If you read one thing today about the NHS and coronavirus, make it this

An open letter published in the British Medical Journal (BMJ) has given the starkest assessment yet of why the NHS is “extremely vulnerable” during the coronavirus (Covid-19) pandemic. It pulls no punches, laying blame at successive Tory-led governments’ doors. But one line hits the nail completely on the head. Because the authors say :

The NHS has been run on the goodwill of its staff for too long

Coronavirus: decimating the NHS

The current coronavirus pandemic has left the NHS in a highly precarious situation. From a lack of personal protective equipment (PPE) to government false promises about ventilators – the UK’s health service has been struggling to cope. Much has been written about how a decade of Tory-led austerity has made the pandemic all the more difficult for the NHS to cope with. But a piece on the BMJ website perhaps puts the situation into the clearest light yet.

The letter was written by three academics:

• Lucinda Hiam, a “GP and honorary research fellow at the London School of Hygiene and Tropical Medicine”.
• Danny Dorling, a “professor of Geography, School of Geography and the Environment, University of Oxford”.
• Martin McKee, a “professor of European public health at the London School of Hygiene and Tropical Medicine”.

The background to a crisis

It detailed various facts about the state of the NHS before the pandemic hit the UK. For example, the authors wrote:

Before the first case of covid-19 in the UK on 31 January, data for the preceding four weeks revealed that the highest number of patients had waited in A&E for more than four hours ‘since records began.’ 2,846 people waited more than 12 hours to be seen. These figures represented increases of 20.4% and 353.9% respectively above the same period last year.

The issue of waiting times in the NHS was also seen in other areas. For example, the Guardian reported that in January 2019:

Record numbers of patients are not getting vital cancer care on time because NHS England performance against waiting time targets has fallen to its lowest ever level

But the BMJ letter went further than just statistics.

A decade of intentional chaos

Its authors noted that in one survey less than 1% of NHS staff felt “well prepared” for coronavirus. Moreover, it said:

a decade of under-funding has left the NHS extremely vulnerable. Worse, repeated warnings about this vulnerability have been ignored.

They also took aim at former health secretary Jeremy Hunt and the Tories more broadly, saying:

The same people that have been in power in the UK for the last decade are now discussing the under-funding and resulting crisis in the NHS as if they had nothing to do with it.

But it’s the letter’s assessment of the wider problems leading to the NHS crisis which is most pertinent.

Embedded problems

It said before coronavirus, things were already “falling apart”:

The state has been failing in its most basic duty, to protect the health of its people. Life expectancy has stalled, and for some fallen. So-called ‘deaths of despair,’ from drug overdoses, alcohol related conditions, and suicides are rising in 45-54 year olds. Health inequalities are widening, access to healthcare is worsening, and the number of people who are homeless has risen. The UK was simply not prepared for an epidemic.

And the authors also noted that the pandemic doesn’t appear to have changed the Tories’ attitude that much. They cite Downing Street adviser Dominic Cummings’ alleged comments about the government’s strategy: “if that means some pensioners die, too bad”.

But it is the notion that the only thing keeping our health service going is the “goodwill” of its workers which is most damning. Because at least 14 NHS staff have died of coronavirus. At the time of publishing, the latest medic to lose their life was Rebecca Mack, a 29-year-old nurse from Newcastle.

Lessons learned?

The authors conclude:

For now, we must join together to support the crucial work of all those fighting to control the pandemic. But once this is done, there must be complete transparency about how the NHS came to be left in this exposed position, how social care had been stripped away, and how those in power will be held accountable.

The coronavirus pandemic has exposed many gaping holes within UK society. Not least in our public health service. And while the time for recrimination may not, for some people, be now – serious questions must be asked about events leading up to this crisis, and the Tory government’s response during it. ‘Lessons learned’ is a well-worn phrase. But for once, it may well be appropriate now.

Read the full article in the BMJ here.

Featured image via Flickr – Garry Knight