A vote for health

Five reasons why the upcoming election is crucial for our NHS.

The NHS is one of the best healthcare systems in the world. But years of underinvestment in the face of rising patient demand mean it’s now failing too many people, too often.

As the UK’s leading trade union for doctors and medical students, the BMA is calling on all political parties to put health and the future of the NHS first.

These are our five key areas of concern. When you’ve read them, use our form to send them to your local candidates.

NHS funding

Europe’s ten leading economies spend an average of 10.4% of their GDP on health.

By comparison, the UK spends just 9.8% – even though we’re the third largest of these economies.

‘The BMA has consistently highlighted the shortfall in NHS funding and the impact this has on the delivery of patient care. At present the NHS is barely coping with unprecedented rising patient demand against a backdrop of crippling financial restraint.’

BMA council chair Mark Porter, writing to chancellor Philip Hammond in 2016

With the NHS in England facing a £30bn funding shortfall by 2020, we’re calling on all political parties to increase the UK’s healthcare spend to 10.4% of GDP – a crucial step towards protecting our NHS.

NHS pressures

BMA JDC chair Jeeves Wijesuriya discusses the pressures facing NHS doctors

Growing demand and a lack of resources has put our NHS under greater strain than ever before.

The UK has fewer doctors per person than other leading European economies, and the second lowest number of hospital beds per head in Europe.

There are also concerns about NHS England’s new STPs (sustainability and transformation plans). Unless these are realistic and focused on patient care, they’ll do nothing to reduce the pressure on our NHS.

‘From the plans publicly available, we know that some plans cut hospital beds, close A&E departments, and restructure maternity services without the necessary evidence to show that they will either save money or improve quality. Given the precarious state of hospital finances, we cannot afford to be taking these risks.’

BMA council chair Mark Porter

We’re asking all political parties to take urgent action to address these pressures. In particular, we want them to make greater efforts to invest in the medical workforce, offer long-term solutions to funding and resource challenges, and ensure that plans to relieve NHS pressures – like STPs – are realistic, evidence-based and properly funded.

Brexit

‘There has not been any support for EU or international doctors since the referendum and no recognition of what we have done for the health of the nation.’

Dr Tatjana Street, a salaried GP who moved to the UK from Germany in 2006

Almost 7% of all doctors working in our NHS qualified in the European Economic Area. Since the UK voted to leave the EU, they’ve been facing an uncertain future.

Despite repeated calls, there’s been no move to guarantee the rights of these vital doctors to stay in the UK.

When we asked European doctors whether they were considering leaving the UK following the referendum, 42% of those surveyed conceded that they were, while 23% said they were unsure.

We’re calling on all political parties to give highly skilled EU doctors and medical researchers currently in the UK – on whom our health service relies – permanent residency.

We’re also asking them to ensure our immigration system meets the needs of our health service and medical research sector, to continue working with Europe on measures to protect patient safety and tackle global health threats, to secure ongoing access to EU research programmes and funding, and to address the unique impact Brexit may have on the health service in Northern Ireland.

General practice

NHS patient Terence Gardner talks about his local GP

The UK’s GPs are the front line of our NHS. But today they’re under unprecedented pressure – facing an unsustainable workload, a workforce crisis and inadequate resources.

When the BMA surveyed its GP members in England in 2016, their views were clear. 93% said that heavy workload had negatively impacted on the quality of patient services. 34% were considering retiring in the next five years, and 17% were considering less than full-time working due to workload pressures.

To protect our health service, we need to support frontline GPs. We’re calling on all political parties to ensure GPs have safe, manageable workloads, and to do more to tackle the recruitment and retention crisis in general practice.

‘GPs want to do the best for our patients. It’s what we have trained for and what makes our job worthwhile. But unless NHS England steps up and provides the resources to make general practice a viable career option, there will be no future for our practices or our patients.’

BMA sessional GPs subcommittee chair Zoe Norris, 2016

Public health

Protecting the nation’s health and preventing illness is an essential part of sustaining the NHS. But pledges to prioritise public health are not being matched by funding commitments.

In 2015/16, public health funding in England was cut by 6.2% (£200m). It’s also facing real-term cuts averaging 3.9% a year until 2020/21.

What’s more, there’s a huge gap between public health spending and wider NHS spending. In England in 2013/14, the average NHS spend per head was £1,742. Just £49 per head was spent on public health.

As a result, vital public health services are under threat, including smoking/tobacco control, public health advice to NHS commissioners, and adult obesity services. Mental health services are also under increasing strain.

Psychiatrist Dr Gary Wannan describes the issues facing mental health services

More investment in public health is desperately needed. We’re asking all political parties to deliver an effective public health strategy – including measures to tackle the impact of unhealthy food and drink, tobacco and alcohol, and greater efforts to ensure parity of esteem between physical and mental health services.

Credits

Digital producer: Sarah Quinlan
Designer: Tim Grant
Editor: Lisa Hansson
Senior digital producer: Eleanor Dean
Photographs and audiovisual: Eleanor Dean, Matthew Saywell, Sarah Turton, Sarah Quinlan, Susan Law
With thanks to: Dr Gary Wannan, Dr Jeeves Wijesuriya and Mr Terence Gardner