It’s that time of the year when the first murmurings of winter crisis emerge in the NHS. The PM invited the top brass to Downing Street to thrash out the latest plan to avert the forthcoming crisis.
Last winter, it was the Coffey plan. Her ‘laser-like’ focus on the problems would solve the inevitable rise in admissions. The plan involved increasing 999 call handlers, adding 7,000 hospital beds, providing an extra £500m for social care discharges and creating a £15m overseas recruitment fund.
Did the plan work? Well, thousands were exposed to severe waits for an ambulance. In London, heart attack and stroke sufferers waited more than three hours for an ambulance. At the Royal Free Hospital, patients waited 27 hours for a bed. By December, the plan evolved – thousands of volunteers would emerge. What they were supposed to do to stem the tide of winter emergencies remains a mystery.
NHS England’s data on Bed Availability and Occupancy show the number of beds is up by 761 from the same period in 2022. Between April and June 2023, 103,818 General and acute beds were available at an average occupancy of 90.6%. The Coffey plan led to an extra 1,486 beds available mid-winter – only 21% of what was promised.
By February, NHS England was in on the act with its two-year delivery plan for recovering urgent and emergency services: 5,000 new beds and 800 new ambulances were promised. The discharge fund was rebranded into ‘Care transfer hubs’ with new services, including virtual wards. According to the PM, this year, the plan has evolved. It’s even earlier than ever: more beds, ambulances and discharge lounges, and 15 million more GP appointments.
But GP workforce data from May this year show there are 27,200 fully qualified GPs in England. Down by 427 compared with 2022 and 2,337 compared with 2016. GP numbers are shrinking at a time when record numbers of patients need seeing and treating. Consequently, something has to give – 30% of patients are waiting more than a week to see their GP.
Therefore, we are on safe ground when we say general practice won’t contribute to solving the winter crises this year. Particularly given they won’t receive a penny from the £200m pot supposed to ease winter pressures.
So what about the 800 new ambulances, we hear you ask. Another let down as freedom of information responses from eight of 11 trusts in England revealed orders have been placed for 655 replacement ambulances from 2023 to 2025; however, only 51 will be new.
Furthermore, as we enter winter, there’s a record 7.7 million on the NHS waiting list. 390,000 have waited at least a year for treatment – just the sort of patients likely to be admitted if they pick up a nasty winter bug.
Increasingly, the NHS is left reacting to problems as they emerge. It cannot be proactive; the current strikes will only add to the waiting lists. By winter, we’ll likely cross the eight million threshold as it continues to trend upwards.
Even more troubling is the lack of beds, which is fuelling a rationing of care. An analysis by the Health Foundation showed that 800,000 fewer patients in England were admitted in 2022 compared with 2019. The analysis suggests hospitals are raising their admission thresholds and so admitting fewer patients. More concerning is that reductions were greatest in deprived areas with the most significant health needs.
The level of bed occupancy considered safe is 85%. Yet year-round occupancy remains above these levels. This is no trivial matter. It is not just an inconvenience; it can prove deadly. Estimates based on NHS data suggest a five percentage point increase in bed occupancy is associated with a 1.1% increase in overall mortality.
Central to the problem for the last two decades is the NHS lacks staff and beds. An additional 46,300 full-time doctors would be required to bring us up to the EU average of 3.7 doctors per 1,000 people. Also, there are substantial regional disparities to deal with: the Midlands has 3.5 million more people than the North West, but 4,000 fewer doctors.
The average number of beds in the EU is five per 1,000 people; in the U.K., it is just 2.4. Oh, and what about Germany, where the number is more than threefold higher? In its system, no central minister decides how resources are allocated. Now, there’s an idea. In its federal system, most of the decisions are taken at the state level, and when it comes to health services, there is also competition. Yet, the Government picks up the tab. As a result, no Nightingale hospitals were built, no unsafe Covid discharges occurred into care homes, and there’s little to discuss regarding a winter crises.
The vacancies in the NHS further exacerbate the situation. As of June, there were 125,572 vacancies in secondary care in England. Nearly 10.6% of all nursing posts are unfilled. Inevitably, those remaining in post are required to do more with less.
The shortages produce high-stress environments with high turnover of staff and absences. Anxiety/stress/depression/other psychiatric illnesses were the most reported reason for sickness in the NHS, accounting for one in four of all sickness absences in April and over 472,500 full-time equivalent days lost.
