It has become a tragic annual tradition for the NHS to head into winter with dire warnings of how awful its performance is going to be. This year the British Medical Association has been clear that if its forecasts become a reality the health service will experience its worst ever winter with more than 1 million patients waiting more than four hours to be seen and nearly 300,000 waiting on trolleys after four hours.
Many voters would be forgiven for dismissing this bleak assessment on the grounds there seems to be an NHS crisis every winter but somehow the system always pulls through.
What makes 2019 different is not only the unwelcome scrutiny of a general election but for the first time there has been no summer respite from high levels of patient demand. Typically, the NHS uses the summer months to catch its breath but this year there was simply no let-up.
Many of the biggest hospitals reported record-breaking numbers of patients turning up at A&E in July and August. Nottingham University Hospitals NHS Trust had to declare a “black alert” incident in July – the most serious level of pressure normally reserved for the depths of winter.
Critics accuse ministers of underfunding the NHS for almost a decade and cutting beds while not delivering better community services which might stop patients turning to A&E. These are allegations the government cannot duck, but the promises so often made by NHS leaders to transform the service appear worthless.
In many ways the NHS is a victim of its own success; it is keeping many of us alive longer than perhaps would’ve been the case decades ago. But while all of us are enjoying a previously unknown longevity, it tragically does not come with good health. More and more people are living with long-term conditions that leave them frail and vulnerable.
Plans to change the official waiting-time targets appear to be minor tinkering in the face of the annual crises. Winter after winter the NHS has been warned it cannot go on doing the same as before.
Ministers and NHS leaders need to acknowledge the truths about patient demand and design a healthcare service that meets the population’s needs.
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