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The Guardian - UK
The Guardian - UK
Politics
Denis Campbell Health policy editor

Most doctors think ministers want to destroy NHS, BMA boss says

Prof Philip Banfield, chair of the British Medical Association, says the NHS is in a state of ‘managed decline’
Prof Philip Banfield, chair of the British Medical Association, says the NHS is in a state of ‘managed decline’ Photograph: David Levene/The Guardian

Most frontline medics believe ministers are seeking to “destroy the NHS” because they have starved it of cash and mistreated its staff, the leader of Britain’s doctors has said.

Prof Philip Banfield also warned that the health service, which on Wednesday will mark the 75th anniversary of its creation, is so fragile that it may not survive until its 80th.

Banfield, the British Medical Association’s chair of council, mounted an unusually strong attack on the government’s handling of the NHS in an interview with the Guardian.

“This government has to demonstrate that it is not setting out to destroy the NHS, which it is failing to do at this point in time,” he said. “It is a very common comment that I hear, from both doctors and patients, that this government is consciously running the NHS down. [And] if you run it down far enough, it’s going to lead to destruction.

“You’ll struggle to find someone [among doctors] on the frontline who thinks otherwise, because that’s what it feels like.”

Banfield said the NHS is in a state of “managed decline” because recent governments had made “a conscious political decision” to deny it adequate resources or tackle staff shortages.

He added: “It was a conscious political decision to underfund and undervalue the NHS as a national asset and its staff – not just doctors but [staff] across the board.”

He often hears doctors say that the government is not committed to the NHS, Banfield said. “And the end point of that is that the NHS does not survive another 75 years. I would be very surprised if the NHS in its current form survives the next five or 10 years, at the rate that it’s declining.”

The BMA boss said the NHS was performing well, despite the challenges it faces. “If you are sick, you cannot beat the NHS most of the time.” But, he added, “the problem with it continuing to be run down is that the frequency with which disasters happen will increase.”

Prof Philip Banfield, Chair of the British Medical Association (BMA) leaves the department for health in January 2023
Prof Philip Banfield, Chair of the British Medical Association (BMA) leaves the department for health in January 2023 Photograph: Carl Court/Getty Images

Anita Charlesworth, head of research at the Health Foundation charity, also described the health service as undergoing “managed decline” and that it had ended up becoming overwhelmed because governments had made “a choice” to give it less money than it needed.

Rachel Wolf, a co-author of the Conservatives’ 2019 general election manifesto, has said that the government has broken its pledge to build “40 new hospitals” and that that is damaging the NHS.

The lack of new buildings is limiting the amount of care the service can provide, at a time when it has record staff and funding, she said.

Speaking to the Guardian, she said: “The 2019 manifesto promised more doctors and nurses – great – but also new and rebuilt hospitals.

“We needed to deliver on the second because we do have more staff but we don’t have the space and the beds and the machines for them to work at maximum efficiency. It’s one of those things that is so demoralising for staff.”

Wolf recently co-wrote a report for the Institute for Government thinktank about the NHS’s “productivity puzzle”.

Ministers need to embark on a massive programme of capital spending so the NHS can leave behind cramped, outdated buildings and offer care in larger, purpose-built facilities, she said – echoing a longstanding demand from organisations like NHS Providers and he NHS Confederation.

Hospitals also need to be able to access capital funding for building projects and buying new equipment far faster than the current system, which critics say is overly bureaucratic, takes far too long and in which the Treasury has too big a role, they claim.

Wolf added: “I’d radically simplify and speed up the process by which capital can hit the ground and be used: no endless planning system, no opaque mechanisms from central government.”

The Department of Health and Social Care declined to respond directly to Banfield’s remarks. A spokesperson said: “There are more staff than ever before working in the NHS, which has led to a record number of cancer patients being treated over the last two years. And in April there were a record number of diagnostic tests carried out per working day.

“The NHS has published the first ever long term workforce plan, backed by over £2.4bn [in] government funding to deliver the biggest training expansion in NHS history alongside measures to improve culture, leadership, and wellbeing.”

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