NHS

NHS Waiting List Could Hit 14 Million in England by Next Autumn, According to IFS Report

A new report by the Institute of Fiscal Studies (IFS) says that the NHS waiting list in England could reach 14 million by next autumn and could then continue to increase “as the number joining the waiting list exceeds the number being treated”. And this, according to the author of the report, is just the beginning: “Much longer waiting lists [could] be with us for years to come.” Sky News has the story.

Currently, the number of people waiting to start routine hospital treatment is at a record high – 5.3 million, according to latest figures.

But the IFS has warned in its new report that there is a massive backlog of people still to come forward for treatment, largely caused by Covid [what about lockdown?].

Health Secretary Sajid Javid said the number of people on waiting lists could rise to 13 million in the coming months, but the IFS projects that the total could eventually surpass the Health Secretary’s figure.

“In our first scenario, 80% of the approximately seven million ‘missing’ patients return over the next year, the NHS operates at 90% of its 2019 capacity this year and next, and then at 100% capacity from 2023 onwards,” it says.

“Under this scenario, waiting lists would soar to 14 million by the autumn of 2022 and then continue to climb, as the number joining the waiting list exceeds the number being treated.”

The IFS said while it is unlikely all patients will return due to the fact some will have died and others might have had private treatment, most will probably require treatment at some point soon, especially as virus cases decrease and “people are more willing to seek health care”.

Max Warner, the author of the analysis, said: “There is a real risk that if the NHS cannot find effective ways to boost its capacity – a challenge at the best of times, let alone after a major pandemic – then much longer waiting lists will be with us for years to come.”

Worth reading in full.

By Michael Curzon  /  8 August 2021 • 08.41
       
43 comments

The Figures Don’t Match Up To the Fear, a Doctor Writes

There follows a guest post from our in-house doctor, formerly a senior medic in the NHS, who says the widely trailed tsunami of hospitalisations has not only failed to arrive after ‘Freedom Day’, but we seem to be on the downslope of the ‘third wave’.

The philosopher Soren Kierkegaard once remarked: “Life can only be understood backwards, but must be lived forwards.” I have been reflecting on that comment, now we are three weeks since the inappropriately named July 19th ‘Freedom Day’. Readers will remember the cacophony of shrieking from assorted ‘health experts’ prophesying certain doom and a tidal wave of acute Covid admissions that would overwhelm our beleaguered NHS within a fortnight. Representatives from the World Health Organisation described the approach as “epidemiologically stupid”. A letter signed by 1,200 self-defined experts was published in the Lancet predicting imminent catastrophe.

Accordingly, this week I thought I should take a look at how the apocalypse is developing and then make some general observations on the centrality of trust and honesty in medical matters.

Let’s start with daily admissions to hospitals from the community in Graph One. Daily totals on the blue bars, seven-day rolling average on the orange line. Surprisingly the numbers are lower than on July 19th. How can that be?

Perhaps there are more patients stacking up in hospitals – sicker patients tend to stay longer and are hard to discharge, so the overall numbers can build up rather quickly. So, Graph Two shows Covid inpatients up to August 5th. Readers should note that Graph Two includes patients suffering from acute Covid (about 75% of the total) plus patients in hospital for non-Covid related illness, but testing positive for Covid (the remaining 25%). How strange – numbers seem to be falling, not rising. This does not fit with the hypothesis – what might explain this anomalous finding?

Maybe the numbers of patients in ICU might be on the increase – after all, both the Beta variant and the Delta variant were said to be both more transmissible and more deadly than the Alpha variant. Graph Three shows patients in ICU in English Hospitals up to August 5th. It shows a similar pattern to Graph Two – a small fall in overall patient numbers in the last two weeks. I looked into the Intensive Care National Audit and Research Centre ICU audit report up to July 30th. This confirms the overall impression from the top line figures. Older patients do not seem to be getting ill with Covid. Over half the admissions to ICU with Covid have body mass indices over 30. Severe illness is heavily skewed to patients with co-morbidities and the unvaccinated. Generally speaking, the patients have slightly less severe illness, shorter stays and lower mortality so far.

Finally, we look at Covid related deaths since January 1st, 2021, in Graph Four. A barely discernable increase since the beginning of April.

