A lot of us have been saying that the NHS has been collapsing for years. Now, maybe you think we were crying wolf previously when there was no wolf. And now there is one, it’s no wonder people don't believe us. That’s what happens when you cry wolf without warrant.
But that's not what happened.
What happened is that we saw the wolf prints and the wolf faeces, and the fact that more lambs were going missing than usual. We saw this evidence and knew that it meant a wolf is present. Even though we hadn't seen the wolf itself, and we hadn't watched that wolf take a lamb and kill it, we knew that there was a wolf because we saw the evidence. And we knew that the issue was just going to get worse unless it was addressed when we said that it needed to be addressed.
But it wasn't addressed. The government denied that there was a problem with the NHS, with social care, with insufficient money going to benefit recipients, with education, with road mending, with public transport, with infrastructure.
And we kept saying, look, look, see the wolf prints, see the wolf faeces, see how many lambs are being taken? There is a wolf. And now the wolf is on our doorstep wanting to come in, and saying ‘I’m here. And look, my wife has joined me and our children. There are many of us.’
We say: there is a wolf. There are many wolves and the country is collapsing.
And still we are told that there is no wolf. ‘You have cried wolf so many times, we do not believe you now.’ And we are saying ‘We warned you. This is the point. We warned you. We said a wolf was coming. We said it was on its way. And now there are many of them. And we warned you; and the fact that we warned you is now being used by you as an excuse to continue to disbelieve us. That is not good enough.
Open your eyes. Look at the evidence. See the wolf at the door.
It takes time, after undermining the foundations of a building, before te building actually collapses. It doesn't mean the collapse wasn't on its way, or that the building wasn't undermined. It takes time, as the wood-worms eat their way through the precious heirloom, before the furniture falls apart at a touch. But that doesn't mean that the wood-worms aren't there.
This country is collapsing. And it's because of the Tories.
The BMA warned us in November 2019 that the NHS was on the edge of collapse. That was before the Covid crisis, which took a breaking healthcare system – an underfunded, under-resourced, under-mined NHS – and pushed it over the edge.
In 2019, doctors were reporting things like twin-bed bays, squashing people together to fit everyone in, occurring not only in the height of winter but on a mild autumn day.[1] Patients suffer cardiac arrests in a corridor. Office spaces were being turned into bays.
In 2020, the number of patients waiting more than four hours from the decision to admit them to actual admission had risen to over 100,000, more than double the level in 2015.[2] Delays in securing social care continued to keep people in hospital after they were well enough to be discharged. People waiting more than 18 weeks for treatment was, at 16%, double the target of 8%, whilst 4.2% waited longer than 6 weeks for a key diagnostic test, against a target of 1%. These are 2020 figures; the situation has got worse since then.
In August of this year, we were 12,000 hospital doctors short and missing more than 50,000 nurses and midwives compared to what we needed.[3] In September, average waiting times for an ambulance for a category two call-out – which includes chest pain and strokes – was 48 minutes, against a target of 18.[4] 10% waited longer than 1 hour 45 minutes. Members of the public repeatedly go to Twitter to report instances of elderly friends and relatives left on the floor for hours with broken bones whilst they wait for an ambulance. Meanwhile heartfelt pleas from doctors and nurses who can’t provide the level of care that they want, and should be able, to provide have become a common occurrence.
The Nuffield Trust report that, “NHS England, the Department of Health and Social Care and the Treasury [are] seemingly caught in a mutual confidence trick where successive funding rounds were premised on unachievable assumptions about efficiency savings and demand management. With failure not something that could be admitted, each new, hard-fought-for slug of cash was wiped out by a pre-existing funding deficit that no one wanted to admit was there.”[5]
As The Pulse note, “The worst part of this is there may be no rock bottom because patient outcomes can always get worse and the workforce can always get smaller and more demoralised.”[6]
Are we crying wolf? Yes, because the wolf is here. And it’s not just him. He’s brought his whole family with him, and they’re growing in size and number.
[1] https://www.bma.org.uk/news-and-opinion/nhs-on-the-cusp-of-collapse [2] https://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2020/02/Combined-Performance-Summary-February-December-January-data-2020-oi2U9.pdf [3] https://committees.parliament.uk/committee/81/health-and-social-care-committee/publications/ [4] https://www.england.nhs.uk/statistics/statistical-work-areas/ambulance-quality-indicators/ [5] https://www.nuffieldtrust.org.uk/news-item/is-an-already-tough-year-for-the-nhs-about-to-get-a-lot-tougher [6] https://www.pulsetoday.co.uk/views/editors-blog/the-nhs-wont-collapse/