The NHS is in deep crisis. Indeed it is a constant crisis that I have been writing about for over 10 years: and year by year the situation gets worse. So this has become a regular blog (links to previous pages are listed at the foot of this blog). So in future the topic will be updated in March every year - even
though the subject will inevitably be the same - just worse each time!
The size of the crisis was demonstrated to me over the weekend by a petition sent to me via Change.org from an NHS nurse asking for "an urgent injection of funds" for the NHS, which she described as being "at breaking point". This text supported the petition.
"As an NHS nurse, I have seen first hand the effect the pandemic has had on our patients, staff, and service. The NHS was already underfunded, but now it is at breaking point. We need an urgent injection of funds to save our health service, and we need it now.
We really feel the pressure of the 100,000 vacancies in the NHS, which means we are understaffed and often having to do the job of more than one person. The workload is impossible. Staff are leaving because they have had enough and there is little incentive to stay or join the NHS.
The safety of our patients and conditions for staff have been getting worse even prior to the pandemic - and it has been happening for over 10 years. We’ve seen our pay eroded meanwhile our responsibilities and skills have only increased and lots of staff are struggling to make ends meet.
We are paying for this crisis with our mental and physical health and in our pay packets and our patients are suffering all the time as a direct consequence.
But my NHS colleagues and I are determined to save our health service. That’s why we’re joining together with the major health unions and over 40 organisations to call on this government to act, to improve the health service, and to safeguard it for future generations
Our demands are:
1. Approve emergency funding of £20 billion to save lives this winter.
2. Invest in a fully publicly owned NHS and guarantee free healthcare for future generations.
3. Pay staff properly: without fair pay, staffing shortages will cost lives.
Across the NHS we are united in saying ’SOS NHS’, and we need your support too. Will you sign my petition to help save the NHS?"
This succinctly encapsulates the problems faced by the NHS, the crisis in which it finds itself, once more; and the normal response to the crisis? Always another massive injection of resources to "save the NHS".
The fundamental reason
for these ongoing, and deepening NHS crises is that conventional (or pharmaceutical) medicine is, as always, ignored. More of the same medicine will not save the NHS.
- The NHS will continue to fail to make us better, to reduce the pressure on NHS services.
- NHS treatment is actually making us sicker, year by year, through
adverse drug and vaccine reactions (see my website on Iatrogenic Disease). I have written about conventional medical failure in detail in my E-Book, "The Failure of Conventional Medicine".
- And any new injection of money into the NHS will be used to pay for yet more of a failed medical system.
So what has been happening within the NHS during the last year? Covid-19 has, of course, provided the NHS with a new (?) excuse for its underlying failure. The NHS has effectively become a Covid-19 service - to the detriment of all else! Throughout the two years of the pandemic the NHS has received significant amounts of new additional money (the Chancellor said from the beginning - "all it takes"). And everything the NHS has received has been spent on "chasing" this virus.
Conventional medicine admitted from the beginning of the pandemic that it had no
treatment. And the public health measures that have been imposed on us - social distancing, face masks, test and trace, and lockdown, have all been spectacularly costly failures. Then, the new vaccines that have been rushed into our arms have proven to be both unimaginably unsuccessful (with more 'booster' injections being required on a regular basis), and the cause of significant patient harm. See this summary of UK data, taken from the UK government website.
So, for the past two years normal life has been put on hold, for the sick and vulnerable, and for fit and healthy people, with strong immune systems, alike. And now we are beginning to see how seriously detrimental these policies have been to all aspects of our social life, our mental health,
to child development and education, to people's
business's and livelihoods, to the national economy, and to lots more.
Yet the NHS obsession with Covid-19, which has not proven to be a significant event in relation to our health, has not altered what is happening within the NHS - it has just further exacerbated its decline into an ever-deepening crisis.
Increasing Levels of Illness and Disease.
For any country that spends ??% of its GDP on health, the bulk of this directly on the NHS, it is surely not too much to expect that it makes a difference to the lives and health of patients, and in particular, that it can be seen to tackle the scourge of illness and disease. The sole purpose of the NHS is to make us healthier. Yet it is very clearly not doing so!
