Philip Banfield says health service is in state of
‘managed decline’ and may not survive next ‘five or 10 years’
Denis
Campbell Health policy editor
Tue 4 Jul
2023 07.00 BST
Most
frontline medics believe ministers are seeking to “destroy the NHS” because they
have starved it of cash and mistreated its staff, the leader of Britain’s
doctors has said.
Prof Philip
Banfield also warned that the health service, which on Wednesday will mark the
75th anniversary of its creation, is so fragile that it may not survive until
its 80th.
Banfield,
the British Medical Association’s chair of council, mounted an unusually strong
attack on the government’s handling of the NHS in an interview with the
Guardian.
“This
government has to demonstrate that it is not setting out to destroy the NHS,
which it is failing to do at this point in time,” he said. “It is a very common
comment that I hear, from both doctors and patients, that this government is
consciously running the NHS down. [And] if you run it down far enough, it’s
going to lead to destruction.
“You’ll
struggle to find someone [among doctors] on the frontline who thinks otherwise,
because that’s what it feels like.”
Banfield
said the NHS is in a state of “managed decline” because recent governments had
made “a conscious political decision” to deny it adequate resources or tackle
staff shortages.
He added:
“It was a conscious political decision to underfund and undervalue the NHS as a
national asset and its staff – not just doctors but [staff] across the board.”
He often
hears doctors say that the government is not committed to the NHS, Banfield
said. “And the end point of that is that the NHS does not survive another 75
years. I would be very surprised if the NHS in its current form survives the
next five or 10 years, at the rate that it’s declining.”
The BMA
boss said the NHS was performing well, despite the challenges it faces. “If you
are sick, you cannot beat the NHS most of the time.” But, he added, “the
problem with it continuing to be run down is that the frequency with which
disasters happen will increase.”
Anita
Charlesworth, head of research at the Health Foundation charity, also described
the health service as undergoing “managed decline” and that it had ended up
becoming overwhelmed because governments had made “a choice” to give it less
money than it needed.
Rachel
Wolf, a co-author of the Conservatives’ 2019 general election manifesto, has
said that the government has broken its pledge to build “40 new hospitals” and
that that is damaging the NHS.
The lack of
new buildings is limiting the amount of care the service can provide, at a time
when it has record staff and funding, she said.
Speaking to
the Guardian, she said: “The 2019 manifesto promised more doctors and nurses –
great – but also new and rebuilt hospitals.
“We needed
to deliver on the second because we do have more staff but we don’t have the
space and the beds and the machines for them to work at maximum efficiency.
It’s one of those things that is so demoralising for staff.”
Wolf
recently co-wrote a report for the Institute for Government thinktank about the
NHS’s “productivity puzzle”.
Ministers
need to embark on a massive programme of capital spending so the NHS can leave
behind cramped, outdated buildings and offer care in larger, purpose-built
facilities, she said – echoing a longstanding demand from organisations like
NHS Providers and he NHS Confederation.
Hospitals
also need to be able to access capital funding for building projects and buying
new equipment far faster than the current system, which critics say is overly
bureaucratic, takes far too long and in which the Treasury has too big a role,
they claim.
Wolf added:
“I’d radically simplify and speed up the process by which capital can hit the
ground and be used: no endless planning system, no opaque mechanisms from
central government.”
The
Department of Health and Social Care declined to respond directly to Banfield’s
remarks. A spokesperson said: “There are more staff than ever before working in
the NHS, which has led to a record number of cancer patients being treated over
the last two years. And in April there were a record number of diagnostic tests
carried out per working day.
“The NHS
has published the first ever long term workforce plan, backed by over £2.4bn
[in] government funding to deliver the biggest training expansion in NHS
history alongside measures to improve culture, leadership, and wellbeing.”


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