I was talking to a friend the other day whose sister-in-law works in the Health Service. She had plenty to tell me about it.
Essentially the ageing population – in itself surely a positive outcome of universal health care – is putting pressure on the Service. That much we know, of course. This is true for obvious reasons. However, it is also true for some not so obvious ones too.
The ageing population does not just mean that a higher proportion of the population requires care, but also that there is a proportionately smaller healthy workforce available to pay for it. On top of that, the ageing population develops increasingly complex needs for which the Service at the outset simply was not designed.
What was most striking about what she said is that the medical profession, in the front line, is a vocation. People in it do not wish to leave anyone behind. It is simply impossible to prioritise one patient over another, even when “systems” dictate this would be wise. The stress caused on practitioners by the knowledge that “systems” say one thing but “emotions” (or even “humanity”) say another is unprecedented and goes largely (if understandably) ignored.
On top of this, there are the additional complex needs of the legacy of conflict and, arguably, an increasingly segregated society in urban areas who may come to resent others having access when they perceive they they themselves do not.
This is why Reform of the Service is absolutely necessary. It is unfair not just on patients, but also on staff who are trying to do the best they can, to leave an overburdened Service which will only become more overburdened (even post-austerity) by simple demographics and increasingly complex needs (and not only among older people).
Hence the Health Service, while much admired in theory, is often described as “on the verge of collapse” in practice.
Oh, by the way, this was not Northern Ireland she was talking about. It was Sweden.