Levels of sickness have been rising, often dramatically, for the past 75 years, for as long as the NHS has been in existence. Most chronic diseases are now running at unprecedented, epidemic levels, and they continue to rise. I have been writing about this for many years - this blog published in 2012. A more recent blog which chronicled the rising incidence, and the associated cost of chronic diseases such as ADHD, Allergy, Alzheimer's / Dementia, Arthritis, Asthma, Autism can be found here - CHRONIC DISEASE. The rise and rise of chronic diseases over the last 100 years; and the introduction of some new ones. There are many more 'out-of-control' chronic diseases detailed here. "Epidemics of Chronic Disease: why we are sicker now than we have ever been".
The almost total focus of the NHS on the Covid-19 pandemic has meant that many patients have had to forego either early diagnosis, or treatment, or both, for these diseases. The NHS fixation on Covid-19, and the public health strategies used to deal with it, have exacerbated the situation. Perhaps the most serious consequence has been the ongoing rise of mental health. Even the BBC, an inveterate supporter of pharmaceutical medicine, has had to admit that the NHS is "struggling with a 'long tail' of pandemic mental health".
"The number of referrals for specialist NHS mental health care reached a record high in England by the end of 2021....
"The Royal College of Psychiatrists says the pandemic has led to unprecedented demand and backlogs, and services are struggling to keep up.
"There were 4.3 million referrals, for conditions such as anxiety and depression, in 2021.....
"Just under a quarter - 1.025 million - were for children or adolescents" where there has been a "huge rise in severe cases" with the previous two years each seeing about 3.8 million referrals.
"The College had delivered 1.8 million mental health consultations in December 2021", but now "an estimated 1.4 million people were still waiting for treatment.
So not only is more money required for mental health services, many other similar situations exist throughout each NHS speciality. An ever-increasing amount of treatment is being delivered, but the treatment does not work, so there is never sufficient to cope with ever-increasing levels of patient demand.
And as usual, both the BBC article and the petition sets up the inevitable scapegoat. It's the government! They are not spending enough on health care - the NHS is under-resourced - it needs more (and more - and more) money. The result, if only politicians had to wit to see it, is what we can see happening before us.
- Record numbers of patients waiting for all kinds of treatment, a demand that the NHS cannot cope with.
- The waiting period for treatment continually increases, regardless of the condition, and regardless of how much additional spending on the NHS.
The Experience of Patients.
So record number of patients are now waiting for NHS treatment, now calculated to be over 6 million; and the amount of time patients are having to wait is increasing. Medscape has recently described this as a "disastrous NHS performance". The waiting list was 4.59 million in January 2020, so we have witnessed "an increase of just under 1.5 million, or almost a third, in a year". A trip to A&E now means that over 16,500 people (in England alone) have had to wait more than 12 hours for be seen (January 2022). Nearly 1 in 30 emergency admissions were delayed by 12 hours or more, and 60.8% were delayed by 4 hours or more. The article provides many similar figures that Medscape describe as "the worse performance since records began".
Worse is to come, apparently. A National Audit Office report has warned that even if the NHS manages to achieve its planned 30% increase in activity, the waiting list will still grow to over 7 million over the next three years. The Public Accounts Committee’s report described this as a ‘huge risk’ to primary GP care.
Many more patients are now queueing for what are described as 'Routine Operations", such a hip and knee replacement, cataract operations, and similar. The government have promised to eliminate all waits of more than a year by March 2025. The reality is that 24,000 people have been waiting for a least two years, nine time more then were waiting in April 2021.
Many patients, with a host of serious illnesses and diseases, are now waiting for treatment. The mainstream media have focused on cancer patients.
- the current 2-week target for urgent referrals for suspected cancer was already in decline, but is now considerably worse. One estimate shows only 75% of people referred toa specialist got an appointment within that time; the target is 93%. Many similar figures indicate that the NHS is continuing to fail.
- some targets are being lengthened to conceal the failure, for example, the 2-week wait for diagnosis is to be extended to 28-days.
Eve Byrne, director of advocacy at Macmillan Cancer Support, has said this about these latest figures.
"It is deeply troubling to see these figures now at yet another worst-ever record, as we know that any delay to diagnosis and treatment causes huge amounts of anxiety and distress for people living with cancer."
It
affected the availability of health services too. People were reluctant to go to hospital,
or to see their doctor. They were scared by the way the NHS spoke about
the pandemic, they were too afraid of living a normal life. Hospitals
and doctors were protecting
themselves, and did not encourage patients to attend.