So, whatever is going on with respect to the progress of the pandemic, the widely trailed tsunami of hospitalisations has not arrived yet – in fact, we seem to be on the downslope of the ‘third wave’.

The Figures Don’t Match Up To the Fear, a Doctor WritesRead More

By Michael Curzon  /  7 August 2021 • 20.49
                   
43 comments

Slowing Vaccine Take-Up Means 170,000 Moderna Doses at Risk of Expiry

The NHS is looking to redistribute thousands of Covid vaccine doses as slowing take-up rates among young Britons, who don’t appear to be moved by petty bribes, could result in doses being thrown away after reaching their expiry dates. The Guardian has the story.

An internal email seen by the Guardian warned of 170,000 doses of the Moderna vaccine at risk of expiry within the next fortnight, as doctors across England have raised alarm at the unpredictability of vaccine take-up among young people meaning more doses will go to waste.

The Government is to unveil a raft of new initiatives to increase vaccine uptake among young people, including discounts on car-hailing companies such as Uber and Bolt, as well as the delivery service Deliveroo.

It is understood the NHS has managed to redistribute 40,000 of the spare Moderna jabs. However, concerns have been raised about the number of jabs wasted as uptake slows among younger people eligible for the Moderna and Pfizer jabs.

The Joint Committee for Vaccination and Immunisation recommends an interval of eight to 12 weeks between doses, initially as a way to offer more people first doses because of limited supply, but studies have since shown that the larger gap could give longer protection.

One NHS doctor in the north-east, Dr Alison George, said colleagues had been forced to routinely discard Pfizer doses, rather than give second shots early to people who requested them. “We have very high rates of infection here and the local hospital is already under significant pressure with some elective surgery cancelled,” the GP said. …

Beccy Baird, a Senior Fellow at The King’s Fund, said it was getting more difficult to predict vaccine uptake.

“Uptake is getting lower as the cohorts get younger and matching the supply of vaccines to demand will get harder as demand becomes less predictable. This is made all the harder as the vaccines have a limited shelf life,” she said. …

“In the early stages of the rollout, you could be confident that wherever vaccines were delivered there would be sufficient demand for them. Now that a majority of adults have been vaccinated, and with uptake getting lower as the cohorts become younger, demand for the vaccine is more unpredictable, making it harder to know exactly where the doses are needed.” …

Pfizer and Moderna vaccines are now mostly distributed to the under-40s, who cannot receive the AstraZeneca vaccine. Those vaccines have a shorter shelf life of up to one month in the fridge, compared with the AstraZeneca vaccine, which can last for up to six months.

Worth reading in full.

By Michael Curzon  /  2 August 2021 • 11.27
       
51 comments

Can Anything Save the NHS?

The Daily Sceptic’s in-house doctor – formerly employed by the NHS, now in private practice – has written a guest post about a recent Policy Exchange report on how the NHS should manage its huge waiting list. He isn’t impressed.

Last week, the think tank Policy Exchange published a report entitled: “A wait on your mind – a realistic proposal for tackling the elective backlog.”

I’m very grateful to the authors, because I love a good chuckle, and this banal document had me laughing out loud at several points. There is so much in it, I barely know where to start – this article can only scratch the surface. It commits the cardinal sin of most NHS ‘strategy documents’ effectively being a wish list for a healthcare utopia – oblivious to the obvious fact that in a world of limited resources, one cannot be strong everywhere.

Readers may not be aware of how or why such reports are constructed. As with all medical/scientific publishing, it’s important to understand the process of production to uncover the real purpose and message. I have contributed to several similar documents over the years. The starting point is normally a specific agenda that the report’s funders wish to push – this isn’t always obvious, although an informed audience can read between the lines. I note that this report was “supported by research grants provided by Ramsay Health Care UK, Smith + Nephew and the Independent Healthcare Provider Network (IHPN)”. Readers can probably figure out the agenda for themselves.

The ‘evidence’ for the report is generally acquired by selecting a compliant group of ‘experts’ that can be relied on to provide the correct opinions. The experts are gathered together with plenty of tea and biscuits – or a couple of cases of wine for a more revealing discussion.

