The NHS Needs Action. As winter approaches, thousands will die needlessly while politicians play games.

Call To Action

I’m not normally one to make predictions. But I spend my life reading what is happening in healthcare and politics, analysing reports, speaking to people and engaging with the media, so I often have a sense about what’s going to happen next. Despite this I’m very, very reluctant to vocalise what I think, and I think this is because of my training as a doctor. When I was at medical school one of the ways they tested our knowledge was through multiple choice questions, but it wasn’t as simple as ticking “true” or “false” - they also asked us to identify how confident we were in our answers. It was impossible to excel in the examinations without a high level of confidence, because you couldn’t attain the highest marks. But if you got an answer wrong, and had written that you were confident about it, you’d be marked down further. It was a tough way to learn, but it was really important.

Speaking up incorrectly as a doctor matters. It can cause inconvenience, confusion, and even danger to your patients. You learn to take information seriously, and become sensitive to the responsibility of sharing it. If someone’s listening to you, you’d better have your facts straight. I haven’t lost that attitude as a campaigner; in fact, I think because I have a much bigger audience now, I’ve doubled down on it. I’m not perfect, I’ve made mistakes, but when I do, I double back and tell everyone that a mistake has been made. This feels even more essential; these days we all operate in a fog of misinformation, disinformation, exaggerations and omissions. The media is political and so the information we are shown is political, and so it’s crucial to cut through it all with evidence. Evidence is the thing that holds true and will always hold true. Evidence, experts, and the patience to listen to those experts.

But, sometimes, rarely, I feel compelled to make a prediction - to speak up about something that hasn’t yet happened, but which I think is coming down the track, hurtling towards us. Sometimes the whispers and testimony and figures and fears from NHS staff and patients stack up to the point where it is impossible to stay silent. This is what is happening now. I’m fearful about what is going to happen over the coming months in hospitals around the country. I’m more than fearful actually, I am utterly appalled, because I believe that our new government is intentionally failing to address this and take action, and will then use this crisis as an opportunity to further privatise the NHS.

I’ve been ruminating a lot, recently, on a quote from an Ernest Hemingway book. One character asks another about their financial bankruptcy, and the exchange goes like this:

“How did you go bankrupt?"

“Two ways. Gradually, then suddenly.”

- Ernest Hemingway; The Sun Also Rises 1926

The quote is used often in discussions about business and economics, describing how things can fall apart; firstly in imperceivable ways, and then, eventually, with such speed and ferocity that those involved may wonder how they missed all of the warning signs. Sadly I don’t think we’ll be left wondering about the NHS - our politicians have been given every warning that this is about to happen. Here is another warning.

We have had winter crises before; terrible times when members of the public have telephoned for ambulances that have taken far too long to arrive, or haven’t arrived at all. Some of those that have gone to A&E have found the place in a state of disarray. Staff have been expected to hold things together against impossible odds; when there isn’t enough room, enough time, enough colleagues or the bandwidth to hold space for an individual or for a family enduring traumatic circumstances. There have been moments, days, weeks even, when the conditions in the NHS have been barbaric. It has been, bluntly, inhumane.

But when they are, the TV news crews descend onto A&E departments. The politicians act concerned. There may be temporary allocation of funds, or additional support drafted in from elsewhere, and we get the sense of action. After all, the headlines are telling us that it’s a disaster, aren’t they? And the authorities are responding to that disaster, aren’t they?

The problem is, once the pressures have eased slightly (perhaps because the burden of community respiratory illnesses has decreased a bit, or emergency funding has helped in some small way), the television crews drive away and the hospitals are ignored again. Ignored by the media, and ignored by the politicians who neglect the NHS either because it’s a huge, complicated and weighty issue requiring resources and money, or because they are ideologically opposed to sorting it out.

This is what we’ve experienced in recent years; rolling winter crises, disinterest from the Conservative government, and the slow decimation of our public healthcare system. But we now have a new government, one that sailed into Number Ten Downing Street promising change, and they too are failing to take action quickly enough. Yes, the system is a mess. Yes, they can’t be blamed for all of the problems. But they can certainly be blamed for not taking the reins and steering us clear of disaster.

