Fix Poverty, Fix Health: Inside the Struggling NHS

In one of the most deprived areas of the north-east of England, a small GP surgery known as Bridges Medical Practice is on the front lines of the healthcare crisis that has gripped the National Health Service (NHS). As winter flu season intensifies, the practice is overwhelmed with patients, struggling to provide care in an already overstretched system. For Dr. Paul Evans, the lead GP, this means long hours, a never-ending stream of consultations, and the constant pressure of trying to keep his surgery afloat amidst increasing demands. His words echo a sentiment that resonates across the NHS: “We are seeing the system fail.”

This detailed exploration of a day in the life of a “failing” NHS highlights the profound challenges faced by healthcare professionals working on the ground, as well as the systemic issues that have led to the current crisis. The Guardian video producers Maeve Shearlaw and Adam Sich shadowed Dr. Evans during this critical time, offering a rare glimpse into the struggles and frustrations of healthcare workers in one of the most pressured parts of the NHS.

The Impact of Austerity and Poverty on Health

At the heart of Dr. Evans’ frustration is the link between poverty and poor health. The area surrounding Bridges Medical Practice is one of the most economically disadvantaged in the country, with high levels of unemployment, low income, and inadequate access to quality housing. According to Dr. Evans, addressing poverty is crucial to addressing the health crisis. He believes that without tackling the root causes of illness—such as poor diet, lack of exercise, and inadequate access to healthcare—efforts to improve the NHS will ultimately fall short.

“Fix poverty, fix health,” says Dr. Evans. This sentiment underscores the idea that socioeconomic factors have a direct impact on the overall health of a community. In areas like the one surrounding Bridges Medical Practice, high levels of deprivation contribute to a range of health problems, including chronic illnesses, mental health disorders, and substance abuse. These conditions often exacerbate the burden on the NHS, leading to longer waiting times, more frequent hospital admissions, and a rise in preventable diseases.

The consequences of austerity policies, which have led to cuts in public services and welfare, are particularly evident in these deprived areas. Dr. Evans notes that many of his patients are suffering from conditions that could have been prevented with earlier intervention or better access to healthcare. However, due to budget cuts and under-resourced services, patients often delay seeking care until their conditions worsen, resulting in more severe health problems and higher healthcare costs in the long term.

A Day in the Life of Dr. Evans

The day begins early for Dr. Evans, who has already spent hours preparing for the clinic. As he enters the surgery, he is greeted by a long list of patients waiting for appointments, many of whom have been on the waiting list for months. The clinic is busy and understaffed, with Dr. Evans working alongside a small team of nurses and administrative staff who are equally stretched thin.

Throughout the day, Dr. Evans juggles a variety of challenges. Patients with complex health issues flood into the surgery, many of them struggling with multiple long-term conditions that require careful management. A significant portion of his patients suffer from conditions such as diabetes, hypertension, and respiratory issues, which are often exacerbated by poor living conditions and limited access to healthy food.

One of the most pressing issues that Dr. Evans faces is the long waiting lists for specialist care. Due to the overwhelming demand for services and a shortage of resources, patients often have to wait months—sometimes even years—before they can see a specialist. This delay in care not only causes distress to patients but also leads to the worsening of their conditions, making them harder to treat and more expensive for the NHS to manage.

“People are being let down by the system,” says Dr. Evans. “I see patients who come in for something simple, and it turns into something much more serious because they’ve had to wait too long for treatment.”

In addition to the medical challenges, Dr. Evans is also faced with the constant struggle of managing the technical side of the practice. The surgery is operating on outdated IT systems that frequently crash, leading to delays in processing patient records and prescriptions. These technical challenges are compounded by a lack of administrative support, leaving Dr. Evans and his team with little time to focus on the critical care that their patients need.

The Emotional Toll on Healthcare Workers

The stress of working in such a high-pressure environment takes a significant emotional toll on Dr. Evans and his colleagues. Despite their best efforts, the relentless demands of the job often leave them feeling helpless and overwhelmed. Dr. Evans explains that there are days when it feels like there is no way out of the system’s failings, and the emotional burden of caring for patients in such dire conditions can be overwhelming.

Healthcare workers at Bridges Medical Practice are dedicated to their patients, but the pressures they face have led to burnout, with many considering leaving the profession altogether. Dr. Evans notes that the emotional exhaustion that comes with witnessing patients suffer unnecessarily due to a lack of resources or timely treatment is one of the most difficult aspects of the job.

“There’s only so much you can do,” says Dr. Evans. “You’re constantly running on empty, trying to do your best, but it’s never enough.”

The emotional toll is not only felt by healthcare workers but also by the patients themselves. The frustration and anxiety that come with long waiting times and a lack of access to care can lead to a breakdown in the doctor-patient relationship, making it harder for healthcare providers to deliver effective care.

The NHS Crisis: A Broader Issue

The issues faced by Dr. Evans and his team at Bridges Medical Practice are not isolated. Across the country, NHS practices are grappling with similar challenges, from a lack of funding and resources to the rising demand for healthcare services. The COVID-19 pandemic has exacerbated these issues, with a backlog of treatments and procedures, as well as a shortage of staff, making it even harder for the NHS to meet the needs of the population.

The crisis in primary care is particularly evident in deprived areas, where there is a greater prevalence of chronic health conditions and a higher reliance on the NHS for care. These areas also tend to have fewer healthcare professionals, making it more difficult for patients to access timely and effective treatment. As a result, many people in these communities experience poorer health outcomes and a lower quality of life.

The situation is further compounded by political and economic factors, including austerity measures, rising inequality, and cuts to public services. These factors have contributed to a healthcare system that is struggling to meet the needs of the population, leading to a sense of frustration and disillusionment among healthcare workers and patients alike.

The Way Forward: A Call for Change

For Dr. Evans and others working in the NHS, the solution to the current crisis lies in addressing the root causes of the problems—namely, poverty, inequality, and underfunding. Dr. Evans believes that greater investment in public health, social care, and preventive services is crucial to reducing the strain on the NHS and improving the health of the population.

“Until we address poverty and inequality, we will never fix the NHS,” says Dr. Evans. “We need a system that focuses on prevention and early intervention, rather than just treating the symptoms.”

Improving access to healthcare, particularly for vulnerable populations, is another key component of the solution. Dr. Evans advocates for a more holistic approach to healthcare that takes into account the social and economic factors that impact health. This includes providing better support for people with chronic conditions, improving mental health services, and addressing the social determinants of health, such as housing, education, and employment.

In conclusion, the NHS crisis is a complex issue that cannot be solved through quick fixes or short-term solutions. It requires a comprehensive approach that addresses the underlying social, economic, and political factors that contribute to poor health and healthcare inequality. Only by tackling these root causes will the NHS be able to provide the care that patients need and deserve. Until then, healthcare workers like Dr. Evans will continue to fight an uphill battle to keep their practices afloat and provide the best possible care in an increasingly dysfunctional system.