Sally Allen: National health service has neither heart nor hope

After doing considerable research, and it wasn’t really necessary, as the result was already clear, the NHS is in an appalling mess.

The NHS is one of the world’s largest employers, with around 1.37 million full-time equivalent staff in England as of January 2025. Consequently, the wage bill for the NHS makes up a substantial proportion of its budget. In 2023/24, the total cost of employing the staff in the NHS was £81.7 billion, which was 49.2% of the NHS budget. These statistics don’t include salaries for GPs (who are not directly employed by the NHS) or employees in the Department of Health and Social Care and other national bodies, such as NHS England. GPs and GP practice staff are indirectly funded by the NHS through a complex system of contracts.

Top management can expect a salary of £280k plus with the lowliest management receiving around £125k. I can understand highly trained medical doctors receiving salaries at this level, but not administrators, particularly when they are clearly not achieving the level of care for patients that we all need.

You add to this successive governments making a total Horlicks of it all, and you end up down ‘no hope alley’. I came across an NHS letter which had been dropped outside a Derby hotel, currently housing illegal immigrants. A copy of which you can see in the photograph. It is mind boggling that on landing in this country, they are entitled to: free NHS prescriptions; free NHS dental treatment (something much of our population can’t get access to); free NHS sight tests; the full value of a voucher towards the cost of glasses and contact lenses; free NHS wigs (WHY???) and fabric supports plus a refund of necessary costs of travel to receive NHS treatment.

Is there any wonder that our NHS is overwhelmed at every level. The government needs to/has to prioritise sorting out illegal immigration to alleviate the pressure on our health system and the huge financial burden it puts on the shoulders of the NHS and the public.

Even without the added illegal immigration problem, the list of waste is endless once you look under the NHS bonnet. For example, and just one small thing, even perfectly good crutches get chucked away and are not re-used. Therefore, I understand the current government’s objective with their 10-year-plan to reform the NHS in England, based on a shift from hospitals to neighbourhood health hubs, a new focus on prevention and better use of technology.

However, and it is a big however, the way that they are going about it at the moment, is going to lose more lives than it will save. All their theories are based on everything working well and people actually not being that sick, so they can pop into their local health hub for clearly nothing very serious of life threatening. If this goes ahead, there is no question that the NHS focus will have changed from saving lives, to preventative care. I understand the theory, but in practice people will die. 

I totally understand the need to save money, but a culling of the fat cat management, who have quite clearly failed at their jobs, might be a better option.

This all brings me back to our extremely critical situation with our own Torbay Hospital and the proposed ‘Case for Change’ initiative by the Devon Integrated Care Board (ICB). This now means that they are now looking into the overall ‘cardiology pathway across Devon’. 

It is now critical for us all to unite and act to ensure that our first-class Cardiac Unit stays at our hospital. The Torbay Hospital Cardiology team stands united in firm opposition to any proposal to down-grade or move the unit to the RD&E Hospital in Exeter. From an ethical standpoint, centralising cardiac treatment away from the Bay is anti-Hippocratic as it knowingly subjects patients to avoidable harm.

Added to this, it is economically short-sighted and unsustainable as delaying treatment by minutes means more cardiac muscle damage and long-term complications. These outcomes will incur lifetime costs to the NHS in the form of medication, ongoing surveillance and hospital readmissions. Death of course is the other most likely outcome, which of course would save the NHS money, so maybe that is their objective!

With the Torbay Hospital’s catchment area of around 300,000 residents and an additional influx of tourists over the summer, it would then make the cardiac facilities at Exeter, or indeed Plymouth unsustainable. Not forgetting that the RD&E already has a large waiting list they are finding difficult to deal with already. Let’s not forget that there won’t be any more beds than are already available at these two hospitals, so in short, none!

The other issue which seems to have been largely overlooked is that any patient needing a general anaesthetic for a procedure, is unlikely to be able to have it at the Torbay should the Cardiac Unit be moved. Surgeons are very unlikely to operate without cardiac support for even the simplest procedures as they do have a duty of care, and there is always a risk with any anaesthetic of a cardiac emergency.

 So, please see how important it is to support the Heart Campaign to keep our Cardiac Unit at Torbay Hospital. Please join us on Tuesday, July 29th at the Livermead House Hotel at 5pm for a prompt start at 5.30pm. Cardiologists from the hospital will be presenting how important it is to get involved to help save their unit and Steve Darling MP will also be giving an update on the latest proposals from the ICB (NHS). This is vital to all of us as we desperately need the Torbay Hospital to retain its status as an ‘acute’ facility. Remember, we are all only a heartbeat away from needing the help of our Cardiac Unit.