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September 28, 2021 - 4:45pm
The NHS is once again in trouble. A mix of “bed blocking”, staff shortages, and increased presentations to A&E (from both Covid and non-Covid causes) have all conspired to push our healthcare service closer to the brink. 18 months on from the first lockdown to “protect the NHS” — and with nearly 90% of adults vaccinated against Covid — the NHS finds itself struggling once again.
More frightening is that talk is once again returning to “firebreak” lockdowns, ignoring the fact that lockdowns themselves are partially responsible for much of the increased attendance to A&E. Now we are seeing soaring weight gains, a doubling of children’s mental health referrals, delayed presentations and treatment for hundreds of thousands of cancer patients, and a spike in RSV in young children — thought by some to be due to an “immunity debt” brought about by lockdowns — it is becoming increasingly apparent that lockdowns themselves are hazardous to health. Then there are, of course, the huge economic costs. So where does this leave us? And what does this mean for the winter ahead?
It’s worth remembering that even in recent years, the NHS has struggled but survived through the winters. As recently as 2018, NHS England postponed all planned surgery for a month in order to cope with winter pressures. Consequently, 62,000 fewer operations were performed. Throw in a bad flu season, combined with Covid and 18 months of restrictions and lockdowns, the NHS could hit breaking point this Winter. We should therefore think very carefully before introducing another lockdown because it could hurt the very thing that it was designed to protect.
After all, the premise of the first lockdown was to flatten the curve and allow the NHS time to increase capacity, which was unsuccessful. Not only did the NHS go into this crisis with one of the lowest number of beds per capita and lowest number of doctors per capita in the EU, it also had longstanding issues with retention of staff. Many of these fundamental problems are still there, despite the government’s massaging of statistics (counting medical students as doctors, for example). This is despite record public levels of support for the NHS, and £13 billion of NHS Trust debt being written off.
Over 18 months on from the emergence of Covid, restrictions cannot be used as a sticking plaster to save a faltering NHS. Maybe it is time to have a conversation about what we can reasonably expect from our healthcare system, and the resources and management we need to achieve that.
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SubscribeIn my uninformed opinion, the lockdowns protracted the problem. I’d much rather have taken my chances with the covid than endure all this masking, lockdown, and vaccine passport nonsense.
Yep. The question we all need to start asking ourselves is who pushed our and other governments down this authoritarian path that has harmed us all. “Follow the money” is always a good clue.
Although authoritarian, I don’t find masks all that onerous. But flimsy bits of cloth may not be all that useful. In fact, it probably would have been better to be more even authoritarian and mandate FFP2 masks as they now do in Germany.
There may not have been much choice but to have had the first lockdown due to alarming back-of-envelope sums etc. After that, who knows? As far as I understand it, the Swedish model may have been better, and may have caused less harm
Why would you say that?
Although I’m largely against authoritarian measures, if you’re going to do it to protect public health you should at least do something that stands a chance of working.
Letting people choose any face covering they like is not very useful. FFP2 or N95 masks at least block the small droplets that carry the virus
… and fit most people better
There is no doubt as the evidence mounts that the Swedish model was much better.
precisely – follow the money and the unchecked thirst for power.
Wasn’t it Neal Ferguson, the sky is falling academic charlatan? Neal and his pals looked with great envy @ China–send in the Army, REALLY lock down hard, have such a massive show of force that people won’t resist. Nah, that will never work in the West, they said. The people won’t just blindly follow what we tell them to do–they’re not sheep. Then someone said “Well, maybe if we can get them afraid enough, keep them afraid, then they will do what we want like chastened children.”
As Freddie Sayers said “the inconceivable has become the inevitable.” People should be afraid, very afraid, of the incompetent, authoritarian, fascist, woke, hard left; Corona not so much. The world must learn to live with Corona, as we live with other viruses/diseases: SARS/HIV/Marburg/Lyme disease….the list goes on. Let’s stop the panic and grow up.
What money? You mean it’s a conspiracy by Big Pharma or something? The country is in an appalling economic mess, there IS no (real) money!
No, all you need is TV cameras in Italian hospitals, no understanding of wider health or economic impacts (which are more dispersed anyway, not so immediately visible), a follow my neighbour approach, media hysteria, a panicking public, and a political class, imbued with short termism in their very marrow.
On a smaller scale I remember working at TfL when the cycling groups were pushing for better cycling facilities, probably reasonably. The Evening Standard jumped on this bandwagon and ran a campaign in which every single cyclist death (about 12 to 15 every year in London) was put on the front page, but no other, whether pedestrian or car driver! It was true, but presented a hugely distorted picture of risk.
.
‘..a political class, imbued with short-termism in their very marrow.’ That’s the essence of it, especially if you throw in a media class whose idea of long-term is 48 hours.
Imagine if all that money spent on lockdowns had instead been spent increasing the capacity of the health service, then it wouldn’t be be an issue
But ‘increasing the capacity of the NHS’ is a matter of training doctors, not assembling flat pack hospitals. The money would still be pouring in, but no doctors yet, come back in 2027…..
