YMust be seen to be believed. A few days after Christmas, I hit my head on a scaffolding bolt. There was a lot of blood and pain on the right side of my face and in my neck. I thought I could live with it, but the next day I noticed a black floater in my right eye. When, after several hours, it had not cleared up, I called 111. I was told to travel immediately to the emergency department at my local hospital. They booked me in for 9:00 pm, my expected arrival time.
I naively imagined that it would be seen then. But when I got there, there were 16 ambulances waiting to unload their patients. The waiting room was a vision of hell. All the chairs were occupied. The sick leaned against the walls. Many of the patients, from infants to the elderly, appeared dangerously ill. And yet, for all of us, the waiting went on and on.
I was seen by a doctor at 3 am. During those six hours, I witnessed two things that distressed me more than my own injury. A man with what appeared to be cardiac symptoms collapsed to the ground, possibly from a heart attack. A little boy was screaming “it hurts, it hurts!” for almost three hours without a break. It was devastating to hear it.
When a nurse called me, halfway through my wait, I asked if this was an especially busy night. “Oh no,” she told me, “this is pretty quiet. Lately most nights have been worse. Nothing I saw was the fault of the staff, working at a frantic pace to handle an impossible load. They seemed exhausted. What I witnessed was the extraordinary but now normal effects of 13 years of austerity. Hospitals across the country appear to be approaching a tipping point.
Last week I spoke to an accident and emergency specialist at a London teaching hospital. He told me that several of the nurses now depend on food banks. Young doctors with huge student debt are paid £14 an hour. Yet every day they must carry unbearable burdens and make morally corrosive decisions as they decide who to prioritize among those in immediate need. The very long waits ensure that “frustrated and scared patients are cared for by exhausted and demoralized health workers”. Verbal and physical aggression is commonplace. Unsurprisingly, the staff is leaving en masse and she can’t fill the vacancies.
There must come a point where those who remain can no longer cope and will be forced to leave as the mental, physical and moral pressure becomes too great. What happens then? Don’t ask the government. That denies the very existence of the crisis
A recent study suggests that the death rate increases 8% among people who have to wait more than six hours to be transferred from the emergency services. One estimate suggests that delays in emergency care are killing between 300 and 500 people a week in England. This is not to mention the millions of hours lost and the infections that circulate in crowded waiting rooms. Government NHS “savings” are the mother of all false economies.
In one fell swoop, the government claims to have defeated Covid so effectively that it no longer needs post infection rate. With the following, he blames the Covid pandemic for the strain on the NHS. While it is true that covid and flu are aggravating factors, the real cause lies much deeper: years of systemic underfunding.
The cumulative NHS funding gap since 2010 is over £200bn. What this means, as the recent book NHS under siege by John Lister and explained by Jacky Davis, is the difference between the money the service would have received if pre-2010 funding levels had been maintained and the money it has received since then. For all New Labour’s flaws, it followed the globally accepted rule that to keep pace with aging populations and technological change, a modern healthcare system requires a 4% annual increase in real terms in funding. when the tories reject the idea of “putting more and more money without ceasing”, they reject the idea of sustaining a functional service.
Since 2010, almost 9,000 general and acute beds have been lost in England. Of these, 5,000 were closed in March 2020 for social distancing and infection control. They have never reopened, because the NHS does not have the money to reorganize their buildings. While the Organization for Economic Co-operation and Development (OECD) average is five beds per 1,000 people, the UK has 2.4. In September 2021, the Royal College of Emergency Medicine warned that the NHS had a shortfall of 15,000 beds for emergency care. But nothing was done.
The bed crisis is compounded by a parallel disaster: the privatization and defunding of social care that began under the Conservatives in the 1990s. Because the social care system is now in permanent crisis, underfunded, personnel and places, an average of 13,000 SNS beds they are occupied by patients who might otherwise leave.
Amid all the reorganizations, disorganizations, reroutes, and U-turns, there have been two consistent policies over the past 13 years: underfunding of the National Health Service and the overfinancing of the private sector.
In the same month that the government closed 5,000 NHS beds, it blocked all 8,000 beds in England’s private hospitals and covered all their operating costs. In return, these hospitals were required to do… nothing. It was free money. Instead of easing the pressure of the pandemic, the 187 private hospitals treated, among them, a grand total of eight covid patients one day. And, perhaps because they were now being paid simply to exist, they greatly reduced the other NHS-funded procedures they handled.
In 2021, through a little-noticed policy that strikes me as outrageous as their crooked PPE deals, the government extended these payments for doing nothing for four more years, with a new “framework contract” for private hospitals. The expected cost is £10 billion.
Even when they do treat patients, transferring NHS services to private hospitals does not increase capacity. It diverts money that would have been spent in the public sector to a less efficient and more expensive service. Private hospitals do not train their own doctors and nurses. They cannot offer more services without taking staff out of the NHS.
I’m fine, by the way. When the doctor saw me, my symptoms had disappeared. But the NHS is bleeding to death in the government waiting room, waiting for a call that never comes.