NHS waiting lists in England hitting new high of 7.2M people

https://www.itv.com/news/2022-12-08/number-of-people-in-england-waiting-to-start-hospital-treatment-hits-record-high

38 83 4 years ago

453qtgreq4• 4 years ago

I think it was such a bad move to tie the driving purpose of Covid Restrictions in the UK to "Saving the NHS". One obvious flaw is that people will retrospectively tie the success of lockdowns with the post-Covid state of healthcare. Given that the NHS was already barely functional pre-Covid, denying healthcare for several years and simultaneously making it harder to give healthcare was a recipe for disaster.

benjaminwootton5• 4 years ago

Many of us predicted that the Covid restrictions would kill more people than they would save.

Excess deaths have been high all year and this is likely to remain the case for the next decade. We’ve obliterated the health service and also damaged the economic engine to pay to fix the problem.

(And I’m still downvoted. Open your eyes people, it’s basically Stockholm syndrome at this point!)

jinder• 4 years ago

How have you determined that the excess deaths are due to "covid restrictions" and not for example, long term sequelae of covid itself or other factors?

lynx23• 4 years ago

Thanks for saying that, 100% agree! It was obvious from the start that the restrictions will do more harm then good. Almost everyone in my circles that has kids is reporting psychological problems. Teachers report that they have to care for three suicidal kids during a school trip. People having long term side effects from the vaccination. And still, the restriction-fanatics are trying to ignore the obvious.

rich_sasha• 4 years ago

I don't really know which way the balance goes, but that the calculus wasn't made is borderline criminal to me.

And I don't think it really was done, when UK decided to not implement any lockdowns initially (right or wrong, don't know), most of the response was emotional. How dare you not care about dying people???

ben_w4• 4 years ago

Yes, many did; and yes, excess mortality is up; so I can sympathise with thinking that’s a smoking gun — but COVID itself also caused excess mortality, some of which was by the pathway “The hospitals are now full of COVID patients so we have to turn away others” followed by “OK, so the COVID has cleared up and we can get back to the others… oh, 10% of those others have since died”. And given this is about the UK, I can also point at Brexit, the final stage of which happened during the pandemic and which I specifically predicted would cause a non-specifically large number of deaths: https://kitsunesoftware.wordpress.com/2019/10/25/oh-no/

(I’m glad to say that Boris Johnson pattern-matches against what I wrote in the final few paragraphs).

I’m sure some deaths will have a causal connection to the lockdown, but I can confidently say that about literally every possible course of action or inaction by any major government on any topic no matter how mundane; to talk about risk to the NHS, one must show that the caused effect is also a substantial part of the total.

andyjohnson02• 4 years ago

You're blaming the wrong things. Its a system problem.

Waiting lists for elective treatment are high because hospitals are full of mostly elderly people who can't be safely discharged because the social care system is broken - largely due to lack of capacity due to underfunding. And the government recently cancelled the national insurance rate rise that was supposed to fund improvements in social care.

Accident and emergency departments, as well as intensive care, can't move patients into regular and high dependency hospital areas because of the problem above. Which is why ambulances have to wait for so long outside hospitals. Which is why ambulance waiting times are seriously dangerously high.

The NHS generally has a lot of burnt-out people who are quitting or retiring faster than they can be replaced. Part of the problem is low pay (arguably partly due to under-funding of the service) and perception of that NHS roles are high-stress. The same is true for GPs (who generally aren't NHS employees) although the shortage of people wanting to become GPs is less about pay and more about the stressful nature of the job. The stress of dealing with the pandemic also substantially contributed to burn-out.

Ultimately, the UK isn't willing to fund public services properly. Health, education, social care, police, military - they're all grinding to a halt after running hot for too long with not enough people or funding.

If you want to take the argument further - we're looking at the economic damage caused by 14 years of austerity topped-off by brexit. The UK economy can no longer fund the expected activities of the state at the level that people expect.

543g43g438• 4 years ago

Not forgetting the obvious problems with turning your entire population into "bubble people". I'm not very excited about the Scarlet Fever outbreak here in the UK, as I have two small kids of my own.

orwin• 4 years ago

I don't know if it's as general as that. I just checked excess mortality, France VS UK [0] as they have a similar GDP and similar health system (and I know France situation better). This summer, we had three heatwaves, reached new record temperatures in 9/12 of all cities I've lived in, and had the longest heatwave ever recorded, as well as the earliest one. We had way more excess death during the 2020 summer, or even the 2021 summer (tbh, although it was pre-omicron, the excess death can probably also be caused by car crashes).

