The Voyage aboard a Harmonic Tide

As we ride past the peak that is the Summer solstice and begin our descent towards the impending gloom of shortening days, we embark upon this journey with glorious heat. Somewhat easing our ordeal, the sun beats down upon the golden beaches and expansive oceans providing the perfect setting for the current student holiday season. With this literal warmth, I gladly welcome back our readers for the second issue of the Journal of Student Medical Sciences. As the information peaked at our launch and ebbed away in our absence, we put forward another packed edition to stimulate our readers in the same harmonic motion that governs the length of days.

Though I allude to vacations and breaks, I hasten to remind you that research and Science itself is perpetually edging forward- and the current period is no exception.

The bell-shaped curve is widely appreciated and accredited to nature, being the embodiment of the “normal distribution”. Could it be, however, that the sine curve of simple harmonic motion may more appropriately be assigned to the cryptic ways of the world? Further to the demonstrations above, might I suggest that the emergence of Influenza A H1N1, in the form of Swine Flu, may exemplify this trend. Currently the World Health Organization has confirmed over 89,000 cases of Swine Flu and classified the outbreak as a Pandemic [1]. This disease has however flown in off of the back of H5N1 or Avian flu, whose curve peaked in 2006 [2] and is in decline as fewer cases are reported each year. It would therefore seem that the instance of the world teetering on the edge of a pandemic follows simple harmonic motion, with the decay of H5N1 and the rise of H1N1- mimicking the preludes that included the Asian and Spanish flu pandemics.

This idea can further extrapolate to the financial state of the NHS. Currently, the NHS is overseeing a rare period of growth. Following a £547m [3] deficit in the 2006-07 year, a £1.658bn surplus was recorded in 2007-08. This led onto a further £1.75bn surplus for the current financial year. The news comes following a decade of reports suggesting that the NHS is unsustainable and on the brink of collapse and surely denotes the summit of the peak of the NHS.

It is in this climate that the NHS Confederation aired their view that the healthcare system will be facing an extraordinary challenge in maintaining its financial viability in the next 5 to 10 years [4]. With an aging UK population and rising costs of newer medical therapies, they argue that future increases in the NHS budget will be fast surpassed by the rises in costs. The BBC reports that these changes may amount to an effective decrease in the NHS budget by £8bn-£10bn after 2011.

The effects of this are likely to affect not only medical students, but also students of other faculties. Such deficits could impact upon the NHS so broadly as to involve sectors not directly responsible for patient care, including clinical scientists and managers. It is possible that spending cuts may encroach upon the research budget and significantly alter the face of clinical research in the NHS. With all these changes and with the current economic climate showing no sign of respite, a vast crop of new graduates may find themselves unemployed in a saturated field of redundancies.

The picture painted by the NHS Confederations seems to converge upon a very sticky and fundamental point concerning the function of the NHS. Should the NHS modernise with an ethos to further medical practice and treatment at the cost of redundancies, or should it devolve back to the roots from whence it came- providing grassroots socialist medicine and employment for the masses whilst sacrificing all else? The former would of course involve embracing the rising costs of newer and better treatments in order to fulfill a role as a dedicated and innovative healthcare provider.  Needless to say, the latter would still provide a basic form of healthcare treatment for the country- but questions regarding the boundaries and ethics of which diseases the NHS can and cannot afford to treat is one that will inevitably remain controversial.

Conceptually, the development of last year’s surplus is the crest of a simple harmonic wave and the potential wayward spiral into budget deficits follows the descent of the curve into the doldrums of the rebound trough. Though knowing the path of trend allows one to deduce the general consequences of the events to occur, the amplitude of these effects remain shrouded in uncertainty.

References

1. WHO Pandemic H1N1 2009- Update 57. [cited 2009 Jul 4] Available from: http://www.who.int/csr/don/2009_07_03/en/index.html
2. Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO. [cited 2009 Jun 27] Available from: http://www.who.int/csr/disease/avian_influenza/country/cases_table_2009_06_02/en/index.html
3. NHS has £1.7bn unspent in the bank, MPs find- Telegraph [cited 2009 Jun 27] Available from: http://www.telegraph.co.uk/health/healthnews/5355974/NHS-has-1.7bn-unspent-in-the-bank-MPs-find..html
4. BBC News, NHS ‘faces huge budget shortfall’. [cited 2009 Jun 27] Available from: http://news.bbc.co.uk/1/hi/health/8091427.stm