Pay for resident doctors has increased by 28.9% in the past three years, the biggest increase of any profession, after years of strike action.
Meanwhile, the UK’s health is showing signs of worsening.
Today’s pensioners can expect to spend around a decade in ill health, but that figure is expected to double for those born now without a gain in life expectancy, meaning that around a quarter of their life will be spent in ill health, at vast cost to the NHS.
Bethell, who was a health minister during the Covid-19 pandemic, said the figures were “troubling” and “frustrating” – and pointed out they were more stark in poorer parts of the country.
“That’s a social, moral and economic disaster for the country,” he said.
“We’re putting the financial future of our nation in jeopardy. Our children are not going to be able to afford the schools and hospitals that they deserve.”
He and Van-Tam urged ministers to change the way health was measured to focus on outcomes, such as healthy lifespans, rather than NHS performance measures.
Bethell said: “We’ve doubled the amount we spend from basically £100b to £200b a year in the last 17 years for no impact on our nation’s health.
“The nation’s health is for the bottom half of the country deteriorated, and for the top half marginally improved, and overall average longevity has flatlined after years of gains.
“That is a terrible return on investment. And the Treasury, quite rightly, are furious and are basically nihilistic about the way in which we spend on health.
“They just think it’s a totally sunk cost, no benefit for the economy and for the financial and spiritual prosperity of the country. And they’ve got a point.
“So why has that happened? Because you have no measurement or target or mission or vision around actually improving the underlying health of the country.”
Average lifespans at birth remain 79 for men and 83 for women, as they were in 2009, figures show.
Van-Tam said the NHS needed to be “re-engineered” to spend far more on preventing ill health and intervening early, rather than waiting until people faced decades with chronic illnesses.
He said the waste “drives him mad” and money was too often spent on taxis for “silly” reasons.
He said he was particularly concerned about the amount spent on hospital care for those who should be receiving treatment elsewhere.
One in six hospital beds is blocked by patients who are medically fit to be discharged, drastically reducing capacity for those in need.
“There’s certainly a lot of wastage in terms of people being tied up with delayed discharge, which impacts patient flows,” he said.
Asked whether lockdown might have been avoided, if the NHS had been able to use its capacity more efficiently, he said: “That’s a big question, and I’m not going to answer that question about avoidance of lockdown. It’s highly, highly political.
“My personal view is that we were very close to really significant difficulties, particularly the intensive care part of the NHS, if we had not had the lockdowns we had.”
He added: “What we need to do is have some kind of really thoughtful reset about how we now, given this demographic issue, how we start to squeeze every last drop out of the resources we have to put into healthcare. Part of that is identifying wastage, where it occurs, and starting to deal with it.”
Van-Tam, who was deputy CMO during the Covid pandemic, highlighted examples of inefficiency, such as hospital pharmacies sending taxis long distances to deliver medicines, rather than allowing patients to collect them locally.
He said: “It drives me mad that the shortfall on a medicine that can be issued from a pharmacy might be a few pounds, and the solution is to throw a lot of pounds at it, to wait for it to be in stock and then deliver it manually in a petrol-powered vehicle to the patient.”
He said poor data collection meant the NHS had no record of how much was spent on taxis. He also raised concerns about “needless” spending on prescriptions, and over-prescribing of medicines.
Both Bethell and Van-Tam called for “a big resource shift” to take money out of hospitals and into services closer to home, a pledge successive governments have made but not delivered on.
They also urged ministers to work quickly on the rollout of more personalised healthcare, to monitor trends, with better data collection allowing “early warnings” and, as a result, much earlier intervention.
Van-Tam added: “Modern public health has to be personal. It’s about tracking risk, looking at trends over time, and intervening early – not just spotting when things have spun out of control.”
A Department for Health spokesman said: “The Health and Social Care Secretary has set a clear mission: to close the gap between the wealthiest and poorest parts of our country, so everyone lives well for longer. Through our 10 Year Health Plan, we are shifting the focus of the NHS from sickness to prevention.
“Just this week, we announced new incentives for GPs to do more to prevent disease through vaccinations, screening and weight-loss.
“The Government has a big public health agenda to improve the health of the nation – including banning energy drinks for under 16s, creating the first smoke-free generation, and clamping down on junk food targeting kids.
“Our ambition is to make sure that kids growing up today are part of the healthiest generation who ever lived.”
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