Clinical managers on the ward reveal the extent of the NHS crisis

There is a legitimate debate to be had about the future of the NHS and how to fund the ever-increasing demands on it. The arguments about how to raise the funding required continue, with the Government committed to “front-loading” the resources required by NHS England’s five-year plan. That commitment, with a substantial real-terms increase in spending this year, has seemingly made little impact on the financial viability of some NHS trusts.

The latest evidence is that some trusts are so desperate for hands on the wards and in theatres that nursing bosses are being recalled to the clinical front line. The national army of health professionals is being asked to do more and more with only a modest improvement in funding – if that.

As soon as one trust’s deficit has been plugged, another appears. More than any other public service, the NHS cannot say no to those in need. As we age and become ever-more demanding consumers, clinical need and Nice cannot keep up with decisions about rationing. Proposals to charge foreign nationals for treatment may well cut “health tourism” but the demands made by the public and ministers are still adding to the stress, as we see with the stalled plan for seven-day working.

Rarely, however, have the political parties been frank with the public about what treatment a beleaguered NHS requires, and, as any consultant can confirm, honesty is usually best for a patient. The voters, in turn, have a sense of entitlement about enjoying the best healthcare in the world, free at the point of use, with no accompanying sense of where the money comes from. There is little sign of a final grand financial settlement for the NHS. In the meantime, trusts will continue to run into crises – and increasingly go bust.