It seems to me that the excess death in my country will reach the baseline (maybe a bit higher since the average age is growing, but not much) as long as this summer is an outlier. UK data almost tell the same story, but I don't think you had the same heatwaves, and I don't know how to explain what is happening right now.

Putting that on the lockdowns only would need explaining why this effect isn't seen in France, as ours were both longer and more numerous I think (we had three, and only two in the UK, right?).

[0]https://ourworldindata.org/grapher/excess-mortality-p-scores...

oliwarner• 4 years ago

Covid it's a red herring. As is the attention given to long ambulance queues, overrun A&Es. This isn't a front door admissions problem.

What we're seeing is a long and accelerating dissolution of social care in the community, mostly elderly nursing but also mental health.

Most hospitals are at least 40% occupied by patients awaiting discharge but who can't be discharged because there isn't a nursing home space, or enough community nursing to support them at home. They stay in hospital.

This blocks admissions. Which blocks ambulance transfer. Hospitals give surgical beds over to ease waits but this only makes things worse. Now people aren't getting surgical treatment, and it's more likely they'll end up coming in for the symptoms.

Covid made things worse, mainly by treating nursing staff horribly, but this was already a trend. We urgently need to pay nurses more, and desperately train a hundred thousand more. Neither look likely under this government.

CommanderData• 4 years ago

Did the government ever solve the NHS PFI scandals?

I remember these being a massive topic some 10 years ago but haven't heard much if anything of them since.

Edit: It looks like some trusts still pay insane interest rates for some of these projects https://www.theguardian.com/politics/2019/sep/12/nhs-hospita...

hermitcrab8• 4 years ago

I remember at the time hearing that PFI was some sort of magic money tree that was better for everyone. You would have to be massively naive to believe that.

decodebytes• 4 years ago

It's not just the waiting lists, it's the dire situation at A&E. Folks waiting around 10 hours to be seen and ambulances parked up with patients onboard as there are no beds available for them to offload and see to the next emergency.

benjaminwootton5• 4 years ago

And a lot of this comes from upstream. It’s bordering on impossible to see a GP so you need to go to A&E for anything semi urgent. I cannot even speak to our family GP, and if I could I would be offered a telephone appointment in 3-4 weeks.

The NHS has effectively collapsed.

was_a_dev7• 4 years ago

It's further upstream than that, it's the successive cuts to all public service.

This makes GPs the backstop for all social problems in the UK, which eventually spills into the hospitals.

bowsamic5• 4 years ago

The NHS has effectively collapsed.

Yep. A lot of people don't realise it because the loudest voices are often Brits that happen to live in locations where it has not collapsed yet, but there is basically no health service in England for a huge proportion of the population. It is only a matter of time before resources get diverted away from those locations where it still happens to be good to try and patch up the failed areas, but that won't solve the problem. Therefore, it is only a matter of time before total collapse in all locations.

Currently there is a lot of ignorance about it. People hear that it's bad but because they happen to live in an area where it happens to be good they can't really accept it. Seriously ill or dead people don't have the energy or motivation to spend time complaining about it on social media or to the press.

There is also an ideological problem for both sides. Both Labour supporters and socialists do not want to admit that the NHS is failing, because they know that if it goes then it is very unlikely to ever return, and they want to generally support nationalisation. On the other hand, Tories don't want to admit that the NHS is failing, because even for the pro-Capitalist Tories, the NHS is a patriotic symbol of the UK loved even by hardcore conservatives, and a symbol of the "blitz spirit". They also are aware of the fact that its collapse would be a sign of its own failures, since the Tories have been in power for a vast majority of the time that the NHS has been collapsing, so who else is there to blame?

I think most likely the Tories are going to try and blame this on Putin, which is quite comical.

Obviously there is this idea going around that this is being done on purpose by the Tories to encourage a move to private medicine, but I don't think this is true because the private medicine in the UK is heavily reliant on the NHS to function and the UK government aren't really doing anything at all to encourage more private hospitals to open either. If the Tories really wanted to move people from the NHS to private healthcare they would offer a statutory insurance system like in France or Germany and tell people to use it at private clinics.

weberer• 4 years ago

Don't you guys have urgent care centers? They're fairly common in the USA.

tailspin20193• 4 years ago

Apparently the problem is also downstream - namely the inability to discharge patients who are ready to go home due to lack of sufficient community care available to support these patients.

