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Unprecedented: The NHS Crisis

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Okuda San Miguel

On the weekend of 3 December 2016, all of London's paediatric intensive care beds were full. The system was under such pressure that every specialist ward had reached capacity. What do you do, as a parent, if your child becomes seriously ill under those circumstances? Pray?

NHS England had been sending alarm signals about resources and safety for months. In September, 32% of the most urgent ambulance calls in England weren't responded to in eight minutes, the worst performance ever. In November, the number of cancelled urgent operations was 466, double the previous year. From 1 to 27 December, one in three NHS trusts issued serious alerts about the pressures they were facing.

The message was clear. But no one is listening. Worse, hospitals were told to shut up by Theresa May.

This January saw the inexcusable dismissed by the government. 20 hospitals issued 'black' alerts, meaning they could no longer guarantee patient safety or provide all services. "If your family live here and make a 999 call, you are at serious risk of not receiving the treatment you would need," said a hospital chief executive in the north of England. In the words of another trust boss, "I've not seen anything like this in 37 years."

For some, it was already too late. Patients died waiting on trolleys in Worcester. In Sheffield, an unnamed man died after waiting two hours and 40 minutes for an ambulance.

The government says all the headlines are just an over-reaction to the annual winter increase in demand. Simon Stevens, Head of NHS England, disagrees. The pressures on hospitals, he says, are "real and legitimate". The Royal College of Nursing says its members are reporting the worst conditions they've ever seen. The Royal College of Physicians says the same.

I've not seen anything like this in 37 years

Why is this happening? Health secretary Jeremy Hunt, a proven liar, points to the 4.6% increase in A&E patient numbers compared to the previous year. Putting aside the entirely predictable nature of this increase (demand rises year on year), it doesn't explain the problem. As one anonymous consultant put it, "Our problem is not the patients. It's the lack of capacity."

According to Hunt, the 37% of patients who are sent home from A&E are irresponsible, capacity-blocking scroungers who are ruining the NHS. Doubtless, some A&E use is inappropriate, although being sent home is not in itself a sign a patient shouldn't have been assessed. But by definition, a patient sent home doesn't take up a bed, and it's the shortage of beds that is precisely the problem. Nationally, we've already lost 13,822 since 2010.

Where are these patients coming from? The underfunded and under-staffed GP service contributes some. More arrive via the failing social care system. In 2015/16, nearly a third of patients who spent more than 12 hours waiting on a trolley were over the age of 80. The number of septuagenarians experiencing the same wait has doubled since 2013.

Other telling details reveal Hunt's deceit. The health service last year spent 20% of its capital budget (normally reserved for long-term investment) on day-to-day costs. The idea that a bunch of feckless drunks is costing £950m is frankly silly. In reality, despite the government's claims of an extra £10bn of funding (now debunked by the UK Statistics Authority), health spending in relation to need remains at some of the lowest levels in NHS history.

As Simon Stevens observes: "There are real pressures [...] It doesn't help anybody to pretend there aren't finance gaps." Campaigning doctor Ben White puts it another way: the government has "taken a political choice to cut the NHS, despite promising [it] wouldn't."

On Saturday 4 March, the #OurNHS national protest will take place in London. Groups from Sheffield will join people from all over the country to say enough is enough. We've all seen the headlines. We all know people who work in or use the NHS and we've all seen the actions of this arrogant, unopposed government. The march will send a very clear message to Jeremy Hunt and Theresa May. Stop what you're doing and act.

Laurence Peacock

Next article in issue 107

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