Sleepwalking into two-tier healthcare 27 July 2021 The pandemic has driven both the NHS and a growing number of its patients towards private healthcare. Heightened awareness of the health service’s frailties, fuelled by repeated warnings that it could be overwhelmed, has prompted a surge in private medical insurance. As the UK drifts into a possible future of two-tier healthcare, with the wealthy given more chances to skip the queue, we need to ask whether the founding principle of the UK’s health service – free at the point of need – is being eroded in front of our eyes. There are about 90 private healthcare providers in the UK, such as HCA, Circle, Ramsay, Bupa, Spire and Nuffield Health. The industry is worth about £9bn a year, compared with £177bn of government healthcare spending across the UK in 2019. It includes hospitals, clinics, diagnostics and imaging and urgent care; typical work is general surgery, oncology, obstetrics, trauma and orthopaedics. Its customers are medical tourists, NHS referrals, people with private medical insurance and self-pay individuals – so-called “out of pocket” payers. This last group includes people paying for one-off operations to avoid waiting for NHS treatment. Ramsay earns about 80% of its revenues from NHS referrals, Spire 30%. The need to clear the operations backlog has made NHS trusts a lot less squeamish about working with the private sector. Read the full article at the Guardian __________________________________________________ Pandemic drives global workforce crisis 16 July 2021 Before the pandemic, the World Health Organization projected that there would be a shortage of 18 million health workers by 2030, compared with demand for 80 million. While lower- and middle-income countries would feel most of the pain, no-one would escape. The pandemic looks likely to attract some people into healthcare careers while driving many more out. In the UK, inspirational stories about the contribution of nursing to the pandemic response has led to applications for nursing degrees jumping by a third to a record 60,000 this year, with surges in both school leavers and people looking for a mid-life change of direction. But there is compelling worldwide evidence of healthcare staff suffering from depression, anxiety and insomnia during the pandemic, while industrial disputes and strikes have been seen in at least 84 countries, largely driven by poor working conditions and lack of PPE. By September 2020, health workers accounted for roughly 14 per cent of all recorded Covid-19 cases globally, despite making up less than three per cent of the population in most countries. Research by the International Council of Nurses found that one in five national nursing associations reported increasing levels of nurses quitting, while 90 per cent reported increased numbers of nurses planning to leave once the pandemic subsided. Read the full article at World Healthcare Journal __________________________________________________ Errors undermine pandemic response 29 January 2021 The annual analysis of Whitehall by think tank the Institute for Government reveals how the response to the COVID-19 pandemic has been repeatedly undermined by avoidable ministerial failures. Whitehall Monitor – now in its eighth edition – gathers and analyses a huge array of data on all aspects of government performance, such as spending, staffing and ministerial activity. Its findings – in areas such as procurement, working with devolved and local governments, and public communications – lay bare just how poorly ministers have handled the pandemic. The numbers bring home the enormity of the policy and operational challenges faced by ministers and civil servants. Government spending hit £1 trillion (US$1.3tn) in 2020/21 for the first time, according to the research – an increase more than £200 billion (US$275bn) on the previous year. This includes £147 billion (US$201bn) supporting households and businesses, alongside £22 billion (US$30bn) on a test and trace system which, according to the government’s own scientific advisers, has only had a “marginal impact” on reducing transmission of the virus. The bill for personal protective equipment (PPE) illustrates how ministers jettisoned standard procedures for handling public money. The total for PPE has reached £15 billion (US$20bn), according to the Monitor. Read the full article at Global Government Forum __________________________________________________