as a junior doctor (I certainly can). Of stumbling across patients who have died or come to serious harm because of hospital understaffing, or inadequate treatment. The recent televised portrayal of Adam Kaye’s This is Going to Hurt is a painfully honest example of the substandard care that doctors in our country are forced to deliver. Every year, more scandals emerge.
Boris Johnson’s government is renowned for its adherence to policy by public opinion. Most medics and health leaders still treat the NHS as a religion. In this context, while the overwhelming majority of the public believe the NHS should be free of charge and primarily funded through taxes, it is difficult to see how meaningful reform might be achieved. Too many are unwilling or unable to accept that other countries deliver equitable and better quality health care using different, more sustainable models.
Public opinion, however, is bound to swing quickly and decisively against the Government if it continues to prop up a failing health service which does not offer safe or accessible care. If the Tory party stays in power, sooner or later they are going to be held to account.
Dr Katie Musgrave is a GP in Plymouth
