I had the misfortune of having to go to A&E recently. A wonderful friend was able to drive me as it was the weekend and they don’t have 24/7 emergency care at my closest hospital. Fearing the worst in regards to waiting times, I sent her home and hoped I’d be done before she had to go to work.
As an accident rather than an emergency, and knowing a friend of mine had waited 8 hours for neurology in this very waiting room, I got out my book and familiarised myself with what I expected would be my surroundings for most of the day.
A&E departments are busy at the best of times, but the relative chaos for what wasn’t a department with that many patients shocked me. I’ve had to go to A&E with chest pain before now (a different one, and pre-pandemic, granted), with every bed full with patients who could actually die rather than walking out of there – but the air of behind the scenes calm made it a completely different environment to be in.
I went in worried and came out calm (not just because my pain turned out to be muscular). The same is not true of my recent visit.
Even over my book, I watched the same nurse hurry past me 4 or 5 times (and she wasn’t the triage nurse). Senior nurses shouted and pointed, receptionists trying to see to patients, answer constantly ringing phones, and radio for a porter to come push the patient in the wheelchair up to x-ray (before giving up and taking him herself). The student nurse had nobody, in particular, looking after her, and I swear I saw the fear in her eyes. It was carnage.
I am fine, by the way, and the staff worked their socks off in what is still a high-stress situation for them because – despite what capacity crowds at stadiums up and down the country suggest – we are still in a pandemic!
A few days later, I had to follow up with my GP. Despite them receiving the details of my hospital visit via email (or possibly fax), I went through the usual process of hearing the engaged tone more than 20 times, waiting on hold for nearly half an hour and then waiting for someone to call me back within 4 hours to assess the situation and possibly offer me an appointment for later in the week.
The telephone consultation service has been a hallmark of the pandemic and in a lot of cases I can’t fault it – lots of things can be dealt with without being seen face-to-face. But my surgery has been using it since before the pandemic, and in cases like mine it adds to the time it takes me to be seen. Tying up a clinician’s time when we both know I need to come in right away, and making my wait longer.
Waiting times for a referral have shot up as well. The standard 18 week maximum for non-urgent surgery and two-week maximum for suspected cancer have recently fallen by the wayside in a lot of areas, e.g. patients in Norfolk and Waveney waiting more than a year for orthopedic surgery or facing having to travel hundreds of miles.
The pandemic is taking a lot of the blame here – specialist departments are backed up from all of the lockdown cancellations, the additional resources used for covid-19 care have not necessarily been replenished. And, as I said, there is still a pandemic happening.
But I think it’s more sinister than that. The NHS is being treated by our government like an old, disused sports centre building – they’re letting it decay and rot until it collapses in on itself or someone sets it on fire and it can be condemned and torn down so someone can build some houses.
The Tories are choosing to let waiting times skyrocket, to have GPs only be able to run same-day telephone services, to put fear in the eyes of student nurses. Disability activists have been warning about underfunding for our NHS for years, but the pandemic has provided the perfect excuse for the government to let it all go to pot.
Why? Well, it’s pretty simple. Patients have three options: go private, get used to this inferior standard of care, or die. Option 1 “just goes to show” that “people” (rich people) would rather pay than wait, option 2 justifies continued cuts because “patients are fine” and “they’re clapping for the NHS anyway”, and option 3 is fairly self-explanatory.
All three of these put whichever waste of space health secretary we currently have and all their chums in pole position to move another step towards condemnation and using the space (money) to build houses instead (line their own pockets).
That next step appears to be the Health and Care Bill, voted through on 23rd November 2021 by a majority of 291 to 244 (the government being minus three rebels). It splits the NHS into 42 component parts, because of course what we need in this time of crisis is a higher administrative burden. These 42 parts or Integrated Care Systems (ICSs) will be made up of Integrated Care Partnerships (ICPs) including charities, council representatives and Integrated Care Boards (ICBs).
Where it takes us another step towards privatisation is that those ICBs can include heads of private health companies – and they can have an influence on funding decisions. It also gives the health secretary overall control of certain aspects of the NHS, allowing them to make minor changes without going through parliament.
The bill is now on it’s second reading in the House of Lords (the first reading being a formality), which is where it can now be stopped – but since when have people identified as “Lords” had the little guy’s interest at heart? Some of those lords may be or may be associated with some of the chums looking to get on the boards of those 42 ICSs.
The Tories’ chronic underfunding of our healthcare system has given them the opportunity to get to this point without total public outrage (although plenty of people aren’t happy).
Standing up in the commons and saying the NHS was being sold wouldn’t get them re-elected, but reforming a system that is failing – because of their own actions – just might.
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