So suddenly
doctors were not available to those who wanted, or needed NHS treatment. There were problems obtaining a GP
appointments. There were no face to face meetings. People who phone d
for appointments found themselves stuck
in long queues, getting through became a major issue. The cancellation of 'elective' surgery added to the frustration.Although not a
new problem, NHS capacity to respond to patient need has been a
problem for decades; but now it could all be blamed on Covid-19.
Doctor so doctor abuse became an issue, as patients became increasingly dissatisfied. This further lowered morale.
Distressing indeed. So what is the solution? The Health Secretary, Sajid Javid has announced there are to be more "radical NHS reforms"! For decades now
there have always been two solutions to the problems of the NHS -
more funding - and organisational reform. Neither ever works!
The Morale of Conventional Medical Staff
All this means that NHS staff are under increasing pressure, and this now seems to be a
major cause of concern within the NHS. Read the wording of the petition again. There were 100,000 vacancies in the NHS prior to the pandemic. This situation did not arise because the NHS refused to employ staff; it happened because people with the right qualifications were not available. So it is unlikely that yet more money will be successful in finding more recruits, let alone prevent or replace those who are leaving, or are planning to leave, the NHS because of poor morale and unbearable work pressures.
Meg Hillier, MP, and chair of the Public Accounts
Committee of the House of Commons, has said recently that she is
extremely concerned that the Government has ‘no real plan’
to translate the increased funding
of the NHS into improved patient outcomes. She did not add that this has
been the case, increasingly, since 1948! She said that the Health
Department still did not understand that the only solution to the
problems of the NHS was to manage its greatest resource properly - "our
heroic NHS staff" whom she describes as
"exhausted
and demoralised, they’ve emerged from two hellish years only to face
longer and longer lists of sicker people. And this is compounded by
staffing shortages in a number of professional areas.’
Director of the Royal College of Nursing, Patricia Marquis, said that the Medscape figures "show the scale of the challenge nursing staff are facing in trying to reduce the backlog while all the other pressures they are under remain" adding that "nursing staff are struggling to provide safe and effective care with a severely-depleted workforce."
So the problem now is not just the effectiveness of NHS treatment, and its ability to get patients off the waiting list, it is the safety of patients.
The Kings Fund, an important 'think-tank' specialising in health, agreed, and stressed the seriousness of the sitution throughout the NHS. Commenting on the latest NHS hospital performance statistics for
September and October, Deborah Ward, Senior Analyst at The King’s Fund
said this:
“Today’s stats reveal the worst performance since current records
began for ambulance calls, A&Es and waits for planned hospital care.
In a normal year any one of these would ring alarm bells; taken
together before winter has even begun they suggest a health and care
system running hot for such a sustained period whilst still dealing with
Covid-19, it is now on its knees"
What this means is that each section of the NHS relies on the performance of other sections. Failure to admit a patient to hospital meant the ambulances had to wait with their patients inside the vehicle. To assist with pressures on hospitals, early discharge was discussed. But this was thought to put too great a strain on primary care, and the GP's. Throughout the last two years the pressures were extreme, there was little slack anywhere in the system.
We are now moving out of winter and into spring, when in previous years "winter pressures" begin to ease. This is no longer the case. NHS Providers have said that staff absenteeism was increasing (a factor of burn-out), there are now 110,000 staff vacancies within the NHS, and together this meant putting significant pressure of the quality of care, and patient safety.
And like all failing organisations, damaging in-fighting is increasing and making the situation worse. The British Health Alliance has recently reported that many doctors are now resigning from the NHS because the Health Department's insistence that they see more of their patients "face-to-face", rather than by telephone or video. The NHS is becoming an 'own goal' organisation - this following the decision to sack any NHS frontline staff who did not want to take a dangerous Covid-19 vaccine.
Money and Resources
Predictably, Covid-19 has offered the NHS a new excuse for making more financial demands - to turn itself into a Covid-19 only service. As usual, every effort, and every pound of additional money, was put
into chasing the virus. Conventional medicine openly admitted it had no
treatment, and no vaccine. It led to a panic reaction.The NHS probably felt that it had to be seen doing something, so it led to social distancing, face mask
wearing, and lockdown. Normal life was put on hold to protect the sick and the vulnerable, which was sensible enough - but insisted on insisting that healthy should be treated in exactly the same way. This was done to the detriment of all aspects of our social life, our mental health,
child development and education, people's
business' and livelihoods, the national economy, and much else.
