As The Guardian notes this morning:
More than 1,000 patients a day in England are suffering “potential harm” because of ambulance handover delays, the Guardian can reveal.
In the last year, 414,137 patients are believed to have experienced some level of harm because they spent so long in the back of ambulances waiting to get into hospital. Of those, 44,409 – more than 850 a week – suffered “severe potential harm”, with delays causing permanent or long-term harm or death.
These people have suffered for just one reason. That is the refusal of the Treasury to create sufficient money to pay for the services required to ensure that they could have the care they needed. There is no other explanation for what has happened. It all comes down to the obsession with balanced budgets and spreadsheets, which obsession has left people ill, dying and dead.
Now, of course, it can be claimed many government policies involve a tradeoff of risk, and that is true. Not every accident blackspot is dealt with when identified on our roads because funding is not available, for example. And risk is taken with regard to the management of extreme events. This I accept.
However, these delays and resulting deaths were not the result of an extreme event. They were normal because the NHS - and social care - had not been funded adequately to deal with the demand they faced.
And, for the record, this is not because the NHS is not working. This is what happened in the NHS in the last year, based on a Google AI search in which data sources are provided
- Primary care appointments: In 2023/24, there were an estimated 353 million primary care appointments. This includes in-person, phone, and online appointments with a GP or other practice staff.
- Outpatient appointments: In 2023/24, there were 135.4 million outpatient appointments. This is an 8.8% increase from the previous year.
- A&E attendances: NHS providers manage 24.4 million A&E attendances each year.
- Ambulance transports: NHS providers transport more than 4 million patients to A&E by ambulance each year.
- Community services: NHS providers provide 95 million contacts in community services each year.
- Specialist mental health and learning disabilities referrals: NHS providers receive 4.4 million referrals for specialist mental health and learning disabilities services each year.
- Deliveries: NHS providers deliver over 578,000 babies each year.
- Operations: Over 10 million operations are performed each year in England.
GP data indicates the growth in demand:
Population has increased from 66.4 million in 2018 to 67.9 million in 2024, or by 2.2%. Demand has increased from 28.5 million appointments to 31.9 million, Covid excluded, or by 11.9 per cent.
The number of GPs in England has fallen from 28,368 (excluding trainees) to 27,839. It is true that the number of non-GP medical staff in GP practices has grown, as has also been the case in hospitals, but they are not alternatives to each other. The skilled resources to meet demand are falling whilst demand is rising, and not because of population growth, which is a minor part of this.
The solution to the problem with the NHS has to be to supply it with more resources. People want those resources because they are creating the demand for its services. That is a simple equation to explain. And if more tax is required. As a result, to counter the otherwise inflationary impact of that new spending, so be it: that is what the UK economy really wants.
What the UK economy does not need is more sick and dying people waiting for care.
And nor does it need far-right politicians suggesting this problem is created by migration when very obviously it is not, as the data shows.
Instead, what we need are politicians who will explain:
- How they will meet the demand for healthcare
- How they will recruit the people required by the NHS
- How they will change the NHS so that trained people want to continue working for it
- How they will put under-used resources - like the unemployed GPs that there are in the UK now - back to work?
None of this is hard. It all comes down to meeting the needs of people who would be willing to pay if only they got what they wanted.
Why do politicians have such difficulty understanding that fact?
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What about tackling the demand for healthcare?
We have recently discussed alcohol what would price increases and restrictions on availability ‘to help the NHS’ do? During the pandemic the Manx Government slapped a 40mph speed limit on the Islands roads because they did not want their limited healthcare resources diverted by idiots who had wrapped their car round a tree. What would reducing and enforcing Speed Limits do both to reduce casualties and Carbon Emissions?
There was an estimate that increasing Universal Credit by £25 a month (week?) would reduce the number of cases of mental ill health by several hundred thousand. Then there is the link between the treatment of claimants and their mental health. Thats before we start on Carers Allowance!
I am sure that there will be some cases where the abolition of the Winter Fuel Payment for pensioners will have pushed some people into mental or physical ill health.
Just dont get me started on Council Tax and the absence of a national Council Tax Benefit scheme. That must be causing a lot of preventable mental ill health.
Then there are housing conditions, repeat A&E users, Drugs etc etc.
Oh and as far as I can make out a fair few unemployed Drs & Nurses no chance of offering any of them a job?
And winter fuel allowance saved lives…..
And doing something about ultra-processed foods and sugar – even bigger and more costly than smoking ever was, and treatable by the same proven strategy.
You are right to expose the link between the public not wanting to pay for something through taxation and the underhand tactics of running down the service. It is a vicious, self replicating cycle.
This is the dark rotten underbelly of how the British state – this ‘imperfect democracy’ works and leads to us all running into the arms of the ‘market’.
