by Amy Jones
Tuesday, 28
September 2021
Reaction
16:45

Another lockdown would hurt the NHS

More restrictions will exacerbate our health service's woes
by Amy Jones

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.

Amy Jones is an anonymous doctor working in the NHS, who has a background in Philosophy & Bioethics. You can follow her on Twitter at @skepticalzebra

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  • 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.

  • 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.

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