What matters is accountability; who should be responsible? If a doctor makes a mistake, you can turn to the GMC to hold that practitioner accountable. But when it comes to the NHS, who should take the blame? Thérèse is not about anymore to ‘fess up to her shortcomings: she lasted all of 48 days in office, the shortest-serving Health Secretary in history. Simply replacing one minister with the next does nothing to solve the systemic problems facing the NHS. Indeed, all it seems to do is lead to regurgitation of the same plan with a bit of window dressing.
The population over 65 has grown by 2.4% in a decade and is much sicker – short-term fixes won’t prevent the recurring crises. Instead of money-throwing and an unclear chain of accountability, it is time for a proper, independent, well-funded study to identify the drivers of this recurring and complex situation and the start of some long-term plans to address the situation.
Central to the problem is the shortage of beds. We could look to our European neighbours to assess what is and isn’t working and determine the safe minimum level of beds and occupancy per head of population required. But we remain resistant to learning how others do it – hence, the troubles persist.
Enough taxpayers’ money has been wasted or stolen in the last few years. We now need answers to care for our people.
Dr. Carl Heneghan is the Oxford Professor of Evidence Based Medicine and Dr. Tom Jefferson is an epidemiologist based in Rome who works with Professor Heneghan on the Cochrane Collaboration. This article was first published on their Substack, Trust The Evidence, which you can subscribe to here.
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Why weren’t mummy and daddy forced to repay the £10,000 damage to the picture frame?
Because the miscreants are adults, at least in terms of age.
I don’t like exemplary sentences.
Two years for wrecking a frame that cost $10,000 and can be easily replaced seems excessive. Replacing the value, a fine and community service would do.
(And for the avoidance of doubt I think JSO activists are as idiotic as their cause.)
It’s a strange world really though. I come back to the horrible things that people in authority do to others on a regular basis, sometimes quite knowingly. Like the invasion of Iraq or the untold damage done during the covid madness.
We definitely live in a multi tiered justice system. The more senior a position of authority you have, the more damage and destruction you can get away with.
You would definitely put and stop to the endless expansion of the state if people in authority would be made to pay for the consequences of their actions.
I am sure there are many like me who applaud the sentences.
The actual value of the damaged propery should be irrelevant. The tariffs for sentencing (the guidlines for judges) to not have a monetary value attached.
Agreed, and I agree with the below comment. It’s not like they’ll even serve all of that time anyway. Meanwhile, my bigger concern is that the UK ( and elsewhere, seemingly ) has a society that is trying to normalize paedophilia. Look at the non-sentences doled out for those caught with child sex abuse images as a comparison. These people get to go about their lives, rub shoulders with decent people, nobody’s checking if they’re keeping a distance from children ( Christ, some of them have children! ) and try their level best not to get caught next time, because this isn’t something that you can just shut off in your brain;
”Two years for the very personification of entitled moronism.
For the first time in her life there are consequences to her actions. It’s… what’s the word I’m looking for? I know: DELICIOUS.
It’s tough way to grow up – but you’ve earned every single second. Your parents should be slopping out with you.”
https://x.com/KiszelyPhilip/status/1839673198142455981
But this Pheobe person is doing this stuff all of the time. When does it become necessary to stop these people? After one incident like this or after 20 incidents. The justice system has actually been very lenient with these people.
Why can’t we just leave these people glued to the wall? Let’s see how they would feel after a few days.
Exactly. Certainly my preferred way of dealing with these Next Tuesdays.
Or glue them together… because if you can’t beat them, join them!
But seriously though that is not a bad idea. They are suggesting that it is our collective responsibility to save the planet by eradicating fossil fuels and and plunging ourselves into the dark ages. So whose responsibility is it to unglue them from the wall? Let the museum close and they can spend the night. If our oil usage has consequences, then so do your tomato soup and glue fetishes.
Maybe after a few days somebody could bring them some soup!
Their cause to many sounds noble and getting rid of fossil fuels sounds plausible. But actually it is not noble to deny the third world fossil fuels that would alleviate their misery and it is not plausible to be rid of fossil fuels since they supply 85% of the worlds energy. ——–So their cause is one based entirely on faith and emotion rather than fact and reason. I blame government and a compliant media for having brainwashed these easily manipulated people into thinking there is a climate apocalypse just around the corner, when infact there is no evidence that CO2 from fossil fuels use is causing or will cause dangerous changes to climate.
imagine the smell.
