The survival of the NHS depends on an immediate investment in staff, wages and infrastructure, followed by a long-term and cross-party action plan.

That’s the advice from Dr Alexis Paton, a health expert at Aston University, who warned that a “back of a fag pack policy” is no longer enough to secure the future of the UK’s healthcare system following years of underfunding and austerity.

The lecturer in social epidemiology and the sociology of health was outlining her short and long-term planning hopes for the NHS in the midst of its current crisis.

Dr Paton, who is also director of the Centre for Health and Society at Aston University, gave her views in the latest episode of the ‘Society matters’ podcast series, presented by journalist Steve Dyson.

She said the NHS was currently in a “real crisis”, from overstretched maternity units to struggling end of life care, and everything in between.

One of the “obvious” reasons was old hospital buildings, with the NHS having a maintenance backlog of more than £10 billion, and doctors and nurses leaving the profession in “absolute droves”, leading to 100,000 doctor vacancies alone.

In addition, hospital A&Es are “absolutely bursting”, more than seven million people are waiting for elective procedures, and nurses and ambulance staff are striking.

Dr Paton said she was not convinced by prime minister Rishi Sunak’s recent pledge to cut waiting hospital waiting lists and provide new social care funding.

She said: “It feels like a sleight of hand. The NHS already pledged, since February last year, that it would be tackling this wait list, so this is not the prime minister’s pledge, it’s the NHS’s.
“He promised he would increase bed capacity by 7,000 and provide new funding for discharge into social care and the community, but exactly who will be caring at these bedsides and where in the community are these people going?”

Dr Paton said the long waiting lists were not due to the Covid pandemic, “which the PM and many others would like us to believe”, but were 12 years in the making.

“This is what austerity looks like when we continue to devalue and de-fund the NHS. Where are the pledges about increasing staff, so they can see more patients, and increasing capacity so crumbling buildings aren’t crumbling anymore.

“And what are we going to do about social care so patients don’t get stuck in hospitals?”

Dr Paton said they had to move away from the NHS’s past “just in time” approach to healthcare service provision which was borrowed from the supermarket industry.

“I personally don’t think it’s the best analogy to make. I don’t like to be compared to apples.”
She said the NHS first needed to fix the current “full-blown” crisis, with the government having to engage with striking healthcare staff and increase the wages of care and social care staff.

Beyond that, they needed a “long-term, cross-party plan of action to support, fund and help the NHS”, through increased funding to recruit staff and maintaining existing infrastructure.

“There’s no getting around the fact that the NHS is an old girl, operating in old buildings and we use old equipment and old technology.

“We have a £10.5 billion infrastructure and estates backlog in the NHS, but in 2004 it was only £4.5 billion, so we have doubled what’s needed in nine years, largely through underfunding and austerity because of successive Tory governments.”

“But, I’m not sure it’s about a change of government, it’s about a change of attitude.”

Dr Paton said Labour’s plans were “lacking too”, adding that shadow health secretary Wes Streeting’s proposal for self-referral and changing how the GP system works “really seems to be missing key information”.

She said: “For me, this crisis is a wake-up call to all the political parties across the UK that the delivery of the healthcare system cannot be successfully achieved with what I think of as back of a fag pack policy.”

Meanwhile, Aston University is to launch a new Masters in Public Health programme in September, offering training in areas such as improving screening.

This will add to the university’s existing work including digital health initiatives and research on the different ways that society impacts on health.