Manufacturing consent is what it is and even then, that is being charitable to this most English of state tactics to manipulate its citizens. What a way to treat people? There is no social contract between a state that does this and its citizens I would say.
We need investment in health care, but we are told we do not have the money. Only ‘markets’ produce money and worthwhile investment. so how does that work? Over the last decades we have not invested in public infrastructure; so what is the ‘market’, given the opportunity to show what it can do, invested in?
London of course, but what caught my eye as a telling comparator to care beds or hospital beds (both in serious deficit); was private sector (non- care, non-hospital) beds either maintained and invested in, or built in large numbers. I have seen two estimates, suggesting there were 20,000 or 30,000 5-star hotel beds in London, including 15 new 5-star hotels (including ‘Raffles’ – in the old War Office building). The big increase in beds supply means the top end is struggling to charge £3,000 per night at the top end.
I am glad we have such a firm grip over what are the crucial priorities for investment; at the cutting edge of 21st century innovation of the big economic drivers; and no waste.
Your cynicism is wholly justified.
Courtesy of Talking Up Scotland by Professor John Robertson. “Finally, that aim of a 6% improvement for N.H.S England is, as the report points out, a big thing, 450,000 more seen on time. Of course, in Scotland, the current 8.6% difference means around 50-60,000 more Scots seen on time than if they had to suffered a Labour Government, these last 17 years”. Just for context.
You end “Why do politicians have such difficulty understanding that fact?” I think they DO understand but think doing what is required is electoral suicide.
First, I am not so sure it is electoral suicide – on the contrary, the last election was, I think, a vote for better public services. The tangled web woven by Labour over taxation was driven by a Tory supporting media rather than regular voters.
But, if raising tax IS such an electoral disaster then voters need to understand that it is their parents/friends/neighbours that are dying. How we do that? I don’t know.
Much to muse on
If only we could hear a consistent debate on the public service broadcaster that ‘yes we do need investment – money – to employ doctors nurses and equipment and maintain hospitals. – and that there is money .
Yes Reeves and co could deny there is money – but at least the populace would be aware that there is a debate – and that there might indeed be money.
Richard and Co here are doing what he/we can … but Starmer and co will continue manufacturing consent with the help of the BBC. He/they have already hit the buffers with this 15th year of austerity – the country is crashing – as Richard says , people in their thousands getting ill and/or dying.
The economy/public serivces are in a monumental crisis – Starmer should admit it and put the country on a civil war footing to deal with it – raising public investment massively.
Every day someone on R4 says – ‘throwing’ or ‘pouring’ money at/into NHS – which continues the propaganda line.
And this is the glaring absence from today’s Downings Street’s lengthy statements about getting waiting times/ waiting lists down.
There should be banners outside Downing Street /Parliament 24 hours a day saying ‘there is money’ and leaflets summarising Richard’s TW report.
You ask why politicians find it so difficult….?
There are several Answers:
1. Their advisers have given up on “deliverism”.
https://democracyjournal.org/arguments/the-death-of-deliverism/
2. Laziness: Its easier to do nothing than react to problems surrounding and engulfing them.
3.They are scared of making mistakes or of being manipulated. They have lost faith in taking action.
4. They look for the weakest to discriminate against. Just as “there are no votes in the mentally handicapped”, there are very few in child protection, services for the very elderly and dying , the chronically ill and disabled etc.
5. Professionals in the field make a lot of money from shortages in public provision and dont kick back enough.
6.Politicians have become managers, infused with managerialism believing that there job is to maintain the status quo and to not rock the boat.
7. Potential Leaders get shot at if they raise their heads above the parapet.
8. Democratic pressure or consumer pressure is a poor lever for exerting pressure on politicians.
9. Party politics rewards compliance not leadership.
10. The Treasury acts as an effective dead hand on spending and is reinforced by the Bank of England, the Media and the Establishment who dont believe in the State, Public Services or public inititiative ; except to bail out the private sector when things go wrong.
So its not surprising that politicians are finding it difficult.Which is why so few try.
We should be grateful that some do.
I’m just making my way through a relevant to this thread & recently published book by 2 Scottish senior public health specialists who label this political (ideological?) choice for what it is: Social Murder.
The authors dispel the significance or relevance oft cited alternative factors as primary causes of soaring mortality rates / plummeting life expectancy such as obesity CVD drug related deaths etc and demonstrate its is Government policy to inflict austerity upon citizens- especially the vulnerable- as the preeminent cause: murder by economic means/ violence.
I am not sure it is murder
But you could try manslaughter
Reverse privatisation and cancel the outstanding loan repayments of all PFI hospitals: they have paid enough already.
Legally that cannopt be d0ne.