Hmm. Could enter them into the Turner Prize?
Or maybe Lego could bring out new enviro sets from various scenes from all this. A couple of Lego characters with hands stuck to a road blocking a Lego Ambulance? Oh! wait…
https://toybook.com/lego-sustainability-news/
Such as this
With people crawling all over the tanker and fiddling with it, where’s the explosion?
Let us remember, back in 2008, when Hedge Fund Billionaire Jeremy Grantham set up the Grantham Research Unit Climate Fraud outfit, including Mega Liar Bob Ward, PhD (failed).
Ward became famed as “fast fingers Ward” and was the go-to guy for all the MSM in their Reality-Denier scams.
Of course, Grantham then had, and very likely still has a portfolio of oil firms.
He also set on our old chum Neil (Professor Pantsdown) Ferguson. The Pandemic and general medical prognosticator that has never been less than one order of magnitude exaggerating risk and outshone himself in some “five orders of magnitude” super scares.
The very bloke who was chosen by the blue arse cheek of the Uniparty to help Stalin’s Nanny Susan Michie in her agit prop nudging.
Now elevated to the WHO, together with Welcome Trust’s Jeremy Farrar.
So, are Grantham (and Kyte) somehow to be considered ax Big Oil people?
Well in some sense. I’m certain that Grantham and his chums are bright enough to have no doubt that Net Zero is bollox on stilts.
But destroying coal in the UK (obviously not in China, India, Indonesia etc.) was a good move in boosting the value of his oil stocks. Gas will be next to be destroyed and Ed Milibrain (of Climate Change Act 2008 again) is now facilitating this endgame).
And destroying Western Economies is the ultimate aim.anyway, as Christina Figueres has confirmed.
That tin of tomato soup could have gone to a food bank. What a bunch of degenerates!
Throwing food around is what toddlers do in high-chairs.
Vastly over-rated. Heinz soup and the picture. That said, it’s damage to someone’s property so whatever the law says for that.
I think MajorMajor has it right: Leave them there. Just to make sure nobody assaults them put some sort of barrier around them (which might accidentality also mean that none of their mates could come along and free them). I also think that’s what should be done when people glue themselves to the road – a few bollards and a hi-vis tarpaulin to try to make sure nobody runs them over – then get the traffic moving around them. Similar for the M25 gantry protests – a quick net fixed underneath and then get the traffic moving again.
Activism is all well and good. If there is injustice that is clear by all means, We often hear the supporters of JSO and Extinction Rebellion etc compare them to the Suffragettes, but these people were protesting about rights for women and the vote. But it was crystal clear that women were not being allowed the vote. Climate Change being caused by the use of fossil fuels is not so clear. It is riddled with uncertainty and is always a question of degree. There has to be an evaluation of cost/benefit and the benefit of fossil fuels is clear. They have brought billions of people out of abject poverty, and this is the part of the equation that JSO etc simply do not accept, basically because they understand virtually nothing about how energy works. So we cannot have energy policy based on faith and emotion, and there comes a point where the activism goes too far all based on irrational fear. These climate activists are starting to go too far and they must be nipped in the bud before people get seriously hurt or worse.
The issue of votes for women was not at all clear. As late as 1917 many working class men did not have the vote either – it wasn’t just women who were not enfranchised. And much of the opposition to votes for women came from women themselves.
Judge Christopher Hehir…told the activists to come to court “prepared in practical and emotional terms to go to prison…”
Many years ago, at a time when UK football hooliganism was world news, a taxi driver in Singapore took me on a tour, and drew up outside a large grim 19th-century brick building. It was Changi jail. ‘No hooliganism in Singapore,’ he stated with a proud air. ‘You get the cane here, you don’t sit down for six months.’
With our prisons full, and offenders undeterred by the thought of a little comfy custody at the public expense, maybe it’s time to look East and rediscover how we used to deal with juvenile delinquents. Maybe Judge Hehir should have told the soup-flingers to prepare not to sit down for 6 months.
We obviously need to heed their great wisdom and knowledge. They have shown us such great incites into the abyss the world is headed into if we do not stop using oil. So young to know so much. What really drives them is their narcissistic egos looking for attention and purpose. We can only hope they grow up some day, but living in their urban protected group think bubbles, there is doubt they will.