July 14, 2024

Holistic Pulse

Healthcare is more important

Danger of ‘two-tier’ healthcare system in face of record NHS waiting lists, watchdog warns

5 min read

Ian Trenholm, the chief executive of the CQC, said: “When we talk about the impact of a two-tier system, in practical terms it means that they either are not getting care at all or waiting longer until they seek care and therefore they are presenting to the NHS often through the front door of an emergency department for things which could otherwise have been treated in a different way.”

Eight in 10 of those who used private healthcare last year would previously have used the NHS, the CQC said.

Despite record funding to the NHS, including a £14 billion boost to help clear backlogs, latest figures show that 7.75 million people are on waiting lists in England. More than one million appointments and operations have been cancelled as a result of strikes.

Junior doctors are threatening to strike “until the next election and beyond” in their demand for a 35 per cent pay rise. The Government has agreed to talks with consultants, who have paused strikes, but has said no headline pay increases will be on the table.

The CQC’s annual assessment of the state of health and care is significantly worse than ever before.

It shows two in three (65%) maternity units are now regarded as inadequate or requiring improvement for safety, up from 54 per cent last year, which was already the worst on record.

The CQC warned of a “deteriorating situation” in many units, with mothers and babies put at risk – often as a result of a failure to listen to women.

The watchdog also found a steep deterioration in safety of ambulance services, with 60 per cent classed as inadequate or requiring improvement, up from 30 per cent last year.

Meanwhile, 62 per cent of urgent and emergency care services received such a rating, unchanged from last year.

The report warns of particularly extreme situations in some sectors, such as dentistry, with families driven into debt and doing without household essentials so that they can pay for treatment.

‘Worst we have ever seen’

The regulator said that poor access to NHS care meant those who could afford to were increasingly going elsewhere for help.

“The number of people on waiting lists for treatment has grown to record figures and in the face of longer waits, those who can afford it are increasingly turning to private healthcare,” the report said.

It quotes research by YouGov that found that eight in 10 people who used private healthcare last year would previously have used the NHS.

The regulator’s adult inpatient survey of 63,000 people found that 41 per cent felt their health deteriorated while they were on a waiting list to be admitted to hospital.

Mr Trenholm said that some patients were paying for care they could not afford, especially in dentistry, and being forced to “make cutbacks in other parts of the family budget to pay for care.”

The watchdog gave an account of a 49-year-old who resorted to extracting their own teeth after being unable to find an NHS dentist who would treat them. When this went wrong, they were forced to pay £1,200 on a credit card for private treatment, going without household essentials until the debt was paid.

Last week the Telegraph revealed a tripling in private GP appointments since the pandemic, with growing numbers seeking to see a doctor without facing long waits.

Meanwhile the cost-of-living crisis is forcing many elderly people paying for care at home to cut back on basics, because they cannot keep up with rates charged, the CQC said.

Charities said that the findings were “without doubt the worst we have ever seen”, painting an “unremittingly grim” picture of the social care sector.

The CQC said that families were being left “overwhelmed” by the amount of care they were left to provide, which was in turn heaping extra pressure on the NHS.

‘Public satisfaction at record low’

Mr Trenholm said that it was “crucial” that doctors’ strikes do not continue into winter, urging the Government and British Medical Association to work towards agreement.

Sally Warren, the director of policy at the King’s Fund, said: “Public satisfaction with the NHS is at a record low. Despite this, and despite signs that some people are paying for care out of their own pocket while others simply go without, public support for the founding principle of services being free at the point of use remains rock solid.

“History has shown us that a slow slide towards a two-tier health service can be avoided through a concerted effort to bring down NHS waiting lists, led and funded by government,” she said.

Louise Ansari, the chief executive at Healthwatch England, said: “The report echoes many of the issues people have raised with us over recent years, such as being stuck on a hospital waiting list and waiting long hours at A&E departments. Finding NHS dental care has also become impossible in many areas of the country.”

Daisy Cooper, the Liberal Democrat health spokesperson, said that the report “shows the devastating impact of the Conservative Government’s neglect of the NHS and care on people’s lives”.

A Department of Health and Social Care spokesman said: “It is vital we provide patients with the level of care they expect and deserve.

“That’s why we are delivering on three major recovery plans to improve access to urgent and emergency, primary and elective care, and have made progress to significantly reduce the longest waits for routine treatment, despite pressures including industrial action.

“There are record numbers of staff working in the NHS and our historic long-term workforce plan will retain and recruit hundreds of thousands more staff alongside harnessing technology to reform the way we work and save staff time.”

Prof Sir Stephen Powis, the national medical director of NHS England, said: “As this report acknowledges, NHS staff faced an unprecedented combination of pressures last year including a record 25.3 million A&E attendances, 14 million more GP appointments and tens of thousands more mental health appointments, all while more than 13,200 beds were occupied by patients who were medically fit to leave each day – a third more than the previous year.”


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