Once the experts have sounded off from their particular perspectives, the writers craft the comments into a narrative. The language is usually verbose in style containing pages of pointless verbiage calculated to dress up the work as deeply researched and referenced. On closer inspection many of the ‘references’ are linked to other opinion pieces that conveniently chime with the predetermined purpose. Reliable ‘elder statesmen’ write a preface and a forward to create an illusion of gravitas and authority. Various other lesser figures in prominent medico-political positions are co-opted for endorsements.

The report is then touted around decision makers and passed off as a representation of current thinking. Successful documents provide decision makers with intellectual cover for controversial changes they want to make anyway. In some ways it’s a bit like employing management consultants – they are paid to tell policy makers what they want to hear, and to take the blame if the decision goes sour.

Can Anything Save the NHS?Read More

By Toby Young  /  26 July 2021 • 18.04
   
76 comments

£2.1 Billion Wasted on Useless PPE – Five Times Higher Than Official Estimate

Over the past year, the Government has wasted more than £2 billion on personal protective equipment (PPE) that could not be used in the NHS. The figure is five times higher than initial official estimates and still under-estimates the true cost. The Sunday Telegraph has the story.

Some 2.1 billion items of PPE have so far been deemed unfit to keep doctors and nurses safe in clinical settings – with 10,000 shipping containers-full still to be unpacked as of May this year, said the Commons Public Accounts Committee (PAC).

The amount of unusable kit is five times higher than the number estimated by the Department of Health and Social Care (DHSC) in January, said the select committee, which monitors public expenditure.

The wasted sum forms part of the estimated £372 billion spent by the U.K. on pandemic-containing measures which will expose taxpayers to “significant financial risks for decades to come”, the cross-party committee warned in two reports published on Sunday.

MPs say they “remain concerned that despite spending over £10 billion on supplies, the PPE stockpile is not fit for purpose” with potential levels of waste “unacceptably high”.

As of May this year, out of 32 billion items of PPE ordered by the DHSC, 11 billion had been distributed, while 12.6 billion pieces are on standby at a cost of around £6.7 million a week in storage, the PAC said.

Some 8.4 billion pieces on order from around the globe have still not arrived in the U.K.

For excess PPE that is suitable for medical use, MPs said they are concerned the Government is “yet to create any robust plans for repurposing and distributing this essential stock in a way which ensures value for money and protects staff and patients”.

A public inquiry scheduled to start next spring into the Government’s handling of the pandemic will not come swiftly enough to ensure lessons are learned, the PAC added.

Ministers also risk undermining public trust by failing to swiftly publish the full details of contracts awarded, the report said.

The PAC noted that details of three-quarters of the 1,644 contracts over £25,000 awarded up to the end of July last year were not made public within the 90-day target.

Worth reading in full.

By Michael Curzon  /  25 July 2021 • 11.36
       
32 comments

NHS Says 66% of 18-30s Are Vaccinated as of July 18th – But PHE Says its 59%. Don’t They Know?

The NHS has announced that around two thirds of people aged 18-29 in England have now had one vaccine dose. The Telegraph reports.

A third of young adults in England have still not had a first dose of a COVID-19 vaccine, new figures show.

Around 66.4% of people aged between 18 to 29 had received a first dose as of July 18th, according to estimates from NHS England.

This means 33.6% are likely to be unvaccinated – the equivalent of around 2.9 million adults under 30.

The data shows that vaccine uptake continues to be lower among men than women, with only 65% of men aged 25 to 29 having had a first dose, compared with 71.9% of women in the same age group.

Yet the update from Public Health England, out today, with data up to July 18th, reports the same figure as 59%. It also shows the trend flattening, suggesting it’s unlikely to hit 66% very soon.

PHE

What’s going on? This is a difference of around 600,000 people. Don’t they know how many they have vaccinated? How can they disagree by over half a million people?

Stop Press: A reader has got in touch with an explanation.

The PHE figure would appear to be sound – see here.

Scroll to the bottom. You’ll see that the 18-24 age group is 59.07% and for 25-29 age group it’s 59%.

