The National Health Service has been creaking at the seams for years. Financial cuts and failed personnel policies have left it in a moribund state. All told, it augurs ill for its ability to deal with a pandemic.
It may be hard to believe, but there was a time when the UK's National Health Service (NHS) was held up as a beacon of equitable and universal health care coverage, funded from taxation and free at the point of use.
But these days the NHS, cherished as a "national treasure" and the "envy of the world" by many proponents, is bedridden and hooked up to a life-support system.
For years the system has been underfunded, understaffed and underequipped. Successive governments made lofty promises to overhaul the NHS financially and structurally, but more often than not failed to follow through.
Drip-feeding the NHS to keep it afloat may work in less turbulent times, but with the coronavirus pandemic sweeping across the UK, it's going to require a lot more money, staff and resources to help the NHS deal with the outbreak.
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The government has announced an emergency response fund for the NHS to deal with the coronavirus outbreak
One silver lining appeared on Wednesday in the form of Chancellor of the Exchequer Rishi Sunak's budget pledge to set aside emergency funds for the NHS in England.
"There's £5 billion (€5.6 billion, $6.3 billion) extra for [tackling] the coronavirus. It's a reserve fund across different public services which is new. We can think of plenty of things that the NHS should be able to do to bring in new capacity quite quickly — like the basics of buying protective clothing, paying for staff overtime and bringing in student nurses to address the problem," says Mark Dayan, policy analyst and head of public affairs with the Nuffield Trust, an independent health think tank.
Money for nothing?
But is that money merely a stop-gap measure? Tens of thousands of nursing posts remain vacant and beds are bursting to capacity. Not only are the beds full, the UK also has far fewer available beds than Germany, for example.
Read more: Crisis hobbles UK emergency wards
Health Secretary Matt Hancock recently said that he was going to open 5,000 intensive care beds. While that may sound good on paper, it actually suggests that Hancock may not have connected all the dots.
"People don't really understand what an intensive care bed actually means. It's not just a bed. It is a bed with a lot of equipment, a lot of very technically skilled, highly trained staff. For every intensive care bed you are looking at at least four fully qualified intensive care nurses. So if we look at opening 5,000 new beds we need to find 20,000 new fully qualified intensive care nurses," says Nicki Credland, head of the Paramedical, Peri-Operative and Advanced Practice Department at the University of Hull and chair of the British Association of Critical Care Nurses (BACCN).
To put it into perspective: It takes over four years of study and specialized training to become a qualified intensive care nurse. As Credland says, "You can't just pluck those from the trees."
An unhealthy mix
To counter that, the NHS has in the past recruited from abroad, notably from EU countries. But the uncertainty over Brexit, which has already led to an exodus of EU doctors, nurses and carers, is putting a further strain on the system. Add to the mix the government's new immigration rules, which will virtually slam the door on so-called low-skilled workers, and the UK could be facing the perfect health storm.
Read more: Brexit cripples Britain's health care system
"There'll obviously be a question about whether the government's new immigration rules might be a deterrent. Certainly they're very bad for social care, and they would bar nearly anybody from coming to work in the sector," says Dayan.
This is bad news for a sector that is already in a very poor state. Much-needed reforms have been put off for years and workforce problems have not been addressed.
"Crucially we also need social care to help keep older people who may suffer from the coronavirus virus at home or in a care home or nursing home," says Dayan.
Desperate times occasionally call for desperate measures — if they're realistic. The Department of Health recently announced that it would consider bringing back retired doctors and medical staff to help tackle the coronavirus pandemic. But is that really feasible?
"There are a number of issues with that," says BACCN Chair Credland. "Once you become a retired health professional you can't keep your professional registration for any length of time so therefore you are not actively maintaining your professional development. If they're no longer registered, they're no longer regulated and therefore no longer insured."
Leaving aside the administrative hurdles, there are also practical implications to consider, says Credland.
"Let's face it: The majority of us retire when we become elderly. The idea of bringing back a part of the population likely to be 60, 65 and over, and therefore already at a greater risk of contracting a virus such as this, and then putting them in a high risk environment, just doesn't make sense to us."