Patients and staff at risk as UK National Health Service faces real-terms funding cuts

Britain’s National Health Service (NHS) has been plunged by the Conservative government into an unprecedented crisis, putting the health, safety and lives of patients at risk and excerabating the already terrible situation facing staff.

A front-line nurse at Royal Bournemouth Hospital told the World Socialist Web Site, “Most days we are short of staff. Sometimes, even though we don’t have enough staff to care for patients in our own ward, we have to go and help on other wards. The Emergency Department is one of the places that’s been battered the most. Their admissions have surged, and they do not have enough nurses. I cannot remember a day when we worked with our full staff complement. This means patients’ treatment and care needs often go unmet.”

There are “dozens of COVID-19 patients in a number of wards and units across our trust. When we juggle for beds, it just spreads more. No proper prevention and control measures are in place. Moreover, without enough staff, it’s very difficult even to practice the limited measures we have. At one point last month, about 200 colleagues were absent due to COVID symptoms. Now it has gone down to 65, but some of my colleagues have been left suffering from Long COVID.” One of the hospital’s COVID wards was left in a “chaotic” state, they said, “This situation can cause serious harm to patients.”

National Health Service workers and air ambulance staff at a hospital in southern England, August 2022

The same experience, or even worse, is repeated across the country. A damning report by the Parliamentary Health and Social Care Committee recently warned the staffing crisis in NHS England was posing a “serious risk to staff and patient safety.”

In England alone, there is a shortage of 12,000 hospital doctors and more than 50,000 nurses and midwives. The number of full-time equivalent GPs also fell by more than 700 over the three years to March 2022. Maternity services are “under unsustainable pressure,” with 552 midwives leaving the profession last year.

Ambulance services

Pressures on ambulance services are acute, with a doubling of calls since 2010 and nowhere near the necessary staff and resources in place. Last month, all ambulance trusts nationwide were placed on Black Alert—the highest escalation pressure level.

Response times for emergency 999 calls have surged, producing enormous suffering and debilitating consequences including deaths of patients.

The Independent online newspaper reported this month that police officers are being sent to answer medical emergencies. Andy Cooke, HM Chief Inspector of Constabulary told the paper, “Recently, officers in armed response vehicles (ARVs) were being sent to reports of people who were having cardiac arrests because the ambulance service couldn’t cope with the demand, because they’re trained in first aid and to use defibrillators.”

According to a survey by the GMB union, 35 percent of ambulance workers have been involved in cases where a patient’s death was linked to delays in the service. The survey also found that 85 percent of ambulance workers had witnessed delays which seriously affected a patient’s recovery.

Over 80 percent of first responders felt the pressures caused them an unacceptable level of stress and 72 percent were considering leaving the service.

According to the GMB, the average response times for serious (Category 2) calls was 51 minutes in April 2022, compared to 20 minutes a year before. This means even patients with severe, time-critical cases, such as stroke and chest pain, must wait over half an hour longer than the NHS target of 18 minutes for any help to arrive. Some patients had to wait two hours.

Staff shortages in Emergency Departments, combined with a lack of beds, have seen queues of ambulances outside hospitals waiting to hand over their patients, further delaying treatment. The West Midlands Ambulance Service reported crews losing nearly 40,000 hours in June due to handover problems, with estimates for August approaching 50,000 hours.

The pandemic exacerbated a long-standing lack of resources, with the operational standard of treating, transferring, discharging or admitting 95 percent of Accident and Emergency (A&E) attendees within four hours not being met in England since 2015. Only 71 percent of patients in England were seen within four hours at A&Es last month. Some 29,317 people had to wait more than 12 hours in England, setting a new record.

NHS waiting lists

Although the numbers waiting more than two years have been reduced, thanks to a massive effort by NHS staff, there remain a staggering 6.73 million on waiting lists for elective surgeries and procedures—the figure growing by 100,000 in June alone. Of these, some 400,000 have been waiting for more than a year to have procedures for painful and debilitating, if not life-threatening, conditions.

While delays mean months of misery for millions, the owners of private hospitals have benefited handsomely. The NHS has referred thousands of patients’ operations to the private sector, while individuals have used life savings, taken out expensive loans or even resorted to crowd funding to pay for treatment.

Comparing the last three months of 2021 to the same period in 2019, before the pandemic hit, the largest increases in self-funding have been in Scotland (up 90 percent) and Wales (84 percent), whose devolved Scottish National Party and Labour Party governments have responsibility for health.

Cancer treatment

More than 10,000 cancer patients have been waiting three months for their treatments, a delay of at least a month against the target. Only 60 percent are starting treatment within 62-days of an urgent GP referral, well below the 85 percent target.

Professor Pat Price, an oncologist from Imperial College London, described the situation as “the worst cancer crisis of my lifetime.” She told BBC Radio 4, “There will be tens of thousands of cancer patients who die unnecessarily”.

NHS England would have to work at 110 percent capacity for over a year to catch up on these missing cancer treatments, according to cancer charity Macmillan.

Mental health

Tory-led governments have slashed more than 1,500 mental health beds since 2010. Combined with acute staff shortages, this has created a terrible situation for patients with mental health issues. Bed occupancy levels in mental health trusts are constantly running above 95 percent, when the safe level is 85 percent. Bed and staff shortages in a particular locality can mean people with severe mental health issues being admitted to special units several hundred miles from their homes, making visits from family members or friends impossible in many cases.

Those waiting to access community health services face massive delays. According to NHS England data, the number on the waiting list has risen to 1.2 million, up from 1.08 million at the end of 2021.

The fight for a fully funded health service

The NHS upon which millions of working people depend has been brought to the point of collapse by Tory government attacks over the last 12 years. These went ahead without the Labour Party lifting a finger in opposition.

The pandemic continues, piling more pressure on an already overburdened service. While the government refuses to implement any serious measures to suppress COVID-19, each successive wave infects millions, with large numbers hospitalised or left suffering for months, or even for life, with Long COVID. With the imminent return to schools and universities following the summer break and the onset of colder weather in autumn and winter, infections and the demands placed on the NHS will rise inexorably.

Vast sums of public money are being spent shipping tons of heavy arms to Ukraine as part of NATO’s proxy war against Russia, and on increased military spending overall. Right-wing commentators have rushed to declare the post-Cold War “peace dividend” over and put what is left of the NHS on the chopping block.

Already the NHS Confederation, which represents the various trusts, is warning that the health service faces a real-terms cut of between £4 billion and £9.4 billion this year. The NHS is being required to make “efficiency savings” of 2.2 percent, double the requirement of recent years.

The health service unions, representing well over a million workers, have overseen the degradation of their members’ pay and working conditions over more than a decade. Faced with a government-imposed 3 percent wage “increase”— more like a 10 percent cut, accounting for inflation—the unions are delaying ballots for industrial action until September or even later.

NHS workers can have no confidence that any fight will be led by these discredited organisations. NHS Fightback, initiated by the Socialist Equality Party, calls for the building of rank-and-file committees of workers to take forward a genuine struggle in defence of their interests and the health service itself:  for a massive ramping up of pay and conditions and the recruitment of hundreds of thousands of additional workers necessary to staff a fully funded public health and social care service for all.

Contact NHS Fightback today.