The problem is that when the NHS report 66.4% vaccinated this is a deception. For the general population statistic, they arrive at this number by taking total vaccinations and dividing by the population in mid 2019. Of course, many who have had vaccinations have (either due to, or for other reasons) sadly died. (I notice that they’ve just updated this to the mid 2020 population, but it’s still not accurate.)

Meanwhile, the PHE statistic is based on vaccinations given to those in an age group with an NHS number. It’s a reasonable guess that those without an NHS number are less likely to go for an NHS vaccine.

Last time I wrote, I predicted that the error was at least 1.5% and growing.

The statistic you quote suggests the error to be more than 6%.

Applied to the country as a whole, this would mean that only 81.7% of the population has been vaccinated.

The statistic the NHS use is simply not a percentage. It is a deceptive misuse of statistics which is mathematically wrong.

The statistic is so badly wrong, that it is possible that in the future it will be possible to have more than 100% of the population vaccinated.

I believe for this reason that once they start vaccinating children they may switch the statistic.

At the moment, if you are to use the total vaccinations given then you must divide this by the total population in 2021.

Total vaccinations = 46,433,845
Total UK population = 68,265,710

So the total with one dose vaccinated is: 46,433,845/68,265,710 = 68%

This is not as impressive a figure, but it sits in the 60%-80% target we were all told about for herd immunity, and given the additional natural immunity, it’s fair to say that the whole lockdown/rules and nonsense can now come to an end.

We all know, though, that they won’t.

By Will Jones  /  22 July 2021 • 18.27
       
15 comments

Brits Told To “Keep Life Moving” by Wearing Face Masks in New Government Scare Campaign

It’s as if ‘Freedom Day’ never happened. A new Government ad campaign tells Brits to carry on wearing face masks and to use the NHS Covid app so as to “keep life moving”. One poster warns that “Covid is still with us” and that you can still pass on the virus “even if you’ve been vaccinated”: “[So] let’s wear face coverings in crowded places to protect others.” The Evening Standard has the story.

An official information campaign, which will hit airwaves, newspapers and other media from Thursday, will see the Government replace its “hands, face, space, fresh air” slogan with its new catchphrase: “Keep life moving.”

A video fronted by TV doctor Dr Amir Khan will also recommend people continue to follow social distancing guidance, as the film shows a young man stepping off a pavement to allow an older neighbour to pass.

The advice comes despite Monday being trumpeted as England’s ‘Freedom Day’, with Prime Minister Boris Johnson removing almost all legal restrictions, including social distancing guidelines.

Pressure has also been placed on young people to get a vaccine, as Health Secretary Sajid Javid reiterates the Prime Minister’s plan to make full vaccination a “condition of entry to nightclubs” by the autumn.

The campaign will warn, however, that being doubled jabbed does not entirely protect you from being infected with coronavirus, or from being told to self-isolate.

The campaign instructs people to stick with the behaviour that has become “second nature” over the past year of lockdowns. This advice appears to have been pulled directly out of Susan Michie’s rule book. In June, the top Government adviser and long-time member of the Communist Party of Britain said measures adopted during the pandemic should become part of our “normal” routine behaviour, just as wearing car seat belts has become commonplace. The Evening Standard continues:

The recommendations include using quick-result lateral flow tests twice a week and booking a PCR test if there is any sign of even mild coronavirus symptoms.

People will be encouraged to keep washing their hands regularly, to check in to pubs, bars and restaurants using the Covid app, and to wear face masks in crowded places where “distancing is not possible”, such as public transport or small shops.

It will also place renewed emphasis on the importance of ventilation in fighting infection during social gatherings, while vaccine take-up will also be pushed.

Worth reading in full.

Stop Press: “Mask-wearers, in my experience, need no encouragement,” says Mail on Sunday columnist Peter Hitchens. “So what’s the aim?”

By Michael Curzon  /  22 July 2021 • 16.31
       
163 comments

“Open a Window”: How Many Are Dying Because This is Still the Best ‘Treatment’ the NHS Offers to Those Suffering With COVID-19 at Home?

The highly recommended HART bulletin this week has a piece on how the NHS is failing Covid patients by not offering any adequate early treatment, despite the now plentiful evidence of the clinical effectiveness of a number of safe, repurposed drugs.