Inevitably, the
inability of the NHS to cope with the demands made by the Covid-19 pandemic, leave alone continuing to do their normal work, led to
increasing demands for more resources. The government response, from the
beginning, was positive - "anything it took". And it did take a lot! A profoundly unsuccessful 'Test and Trace' scheme was set up - with over £30 billion of taxpayer money - outside the NHS budget. People were not allowed to go to work; so companies had 85% of their employees wages paid by government - costing more £billions - all coming from outside the NHS budget.
All this expenditure, and more, was made necessary not by the Covid-19 virus, but by the policies pursued by government and the recommendation of 'experts' within conventional medical science.
The budget of October 2021 included a commitment to increase NHS
resource budget to over £160 billion by 2024-5, with investment
projected to grow by 3.8% annually in real terms. A great deal was made about this money reducing the waiting lists.
At the same time, a new, long-expected policy for social
care was announced, with £5.5 million of controversial new taxation announced. However, it was
quickly decided that all this money would be given to the NHS - for the next 3 years.
The Guardian outlined the situation.
"In an effort to get a grip on the crisis, the Chancellor will unveil
plans for investment in NHS capital funding this week to help deliver
about 30% more elective activity by 2024-25 compared to pre-pandemic
levels. This is equivalent to millions more checks, scans and procedures
for non-emergency patients."
The Chancellor, Rishi Sunak, described the importance of the new investment in no uncertain terms, indicating exactly what he though the money would acheive.
“We are committed to getting health
services back on track and ensuring no one is left waiting for vital
tests or treatment. This is a game changing investment in
the NHS to make sure we have the right buildings, equipment and systems
to get patients the help they need and make sure the NHS is fit for the
future.”
Inevitably, and predictably, this was not enough money for the NHS. Dr. Layla McCay, Director of Policy at the NHS
Confederation, said health leaders would welcome the funding, but added
that it still “falls short” of what is needed “to get services
completely back on track”. Medscape outlined the NHS financing debate in more detail at the time. I suspect if Sunak had announced the doubling, or trebling of the NHS budget increase the assessment would have been little different.
In more recent weeks the UK's Health Secretary, Sajid Javid, has declared there will be no more new money, that the NHS would have to cope with what it already has. We had to learn to live with Covid-19, an admission that the previous policy, of eliminating the virus could not be met. For the first time, for as long as I can remember, a major UK politician was NOT promising more resources for the NHS. Covid-19 spending, that is, spending on health, had put unprecedented strains of the national budget. And this decision has been taken at a time when the NHS is in dire straights.
This is the inevitable result of the NHS investing its entire budget, exclusively, on pharmaceutical medicine. For the drug companies it has been a bonanza. For the NHS it is bringing forward what has been, for many years, an impossible situation. The NHS will not survive unless, and until, it offers patients medical therapies that work, that make sick patients better, and does not make their illness worse.
I have always supported the principles of the NHS - the provision of medical treatment for all, regardless of income or wealth, at the point of need. But there is one part of this principle that the NHS has failed to provide - the provision of the best treatment. Increasingly it has failed to offer patients anything other than the false promises of pharmaceutical medicine. The NHS is about to learn tht health does not emanate from a bottle of pills, or a jab in the arm. It has become the captive of pharmaceutical medicine, a hostage to the performance of drugs that have done more to damage patient health than improve it. The drugs and vaccine don't cure patients, they harm patients.
And this is why the situation will only get worse; although how much worse it can become without a complete collapse is problematical. But then, the situation can always be blamed on a virus!
I will be back next year at this time with an update.
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To plot the decline of the NHS over the last decade, this is a list of my previous posts on the un-ending . crisis of the NHS. They describes how the NHS has been brought to its knees.
The NHS Debate (The NHS in Crisis 2011) published in May 2011.
Our doctors in crisis (NHS in Crisis 2015) published in March 2015.
Britain's NHS in crisis (2016) published in February 2016.
NHS in Crisis (2016) published in March 2016.
NHS in Crisis (Winter 2017) published in January 2017.
The NHS Crisis (2017-2018) published in November 2017.
NHS in Crisis (Summer 2018) published in April 2018.
NHS in Crisis (2018-2019) published in October 2018.
NHS Crisis (2019-2020) published in February 2020.
NHS in Crisis (2020) published in June 2020.
NHS in Crisis (Autumn 2020) published in October 2020.
The NHS Crisis (January 2021) published in January 2021.