To hell with the corrupt, self-serving NHS. Lockdowns are a crime against humanity,
At some point, governments are going to have to rip the band-aid off and let COVID burn itself out. This attempt to cure the common cold is destroying life, liberty, and trust in institutions left and right. Because at its heart, that is what covid is, a ramped-up cold. And looking at the numbers in both the UK and USA, we could have handled this thing in a calm, rational manner; vaccinate the old and infirm, let everyone else go about their lives.
But it sure has put the idea of centrally controlled health care to shame. We here in Oregon, in the ever-going effort to save on health care, limited the number of hospital beds. And, now that there is a need for more beds, we have a crisis. Of our own making. It seems from your article that England has a bit of the same problem. When healthcare becomes a budget item, its primary utility becomes secondary to how much money can be saved.
Thank you for this important take. Whatever anyone thinks about lockdowns, our lack of doctors compared with every other EU country is shocking and unsustainable. In a vicious spiral, their lives are relentlessly hard, making retention poor, and increasing the burden on those remaining.
Most of the public know there is a financial hurdle to employing more but few realise the unnecessary burdens placed on our hospital doctors, misleadingly called “trainees” right up until they become consultants.
The NHS has exploited its monopsony (trainees can only work in the NHS – as explained, trainees means most hospital doctors) so when they give up it’s not to go private – it’s to emigrate, pause or throw away their life’s work. Yet over 65% do so after two years of unsustainable hours with little support, often having to fight for their correct pay, coping with deficient PPE, whilst largely assigned holiday dates and places of working ensure isolation from family, friends and support networks.
There is low hanging cost neutral fruit to improve their lives and improve retention;
guarantee 1 week of pre- bookable holiday at a date of their own choice;
attempt to get their pay right so they don’t have to waste hours checking….they don’t even get proper payslips unless they jump through hoops. Most doctors say they have never been paid what they are owed without questioning it, especially in August when they change hospitals;
assign them priority at hospital switchboards so they don’t waste hours listening to automated messages whilst trying to contact colleagues;
don’t make them write out all the notes by hand;
provide loo paper and soap in their toilets;
Provide a functioning shower for when they get contaminated with bodily fluid;
provide transport home if they finish shifts at 2am (or at least parking);
don’t make them move every 12 months sometimes finishing a shift late one end of the country and having to start one early the next day hundreds of miles away whilst miraculously moving house;
don’t charge them £850 pa for a spreadsheet to record their training;
Provide rotas a year ahead so they can plan childcare;
allow them to go part time where evidence shows you will actually end up with fewer rota shortages thro increased retention;
allow time off to sit compulsory exams rather than insisting they fit them on top of a 47 hour work week – not only do they have to pay for the exams themselves out of a relatively low salary (below where Starner campaigned should be the minimum for a worker at McDonalds), but if they are on nights they only get one of them off so have to do a 24 hour stint within their then 52h week.
I find this very simplistic. The “lockdowns” might have deterred people to seek medical help but they did not require it. There was a policy in the NHS to defer treatments to keep capacity for covid patients but the aim of the lockdowns was to reduce the demand for covid patients and the lockdowns should therefore have released capacity for other treatments. There were failings in PPI in hospitals which reduced the availability of medical staff. There were NHS staff who isolated but the intent was to reduce transmission to other staff and patients. What is needed is a careful analysis of how the NHS resources were reduced and how they were applied in the last 18 months.
You beat me to it! I’m not aware of such an analysis. Has the government not commissioned one? If so, they should publish (fat chance!), or we’re just guessing.
Someone with the mindset of Tom Chivers could do it (if he had the figures). I’m imagining a detailed cost/benefit spreadsheet, updated as and when better figures come along.
I just feel that the government is making policy on a whim. We deserve better
Now they will say that the only way to save the NHS is to privatise it. So big pharma/insurance wins. Probably this was the end-game all along.
Is there any real evidence that the lockdowns, except the very first two-week true lockdown, made any difference?
No.
The NHS will never recover, ever however much money will be thrown at it, unless ….. medicine will become interested in researching what makes people healthy rather than what makes people ill. Treatments will change and outcomes will change and medicine will become affordable again …. the illness industry won’t like it…
https://doi.org/10.7812/TPP/17-025
It is highly unlikely that there will be a bad ‘flu’ winter and a bad Covid .They both attack the same vulnerable group.
The UK is not a country (4 countries? 3.5 countries?), but a failed health care scheme masquerading as a country. NHS is unsustainable in the long term–also in the short term.
Here’s an idea: let’s poach “doctors” (much, much fraud in their credentials–see most recent Indian cheating scandal) and nurses from desperate Third World countries. Brits voted leave, so Europeans left. But maybe NHS can poach a “doctor” from Nigeria, a nurse from the Philippines, another doctor from South Africa. What a great idea! They will be happy to work in the pigs breakfast that is the NHS.