Some truly terrifying statistics were recently published which I think highlight how close we are to the edge. The House of Commons library was commissioned by the Liberal Democrats to undertake an analysis about waiting times in A&E departments, and they have found that over 1 million patients have waited for more than 12 hours in an A&E department already this year.

As the statement from the Lib Dems says:

“Blackpool Teaching Hospitals saw more than a quarter of A&E attendances this year experiencing a wait of 12 hours or more, higher than anywhere else in the country. This was followed by the Countess of Chester Trust with 24.1% of attendances taking longer than 12 hours, and United Lincolnshire with 21.1%.”

Waiting in an A&E for interminable lengths of time isn’t simply an inconvenience for a patient and their family; it can be fatal. As the Lib Dems explain:

“The Royal College of Emergency Medicine has previously estimated that long A&E delays led to around 14,000 excess deaths last year, or 268 a week.”

The situation is not the same across the country, and probably the most alarming thing about this analysis is the rapid deterioration within some NHS Trusts. If you concentrate on individual examples, you can take a look at how things have changed between Feb-Sept 2023, and Feb-Sept 2024. Chesterfield Royal Hospital NHS Foundation Trust has had an increase in patients waiting 12 hours or longer of 148.1%. Airedale NHS foundation trust has an increase of 145.1%. Harrogate and District NHS Foundation Trust 186.4%. That’s a very steep decline in functioning between one year to the next.

The A&E failings do not sit in isolation. We know that over 10 million patients have waited more than 4 weeks to see a GP this year. The waiting lists are not shrinking in a convincing manner, and we are now hearing of a “tripledemic”; with three viruses (COVID-19, flu and RSV) circulating simultaneously, in ways which may heap yet more pressure on our healthcare system. Our new government should have taken action this Summer, as soon as they took charge. An emergency task force should have been built to prepare us for the winter ahead. Experts and frontline staff should have been swiftly consulted, resources should have been allocated, and a sizable budget should have been set aside.

What has happened instead? Our government appears to be dithering, holding a consultation about the NHS which no one seems to have a lot of confidence in and which could have happened years ago, and appear to be courting offers from the private sector.

The Telegraph ran the headline:

“Private hospitals to rescue NHS.

Government considers £1bn plan to clear waiting lists for 2.5 million patients, which could start in weeks”.

The Chief Executive of BUPA spoke to the Telegraph around the same time, and the article says:

“One way to relieve some of these pressures on the NHS is for the Government to rely increasingly on private healthcare, Mr Jaureguizar said ‘...I haven’t had direct contact with Mr Streeting. But there’s a mood that we’re here to collaborate’.”

And meanwhile, our new Health and Social Care Secretary Wes Streeting is keen to let everyone know that NHS investment will be limited at the moment, telling The Sun recently:

“The days of blank cheques for the NHS are over. The money simply isn’t there.”

I think that NHS will be under unprecedented pressure this winter. I fear, and I lie awake with this fear, that many people are going to die this winter because our new government has chosen not to invest necessary funds to safeguard lives.

I wonder, when I see Streeting going to the press, with his attacks and his sweeping statements and his inflammatory language, what price he puts on the life of each patient who is profoundly failed by his lack of action. Does he think about them at all?

I don’t think the new Labour government will take action soon enough to avert disaster in the NHS this winter. In fact, I think the opposite. I think they will use the crisis to convince us all that we need to accept a deal from private healthcare companies to “rescue the NHS”. Private companies will poach yet more NHS staff in order to do the work, and who will really benefit from all of this? The company shareholders.

I am absolutely committed to bear witness to what happens this winter. I am absolutely committed to speak up and out at every juncture, demanding action, and I am utterly appalled at the lack of moral backbone from our politicians. Sometimes, all we have is our voices, and so we must use them. We must hold our leaders to account. We must demand better. We must not tolerate the insidious, careful, callous sell-off of the NHS, at the expense of patient lives and the well-being of our incredible NHS staff. It is despicable, and we all deserve so much better than this.