NHS: Care on a stopwatch

There is no denying the seismic upheaval Covid-19 has had on health and care services and on people’s lives. As society faces ongoing challenges post-Covid, frequent headlines draw attention to the growing backlog for elective care (non-urgent medical treatments, procedures, and surgeries), increasing waits in A&E departments, longer ambulance response times and waits for cancer treatment that have built up over the course of the pandemic and only increased afterwards.

But what was happening to access and waiting times in the years preceding the pandemic and to what extent is Covid-19 to blame for the current pressures facing the NHS? Is there a fundamental problem in how care is analysed for efficiency and quality?

The modern Western world prides itself on their standards and advancements of healthcare, especially the UK through the existence of the NHS, a beacon of universal healthcare and “of how great; Britain really is”, it champions the right of every citizen to enjoy this foundational piece of their society. However, during the Covid-19 pandemic the paradox was put on full display. On the one hand, the UK government celebrated the NHS and the values that came with it, while on the other, they kept cutting its budget, further damning its quality of care, and the cuts are still on-going. This paradox has existed for more than a decade preceding the pandemic, there has always been constant cuts to the NHS, and endless calls for privatisation.

The cultures of deadlines not met and waiting times has become well-known. Pressure from superiors and members in Whitehall leading the rushed decision-making leading to errors and sub-optimal care. As well as burnout amongst “underpaid” nurses, doctors and healthcare professionals due to stress and long-working hours which again impair decision making and patient care.

Why are we in this predicament? The simple reason is because the healthcare service is run by the government, and the government has to balance the books, so even though universal healthcare is a right for every British citizen, if the economic outlook is not favourable then the finances take a priority over the quality given.

This argument may seem logical on the face of it, if there is scarce money to spend, we need to prioritize where the remaining is distributed, however this argument is left in the water, once we saw tax cuts to the rich at the same as cuts to benefits given to the poor, the pay rises given to MPs before being given to nurses and doctors, when we saw billions given to associates of MPs and Lords though the awarding of contracts during the pandemic for PPE which was ineffective and other materials, all purchased at inflated rates.

This choice to benefit one group over another, or benefit themselves and their associates over the populace is the fundamental problem. Politics in this day and age is for power, control and influence; not for the betterment of the people and looking over its affairs. This is evident by the constant investigations and exposés about politicians in this country, it is a common narrative, that the vote is not worth what is once was, the political options are more of the same, and there is no true alternative to the corruption we see today.

In contrast to the shallow popular culture of the West, one might recall that the Khilafah was once the beacon of healthcare throughout history. it excelled in all fields such as science and technology. In the past, individuals under the Khilafah made a tremendous contribution to the medical field.

The Khilafah was blessed with many first-class hospitals and doctors in several of its cities: Baghdad, Damascus, Cairo, Jerusalem, Alexandria, Cordova, Samarqand and many more. Baghdad alone had sixty hospitals with in-patient and out-patient departments and over 1,000 physicians.

Public hospitals like the Bimaristan al-Mansuri Hospital, established in Cairo in 1283, had accommodation for 8,000 patients. There were two attendants for each patient who did everything for his/her comfort and convenience and every patient had his/her own bed, bedding and vessel for eating. It treated in-patients and out-patients giving them free food and medicine.
There were mobile dispensaries and clinics for the proper medical care of the disabled and those living in the villages. The Khalifah, Al-Muqtadir Billah, ordered that every mobile unit should visit each village and remain there for some days before moving to the next.

From the above historical accounts, we see that when the leaders see their position as a responsibility rather than an opportunity, then and only then did a society truly thrive and succeed. For the Khulafaa’ it was not about simply providing medical services, rather it was to fulfil the needs of the citizens entrusted to them for which they will be held accountable for.

The lessons from the Khilafah’s historical legacy remind us that civilizations thrive not through the individual aspiration of the populace, but through the understanding of everyone’s role and responsibility, from leader to citizen.

The leader has a responsibility to provide sufficient funding for quality healthcare of the people entrusted to him, the ministers have a responsibility to use the money provided in the best, most efficient way and not inflate prices for personal gain, the doctors have a responsibility to the patient to attend to their ailments for however long is needed and not have the burden of caring on a stopwatch, and the citizen along with Allah (swt) has the responsibility to account all three tiers above when that is not the case. This environment cultivated the progress and success in the past, and is the only way we will see it again.