Nick Hulme Reflects on NHS Challenges and Calls for Urgent Reform
Nick Hulme, the chief executive of East Suffolk and North Essex NHS Foundation Trust, is stepping down after 46 years of service in the NHS amid ongoing junior doctors' strikes and a severe flu crisis.
Hulme asserts that while the NHS remains the best system, it is not delivering the best results and warns that without rapid improvement, the service could be vulnerable to exploitation by its opponents. He highlights that Labour's increases in funding and staffing have brought only modest productivity gains and slight reductions in waiting times, with waiting lists remaining high.
The rise in private practice activity, which previously surged when waiting times were reduced, may increase again if waits fall, with insurers such as Bupa citing NHS waits as a significant risk. Hulme criticizes the political focus on 'choice' that demands spare capacity and advocates for tougher action on long consultant lists, acknowledging resistance from the British Medical Association and Royal Colleges and noting cross-border use of physician associates in Europe.
During the pandemic, the NHS experienced cross-disciplinary collaboration, but since then, the system has reverted to restrictive silos and professional demarcations.
Hulme's career began as an 18-year-old porter, including a brief tenure working in Boris Johnson's No 10. In his area, 70% of hospital bed occupants are over 65, and 75% suffer from poverty-related diseases. Recognizing poverty as a major driver of high treatment costs, he supports a social-priority approach targeting functional issues in poorer communities such as Clacton and Jaywick.
In Colchester, a new £90 million orthopaedic centre featuring private-style single rooms costs 30% more to nurse than traditional larger wards. The centre is not yet at full capacity, and its future depends on decisions by the integrated care board regarding consolidation of units.
