{"id":37430,"date":"2016-09-20T15:05:29","date_gmt":"2016-09-20T14:05:29","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/bmj\/?p=37430"},"modified":"2017-09-11T09:24:45","modified_gmt":"2017-09-11T08:24:45","slug":"nick-hopkinson-saving-the-nhs-a-lesson-from-carthage","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/bmj\/2016\/09\/20\/nick-hopkinson-saving-the-nhs-a-lesson-from-carthage\/","title":{"rendered":"Nick Hopkinson: Saving the NHS\u2014a lesson from Carthage"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-37328\" src=\"https:\/\/stg-blogs.bmj.com\/bmj\/files\/2016\/08\/nick_hopkinson-300x300.png\" alt=\"nick_hopkinson\" width=\"135\" height=\"135\" srcset=\"https:\/\/stg-blogs.bmj.com\/bmj\/files\/2016\/08\/nick_hopkinson-300x300.png 300w, https:\/\/stg-blogs.bmj.com\/bmj\/files\/2016\/08\/nick_hopkinson-150x150.png 150w, https:\/\/stg-blogs.bmj.com\/bmj\/files\/2016\/08\/nick_hopkinson.png 480w\" sizes=\"auto, (max-width: 135px) 100vw, 135px\" \/>Cato the Elder is said to have concluded every speech he made in the Roman Senate, regardless of the topic, with \u201c<em>Delenda est Carthago<\/em>\u201d\u2014Carthage must be destroyed. In answering the Editor of <em>The BMJ<\/em>\u2019s <a href=\"https:\/\/twitter.com\/fgodlee\/status\/774277019433598976\">call<\/a> for ideas on how the medical profession can protest <em>against<\/em> the destruction of the NHS, a similar clarity and consistency of message is essential.<\/p>\n<p>The simple proposal is that in every discussion on every topic of medical interest, the management of long term conditions, novel therapies, the causes and the cures of cancer, avoidable deaths, whatever thing awareness is being raised about this week, good news or bad, doctors need to include a clear statement that it is <a href=\"https:\/\/www.theguardian.com\/society\/2016\/aug\/26\/nhs-plans-radical-cuts-to-fight-growing-deficit-in-health-budget\">government policy to underfund the NHS by \u00a320 billion pounds by 2020<\/a>.<!--more--><\/p>\n<p>A new cytokine target for asthma\u2014great, but the audience needs to know that right now asthma care is constrained by <a href=\"https:\/\/stg-blogs.bmj.com\/bmj\/2016\/08\/31\/the-burden-of-asthma-how-to-frame-it-and-what-needs-to-be-done\/\">staff shortages, child poverty, cuts that are being made to smoking cessation services and poor air quality<\/a>.<\/p>\n<p>A breakthrough in Alzheimer\u2019s research\u2014great, hope for the future, but patients and families need staff with time to care now, not rota gaps and overstretched nurses.<\/p>\n<p>Every announcement (and re-announcement) of supposed \u201cextra money\u201d for today\u2019s policy priority needs to be met with a clear reminder of the overall funding picture.<\/p>\n<p>A statement from the <a href=\"https:\/\/www.theguardian.com\/society\/2016\/sep\/15\/elderly-people-social-care-cuts-kings-fund-nuffield-trust-report\">Department of Health<\/a> of a government \u201ccommitment\u201d to ensure that older people can get \u201cdignified care&#8221;\u2014you get the idea.<\/p>\n<p>The recent joint report from the Kings Fund and Nuffield Trust finds that social care spend has also <a href=\"http:\/\/www.kingsfund.org.uk\/publications\/social-care-older-people\">collapsed<\/a> with an 11% reduction in local authority funding for social care of older people and a 26% fall in the number receiving it. This, despite the supposed demographic time bomb of our ageing population. We must not allow this to disappear from the news cycle.<\/p>\n<p>An audience encouraged to take an interest in health, while the fact that the services patients need to help them cope in the community are not there, as councils are forced to implement the consequences of the government\u2019s choice to pursue austerity policies, is an audience misled.<\/p>\n<p>People do not want to believe that the NHS is in danger\u2014the least we can do is to place the consequences of political choices about health and social care, the causes of much of the inequality in life expectancy that our <a href=\"http:\/\/www.theguardian.com\/politics\/ng-interactive\/2016\/jul\/13\/theresa-mays-speech-what-she-said-and-what-she-meant\">Prime Minister has promised to address<\/a>, at the forefront of their minds.<\/p>\n<p><em><strong>Nicholas Hopkinson<\/strong> <a href=\"https:\/\/twitter.com\/copddoc\">@COPDdoc<\/a>, reader in respiratory medicine, Imperial College, London.<\/em><\/p>\n<p><strong>Competing interests:<\/strong> None declared.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Cato the Elder is said to have concluded every speech he made in the Roman Senate, regardless of the topic, with \u201cDelenda est Carthago\u201d\u2014Carthage must be destroyed. In answering the Editor of The BMJ\u2019s call for ideas on how the medical profession can protest against the destruction of the NHS, a similar clarity and consistency [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/stg-blogs.bmj.com\/bmj\/2016\/09\/20\/nick-hopkinson-saving-the-nhs-a-lesson-from-carthage\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[236,18889],"tags":[],"class_list":["post-37430","post","type-post","status-publish","format-standard","hentry","category-nhs","category-nick-hopkinson"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts\/37430","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/comments?post=37430"}],"version-history":[{"count":0,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts\/37430\/revisions"}],"wp:attachment":[{"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/media?parent=37430"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/categories?post=37430"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/tags?post=37430"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}