Thus taking up a lot of extra beds and having a knock on effect on A&E queues etc

That and a recruitment problem - as I understand it. (Likely partly due to poor wages but that’s an assumption on my part)

albertopv• 4 years ago

Welcome to Italy.

langsoul-com• 4 years ago

Don't worry UK friends, Australia is on its way.

In the health care world, you either have private, or wait until your condition worsens. Then get put on a different waiting list for that.

There are the haves and have nots.

I wonder if going the Singapore route would work? Probs not though, UK is significantly larger than Singapore.

was_a_dev7• 4 years ago

Ironically, one issue with the NHS is retention of staff. A sizeable majority of the new cohorts of junior doctors are steadily migrating to Australia due to the better working conditions.

StapleHorse• 4 years ago

Don't worry spaniards will cover for them and doubling the salary doing so.

inkyoto• 4 years ago

The UK style healthcare system is fundamentally flawed as it does not attempt to address the root cause of a health problem, and is skewed towards providing a tactical solution to the health problem instead. I.e. fixing up the patient just enough to make them come back later again either with the same or with a new but related health problem. Patients are seen as commercial clients (i.e. cash cows) rather than somebody in a real need. It does not matter who pays (the state or the patient out of the pocket or through a health insurance), as somebody generates the revenue stream for the doctor anyway. Which creates a vicious circle for the patient and adds a unnecessary extra burden on the already strained healthcare system.

Australia and New Zealand face the same problem, but Australia is rolling downhill at a faster pace.

pharmakom3• 4 years ago

This is roughly 1 in 10 people

bowsamic5• 4 years ago

More like 1 in 8 because this is just England, not the entire UK

bowsamic5• 4 years ago

If you're in the UK, please go private if you can afford it. You cannot rely on the NHS.

hermitcrab8• 4 years ago

This helps the individual, but doesn't do much to help the NHS. The NHS is one of the best things about the UK and we need to fight for it. Making big corporation and the super wealthy pay taxes would be a good start.

robin_reala• 4 years ago

It helps the NHS in as much as it reduces load on them. Though what percentage of people would have to do that to have an appreciable benefit is another matter, and it doesn’t do anything about A&E.

bowsamic5• 4 years ago

Healthcare is a life or death situation. I'm not going to abandon my own health because I think that if I don't do so I might hurt the NHS

usedtoprog2• 4 years ago

You've got to be kidding

n4r93• 4 years ago

The NHS is still functioning. I am still able to get GP appointments within two weeks, be prescribed medication, etc... . Your suggestion, if widely adopted, risks splitting the country into a two-tier system and hastening the demise of the NHS. Much better to vote in a party that will start to fund it properly and undo some of the privatisation and mismanagement that has been damaging it for years.

benjaminwootton5• 4 years ago

Ours cannot offer a telephone appointment for 3-4 weeks. That is not acceptable for pretty much any situation require healthcare.

The NHS has a record budget of £200 billion for 2022. Serious questions: How much extra money do they need to provide an adequate health service, and how would another party fund the gap considering our current economic situation?

543g43g438• 4 years ago

risks splitting the country into a two-tier system and hastening the demise of the NHS.

You mean, something like the rest of Europe has? Sign me up!

colinb• 4 years ago

Is it still the case that if you're in a private hospital for anything bigger than an ingrown toenail, and something goes wrong, then they'll shove you in an ambulance and take you to the nearest NHS teaching hospital, because:

- that's where all the big kit is - that's where all the top experts are - that's where the nurses and procedures are in place for critical care

Because that was the case 10 years ago. BUPA is great for seeing a doctor quickly with a non life threatening condition. And the biscuits [cookies] were nicer.

My knowledge of the NHS is almost a decade out of date though.

tailspin20193• 4 years ago

Yes I think this is still the case, however the emphasis is on “if something goes wrong”.

I don’t know how often something does go wrong to trigger this scenario though!

ZeroGravitas2• 4 years ago

I believe the new policy document from the Labour party is trying to put healthcare in the constitution, which would help with this.

hermitcrab8• 4 years ago

The UK doesn't have a constitution in the sense that countries like the US do. Are they going create a constition as well?

ZeroGravitas2• 4 years ago

Yes, and get rid of the House of Lords etc.