Nearly a year and a half after the country was locked down to protect the NHS, how is the NHS performing in managing the very condition that so threatened it?

If you suspect that you or a member of your household is suffering from COVID-19 the advice is to get a test and contact NHS 111 for advice. When you do this you are asked a series of questions designed to ascertain how seriously ill you are. If you report “red flag” symptoms such as severe breathlessness or oxygen saturations below 90% quite rightly you are advised to call 999. But what about the less severe cases? The National Institute for Health and Care Excellence (NICE) has issued guidance to clinicians on how to assess and manage patients with COVID-19. Patients not severely ill and requiring hospital admission are managed in the community. The guidance advises symptomatic treatment such as a teaspoon of honey or linctus or even morphine sulphate tablets to suppress coughing. This in itself is bizarre advice, given that the British National Formulary (BNF) only recommends morphine for treatment of cough in palliative care with a ‘reminder of the risk of potentially fatal respiratory depression’.  Paracetamol or ibuprofen is recommended for fever. For breathlessness it advises to keep the room cool and open a window. For agitation and anxiety it even recommends a trial of a benzodiazepine (a tranquiliser medication) despite this potentially leading to respiratory depression.

What does not feature in the guidance is early treatment of COVID-19 in the community. Drug treatments such as dexamethasone and remdesivir are recommended for hospital patients. There are a number of established medicines such as ivermectin, hydroxychloroquine, zinc and famotidine which have been advocated for early treatment. The evidence in favour of ivermectin, in particular, is growing rapidly as this meta-analysis by HART member Professor Norman Fenton and his colleague Professor Martin Neil shows.

Similarly, early administration of inhaled budesonide (an asthma drug) has been shown to reduce the likelihood of needing urgent medical care and reduced time to recovery while a peer-reviewed study in the USA showed fluvoxamine (a common antidepressant drug) prevented clinical deterioration in outpatients with clinical COVID-19.

The U.K. has been quick to roll out COVID-19 vaccines that are still undergoing their clinical trials yet seems reluctant to explore the possibility of cheap treatments with long established safety records. Surely this begs the question why?

Read the bulletin in full here and sign up to receive the next one here.

By Will Jones  /  15 July 2021 • 21.20
     
62 comments

How Would You Prepare Your Former Self for the Age of Covid?

We are publishing an excellent comment today by reader Jimi Cazot that he wrote in response to a Telegraph article on the introduction of Covid vaccine passports. Jimi asks: “If you could go back 10 years and speak to your former self, what would you tell that unsuspecting fool?” His answer below is bound to resonate with many readers.

In the future, many of your national assets will be owned by China. Most of the goods you buy will be made there too, which you will not purchase from your fellow countrymen but a sole supplier owned by an American.

The most successful politicians will not be elder statesmen committed to public service but young upstarts who view the job as a stepping stone towards tremendous personal wealth in later life.

Your Government will pass bills to quash peaceful protest and enable the recruitment of child spies. This won’t be limited to the intelligence services but bodies like the environmental and food standards agencies too. When you ask “why”, nobody will be able to tell you.

Your Government will set up ‘nudge units’ staffed by unknown behavioural scientists. They will tell you what to eat, drink and how you should behave. There will be patronising health and safety signs everywhere you look.

“The media will grow dependent on Government advertising revenue and cease reporting opinions and events that contradict official narratives.

The internet will be dominated by a small number of big-tech companies who will delete all information that they disagree with.

In the name of safeguarding students from harm, schools and universities will cease debate and enquiry. People with contrary views will be barred from campuses. Even student newspapers will be censored by ‘sensitivity readers’.

At work, you will be made to undergo psychological re-education. The people lecturing you will have no knowledge of psychology but nonetheless try to change you at a subconscious level.

People will be sacked from their jobs for saying there are two biological sexes or for telling an ill-judged joke. They will not be forgiven if they apologise.

Every major institution and employer will sign up to this censorious culture and soon you will censor yourself when speaking to friends and colleagues without even knowing that you’ve done so.

When a virus emerges that only kills 0.3% of those who catch it – the majority of which older than the average span of a life – you will be bombarded, 24-hours a day, by terrifying public messaging.

