past 30 years the Official I may be a white boy but i’m not stupid joe biden shirt in other words I will buy this number of beds in England has more than halved, from around 299,000 in 1987 to 141,000 in 2019, according to analysis by the King’s Fund, an independent think tank. Siva Anandiciva, chief analyst at the King’s Fund, told this decrease was partly attributable to the “changing model of care.” As technology and treatments improved, people spent less time in hospital, reducing the need for beds. The last Labour government, in power from 1997 to 2010, also cut bed numbers, despite increasing investment elsewhere. “You can keep reducing how long patients stay in hospital,” said Anandaciva, but eventually “you approach a minimum. If you then keep cutting bed numbers … that’s when you start to get into problems like performance.” During the austerity years, bed numbers continued to be cut, leaving the UK with fewer beds per capita than almost any developed nation, according to OECD data. “For a long time we knew we just didn’t have the bed capacity,” Anandaciva said. But cuts continued in the name of “efficiency,” he added. While low bed numbers were seen as a marker of “success” indicating that the NHS was running efficiently, it left the UK woefully underprepared for a shock like Covid-19. The same factors that made the NHS “efficient” in one context made it grossly inefficient when that context changed, in his analysis. Social care The bed shortage has been made even more acute by the fact that many of those in hospital no longer need to be there – there is simply nowhere else for them to go. “The longest I had a patient that was physically and medically ready to go home, but was sitting around waiting for discharge, was four weeks,” said Angus Livingstone, a doctor working in the John Radcliffe Hospital in Oxford. The problem is caused by a crisis in another sector: Social care. Patients that could leave the hospital end up staying there because they cannot access more modest care in a home setting and so cannot be safely discharged. Many
patients are well enough to leave hospital, but cannot be looked after elsewhere. Jeff Moore/PA Images/Getty Images Health and social care are separate sectors in the Official I may be a white boy but i’m not stupid joe biden shirt in other words I will buy this UK system. Healthcare is provided by the NHS, whereas social care is provided by local councils. Unlike the NHS, social care is not free at the point of use: It is rationed and means-tested. There have long been calls to integrate the two systems, since a crisis in one system feeds through into the other. “If you allow us to regain the enormous number of beds that are currently occupied by people awaiting social care, then I would be very confident that the immediate snarl-up in A&E and ambulances waiting outside would pretty much disappear overnight,” Neville said. “When people ask me, ‘where do you want the money in the NHS?’ My answer is ‘I don’t want it in the NHS. I want it in social care.’” With an increasingly aging population – the latest census data show nearly 19% of the population of England and Wales is now