It seems quite a smart strategy, they're effectively talking about Brexiting from the Westminster elites and "taking back control".

https://www.instituteforgovernment.org.uk/explainers/labour-...

was_a_dev7• 4 years ago

We have a constitution - it just isn't codified [1]. Therefore doing so would just mean having a set of written laws that effectively make public healthcare part of the UK political structure.

[1] https://en.wikipedia.org/wiki/Constitution_of_the_United_Kin...

jmyeet3• 4 years ago

Labour (under Jeremy Corbyn) shares a lot of blame for this situation. Why? In the last election, Labour refused to take a stance on remaining in the UK [1]. To be fair, there was also a massive, coordinated and successful smear campaign against Corbyn. Brexit won by a narrow majority (52-48) and there was no party to vote for to vote against it in the election.

The Conservatives went from having a narrow majority (and requiring DUP support for that) to having a massive majority not seen in 40+ years.

[1] https://www.reuters.com/article/uk-britain-election-corbyn-b...

hermitcrab8• 4 years ago

And now the tories are imploding it looks like we are going to get a massive Labour majority at the next election. And that probably isn't good either. Especially given that Labour prefer to spend all their energy fighting each other.

I think the antiquated first-past-the-post system is at least partly to blame for the mess that is UK politics.

jmyeet3• 4 years ago

Remember how Brexit was going to save the NHS [1]? It has instead worsened the situation [2]. Remember how the previously short-lived PM Liz Truss wanted to drive up the deficit with massive tax cuts [3] instead of, oh I don't know, spendin gmoney on the NHS backlog and staff shortages?

Here's something you may not know: the cost of living situation is a genuine crisis in the UK, Russia's unjustifiable war on Ukraine and the resulting cut in gas supply and rising energy costs have led to the creation of Warm Hubs in the UK [4]. What's a Warm Hub? It's somewhere warm people can go because they literally cannot afford to heat their homes.

This is no doubt contributing to demands on the NHS.

It's wild to see comments even here suggesting Covid lockdowns were the problem. No, the collapses we're seeing in the NHS were the very thing lockdowns avoided.

[1] https://www.healthjobs.co.uk/health-care-uk/blog/what-happen...

[2] https://www.theguardian.com/society/2022/nov/27/brexit-worse...

[3] https://www.npr.org/2022/10/23/1130782408/how-liz-truss-aggr...

[4] https://www.lep.co.uk/news/people/cost-of-living-crisis-warm...

was_a_dev7• 4 years ago

Russia's unjustifiable war on Ukraine and the resulting cut in gas supply and rising energy costs

While true, Putin's war is being used as a scapegoat in the UK for poor policy decisions. For a country in Europe with the lowest reliance on Russian gas, we have seen some of the largest increases in energy prices.

jmyeet3• 4 years ago

It doesn't really matter where the UK's gas comes from. That's not how global commodities markets work. If it was domestically produced you could legislatively do something about it but the UK's gas seems to primarily come from Norway.

Also, the UK has the second-highest dependence on natural gas in their energy mix (after Italy; ignoring Belarus and Russia) [1].

[1] https://www.aljazeera.com/news/2022/9/6/infographic-how-much...

robga2• 4 years ago

Much better source than some schlocky tv channel copy

https://www.bma.org.uk/advice-and-support/nhs-delivery-and-w...

cosmodisk3• 4 years ago

We left the UK last year. I liked many things there, but the NHS was never one of them. The GPs who are often borderline incompetent. The administrative staff and their endless errors. Wait times were always bad. A few years ago we waited 9 months so for an appointment with a pediatrician. I recently had to make a couple of appointments with specialists, cardiologist was one of them. Less than two weeks wait time+ multiple doctors to choose from. In the UK I would have waited for month for this to happen.

zelos• 4 years ago

It seems like there's a massive cognitive dissonance in the UK. Everyone 'loves' the NHS, says nurses are underpaid and decries any attempt to privatise provision. But everyone also has endless complaints about it. Useless doctors/nurses, appalling administrators and reception staff, mistakes with test results and communication and so on.

cosmodisk3• 4 years ago

I think for an average Brit the NHS is the same as the queen used to be: you may not like it, but if anyone says something negative about it, you are absolutely ready to die for it. At least this was the impression I used to get whenever I brought up the subject.

usedtoprog2• 4 years ago

Glad to see the leftist lilt on HN downvotes and flags anything contrary to the narrative.

NHS waiting lists in England hitting new high of 7.2M people

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