The police will stop you from meeting a friend for a coffee in the park. They will rummage through your shopping bags to make sure you’ve only bought things that they deem essential. They will film you as you walk in the countryside and put the footage on the internet so to shame you.

Neighbour will be told to spy on neighbour, and when you have friends round for dinner the police will knock on your door and give you a fine.

You will be told to stay two metres away from other people at all times. You will be made to wear a facemask even though there’s no evidence that they do anything at all. When this becomes apparent, scientists will say you must wear them so as not to frighten other people. Your freedom will end where another’s fear begins.

Families will be kept from dying loved ones. Widows will be denied the comfort of human touch. Daughters will be arrested for collecting their mothers from care homes.

Vast numbers of children will be sent home from school and denied a proper education just because one classmate lost their sense of smell.

Weddings will be cancelled. Nightclubs will be closed. Churches will be shut. Singing and dancing will be prohibited. Lovers will be kept apart.

Vaccines will be created using messenger ribonucleic acid technology. When the inventor of that technology warns against its use by those at little risk from the virus, records of him will be expunged and someone more ‘helpful’ will be credited with his work.

You will be told that the vaccine isn’t compulsory, yet those who refuse might be sacked from their jobs. They will be made to queue for longer at airports. They will be put under house arrest if they come into contact with someone who has the virus, whilst those who have had it will not. They will be stopped from going to bars and stadiums. There will be two classes of people: the clean and the unclean.

Your unassailable and decadent leaders will ignore the rules they set for others again and again, blissfully untroubled by the cries of hypocrisy.

Global leaders, bureaucrats, scientists, royalty and the super-rich will meet in private to discuss how we all must live. They’ll say there are too many people and not enough resources, but nobody will ask who we should get rid of and how. Blinded by hubris, they’ll believe that they alone can bring about a utopian future. The language they speak will be impenetrable to most, it made up of meaningless phrases like ‘stakeholder capitalism’, ‘collectivisation’, ‘sustainable development’ and ‘Build Back Better’. Every now and then, however, they’ll make things very clear: “You will own nothing. You will rent everything. You will be happy.”

Few will question what this means, how it will be brought about or what mandate they have for doing so. Those who do, or any of the above, will be insulted, ridiculed and so pushed to the margins of society that they are effectively silenced.

Most will stand on their front doorstep at 8pm every Thursday, clapping their hands and bashing saucepans.

Now, what do you think your former self would say?

By Michael Curzon  /  13 July 2021 • 12.13
       
136 comments

A Doctor Asks: The Data Is Looking Good, So Why the Doom-Mongering?

There follows a guest post from our in-house doctor, formally a senior medic in the NHS, analysing the latest NHS England data packet.

Once a month, the NHS releases a more detailed summary of COVID-19 related data than provided in the regular daily updates. Although the data set is far from complete, the monthly packets provide a better impression of what is really happening in hospitals than the daily snapshot. I find this month’s information particularly interesting. Apologies in advance to readers for reverting to a more data-driven ‘chart fest’ format for my latest contribution – but stick with it, because there are some important messages here which have not been widely reported so far.

Take a look at Graph One. This rather complicated graphic shows daily admissions in the vertical orange bars and paired daily discharges in the vertical blue bars. Readers will notice that on every day between April 7th and June 30th, there were more discharges than admissions.

The grey line with the secondary y-axis to the right of the chart shows the total number of ‘COVID-19’ patients in hospital on each given day. For the first period from April 7th to May 25th, this was on a falling trend – that’s what one would expect if there were more discharges than admissions each day.

From May 26th to the end of June, however, the total number of patients in hospital ‘with COVID-19’ was on an upward trend – but on each day of the series, there were still more discharges than admissions. How can that be?

I’ve discussed this issue with colleagues and there are only three interpretations we can think of. One is that there are a very large number of patients contracting COVID-19 in hospital who came into hospital without the virus. The second is that some of the ‘discharges’ are in fact patients who were never admitted to hospital at all, but seen in A&E and then sent home. The other is that the data quality is very poor and gives a misleading impression of the true picture.

A Doctor Asks: The Data Is Looking Good, So Why the Doom-Mongering?Read More

By Michael Curzon  /  10 July 2021 • 11.14
         
76 comments