Nick Hulme, the chief executive of the East Suffolk and North Essex NHS Foundation Trust, has issued a stark warning about the future of the National Health Service as he prepares to leave after nearly five decades in healthcare. With the NHS facing critical challenges, including a recent doctors’ strike and a burgeoning flu crisis, Hulme’s departure comes at a time when the system is under intense pressure.
Hulme expressed deep concerns, stating, “I can’t remember a time when the NHS was at such risk.” Despite increased funding and staffing under the Labour government, he noted that waiting lists remain stubbornly high. He emphasized that this situation could provide ammunition for critics like Nigel Farage and the Conservative Party, who have long advocated for alternatives to the NHS. “Private practice is soaring,” he said, pointing out that a return to historically low waiting times could again threaten NHS viability.
In his view, the idea of “choice” in healthcare is misleading when the system lacks the necessary capacity. He criticized politicians for failing to address issues stemming from long wait times and suggested that consultants should face stricter scrutiny for maintaining lengthy waiting lists to boost demand for private services.
Hulme’s career has been marked by both triumph and frustration. Starting as an 18-year-old porter, he rose through the ranks, even spending time in Boris Johnson’s administration. He has witnessed the NHS navigate complex challenges, including the ongoing effects of poverty and inequality that impact healthcare delivery.
The trust operates a well-regarded cottage hospital in Aldeburgh, which has a dedicated volunteer base that raised £320,000 for a new X-ray machine. In contrast, the trust also serves areas such as Jaywick and Clacton, where healthcare access is significantly more challenging. Patients in these communities face barriers, such as the need for multiple bus rides to access screenings and treatments.
Hulme highlighted that approximately 70% of patients in his beds are over 65, with many suffering from conditions linked to poverty, such as obesity and diabetes. He argued that the NHS should pivot towards preventive care rather than focusing solely on treatment, especially as resources remain stretched thin. “What couldn’t we do for Jaywick with those scanners?” he lamented, emphasizing the disparity in healthcare access across regions.
Despite his frustrations, Hulme remains hopeful about the future of the NHS. He believes that meaningful change is possible, but it will require a concerted effort to address systemic issues. The recent Care Quality Commission inspection of his trust, which resulted in a “requires improvement” rating, was a source of frustration for him, especially since he believes the quality of care provided is high.
At Colchester Hospital, where he spoke, Hulme highlighted the challenges of maintaining productivity in a system under constant strain. The trust has invested in a new £90 million orthopaedic centre, which offers modern facilities but comes with increased costs associated with staffing. “Why do some wards turn around an empty bed in 20 minutes, while others take three and a half hours?” he asked, illustrating the inconsistencies that plague the system.
Looking ahead, Hulme is wary of the NHS’s ability to sustain itself without rapid improvements. He warned, “Unless the NHS improves fast, people will fall for charlatans offering snake oil alternatives.” His concerns reflect a broader anxiety about the future of public healthcare in the UK.
As he prepares to leave his role, Hulme has sharp words for resident doctors, reminding them of their privilege in the system. “Not many have such a guaranteed very good job and pension for life, starting at £38,000, £109,000 once fully trained,” he stated, urging them to remain connected to the realities faced by their patients.
Nick Hulme’s departure marks the end of an era for the East Suffolk and North Essex NHS Foundation Trust. His insights underscore the pressing challenges the NHS faces and the critical need for reform to ensure that it continues to serve all citizens effectively.
