The future of the NHS as a topic for medical interview questions

Several recent and current healthcare news stories from different viewpoints are colliding to create increasing alarm over the future pressures upon the NHS. The Health Select Committee has highlight the fact that dealing long term health conditions, such as diabetes, accounts for 70% of all health spending to be focused upon just 30% of patients.  By 2025, they estimate the number of such patients could rise from the current level of 15 million in England to 18 million.  The MP’s state that cutting back on hospital services “is a recipe for disaster”.  Side by side with this on the BBC News Health webpage coming regular reports of major investments in research and drug developments – investments which the manufacturers will want to recoup once their products are approved and released.

On the 7th of July, a letter was sent to The Times, signed by numerous high profile healthcare opinion leaders, including heads of Royal Colleges, provider representative groups and charities.  Their message was hard hitting and clear.  “Unless action is taken, by 2020 maintaining the current level of service provision will require an extra £30 billion just for the NHS.”  To put this in context, £30 billion is equivalent to the amount that we spend each year on defence.  They add the fact that similar financial crises face both social care and housing.  Simply making the NHS more efficient will not be enough and “the status quo is not an option.”  Stretching resources further can only add to the shortfalls in care which make the headlines.  The signatories point out the options: “higher taxes, payments for some elements of healthcare or a review of what is available on the NHS.” And they call for a “national conversation” to start now between politicians and citizens to be completed by the end of 2015.

Any doctor currently preparing for a medical interview, whether for a new consultant post, or at this autumn’s round of ST interviews, can reasonably expect NHS funding and structure to be on the agenda.  A firm grasp on the facts, including the range of opinions and an understanding of how future changes may impact upon patient care, colleagues and personal practice will demonstrate that you are in touch with reality.  This requires time to be set aside to proper research the topic and to crystallise you own point of view.   When doing so, it is always worth looking outside of our own system to see what others are doing.

One article in the Health Service Journal argues that Japan’s healthcare model, with a radical 2025 vision to address its own ageing population sets an example to the UK. Appealing though the ideals of integrated health and social care delivered via micro-multifunctional facilities may be, could an approach with such extensive private sector, corporate involvement ever gain commitment on these shores – especially as there is minimal evidence to support the model’s foundations?