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The UK is falling apart, an ongoing saga

Brian Leiter

MOVING TO FRONT FROM DECEMBER 20–AS THE COMMENTS SADLY CONFIRM, THE SITUATION IS INDEED GRIM

I guess this is the legacy of Tory rule:

Countless harrowing incidents have called attention to the ambulance problem in Britain, including that of an elderly man whose family covered him with a tarp as he waited seven hours after falling outdoors, and a 17-year-old soccer player who waited for four hours lying on a rainy field after suffering a neck injury….

Ambulance services across the country, almost all of which are part of the National Health Service and managed by an area’s local health trust, have described a rising number of deaths linked to long waits. One English ambulance service noted that the number for its crews had risen from just one in 2020 to at least 37 in 2022.

Curious to hear from UK readers whether this grim picture is accurate.  Waiting hours for emergency help is pretty horrifying.

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13 responses to “The UK is falling apart, an ongoing saga”

  1. Enzyme

    Yep: there's been some genuinely breathtaking horror stories.

    In no small part, this is because of the shitshow in adult social care. Patients who no longer need hospital treatment but who do need ongoing care cannot be discharged, because there's nowhere to send them. This means that the beds on wards aren't available, which means that there's nowhere for newly-admitted patients. This means they stay on beds in corridors, cluttering up A&E and MAUs. This means that there's nowhere for ambulance staff to drop off their patients… and so it goes on.

    Why is this? There's been a chronic lack of investment in adult social care; the cracks had hitherto been papered over because we could pay (say) Romanians to do this kind of job on the cheap. But since Br*x*t and COVID, there's simply not been the available workforce, and so an already shonky system has just staggered from crisis to crisis.

    Even reentering the Single Market isn't likely to be enough to restore things now. We're looking at a 5-10 year process at the very least.

    Reply
  2. Jennifer Hornsby

    Grim indeed. You need to factor in what the New York Times calls ‘the broader background'(one part of which Enzyme [above] follows the Times in describing)in order to understand why the picture is so grim, and why it can only be expected to get grimmer (albeit not to continue to generate so much in the way of horrific headline news).
    Our Conservative government takes no notice of the facts (a) that continuing recruitment and retention problems in the Health Service can be predicted further to worsen unless a pay increase for Health and Social Care staff for the present year is guaranteed, (b) that the effect of under-staffing is that billions are spent on agency and bank staff. (The British Medical Journal, using some actual figures and admittedly much extrapolation, puts the amount spent in 2021–22 at £8.9 billion.)
    My personal theory is that the government thinks that if the NHS is in a state of collapse when the election comes, then things will be bad enough for the Labour government which takes over from them that their (the Conservatives’) chances of being out of office for only a single term are improved. This theory would at least serve to explain why the government's response to the strikes is an intransigence based in ignoring crucial facts and putting out a few falsehoods.

    Reply
  3. David Morrice

    Instead of negotiating seriously with the relevant health unions, about pay and working conditions, a government health minister has suggested that during the strike by ambulance workers tomorrow (21 December) people should avoid "risky activity". This is the level to which Conservative misgovernment of the UK has sunk.

    Reply
  4. Rollo Burgess

    Yes sadly I fear it is largely accurate, the consequence of real underlying problems (demographics and long term funding challenges) in conjuction with a period of dreadful government particularly since the Brexit referendum. Basically the government has been completely paralysed and unable to address anything else, and its leadership is terrified of various groups of crazed swivel-eyed backbenchers (we don't quite have a Marjorie Taylor greene over here but we have some pretty exotic specimens of our own).

    That said – fwiw I have always found that my personal experiences of accessing healthcare are a lot better than the media headlines about chaos and doom would imply. This may be as most of my recent interactions with the NHS have been about kids and I think paediatric services are probably in better shape than some other areas.

    Reply
  5. Kelby

    @Jennifer Hornsby "My personal theory is that the government thinks that if the NHS is in a state of collapse when the election comes…"

    Is it likely the Tories are playing this kind of four-dimensional chess? Given their performance over the last few years, it's not clear they can play one-dimensional checkers

    Reply
  6. Concerned Brit

    Sadly the picture is accurate. I have been fortunate enough not to have experienced the ambulance delays first-hand or second-hand. But, sadly, I have lost family members to another related crisis: delays for cancer treatment. At present, around 40% of patients urgently referred by their GP for cancer treatment wait two months or more to begin treatment (see article below). A scandalous and sorry state of affairs.

    https://www.theguardian.com/society/2022/dec/14/treatment-delays-leave-uk-facing-cancer-emergency-doctors-warn

    Reply
  7. Jennifer Hornsby

    Certainly the performance of UK governments over the last few years would suggest a lack of competence. But that doesn’t mean that the Conservatives aren’t any good at electoral strategy (much helped by funders, think-tanks and lobbyists). I didn’t mean to say that they actually articulate the reasoning attributed to them in my theory. I sought an explanation why they should seem to be prepared to lead the NHS towards breakdown in spite of the fact that polling suggests that their intransigence on the nurses' strike lacks public support. But I make no predictions. I acknowledge (i) that they may get the public to believe their figures on costs and their claims about the inflationary effects of public sector pay rises, and (ii) that public support for the nurses may diminish when the effects of further strikes of health workers are seen.

    Reply
  8. Academic in the UK but not of the UK

    The situation is horrifying. Ambulance waits are long and today ambulance staff are on strike nationwide. If you can get to an A&E department, there's a 30-minute wait to see a paramedic for the initial triage. The outcomes are then basically three:

    1. You are seriously but not severely ill –> You're unofficially told to go home. (Of course you can't officially be told that, for legal reasons.)

    2. You are severely ill but not on the verge of death –> You face a several-hour wait to see a doctor in a very crowded waiting room full of other people in severe ill health.

    3. You're on the verge of death –> Only then are you likely — but not certain — to be seen immediately.

    If you thought private hospitals were any better, think again: in the current crisis, they too are overrun and often have to turn away urgent-care patients. My parents emigrated last year citing poor healthcare in the UK as a major concern.

    Reply
  9. Gary Kemp

    I'm not a supporter of the SNP but the situation is markedly better in Scotland. They settled the nurses strike and ambulance driver are not threatening to strike (I think).

    Reply
  10. Michael Magoulias

    Thinking about how this kind of information can be misused more broadly, such manufactured lapses in service can be easily cited by conservatives in the US as reasons why government-funded healthcare can only lead to disastrous outcomes. "Look at England, you want to be there when you need an operation? Be my guest, snowflake." Of course, the correct conclusion to be drawn from all this — that conservative governments only care about furthering the wealth creation of the already wealthy at the expense of everyone else — will not get the same airtime.

    Reply
  11. Carl Knight

    @Gary Kemp "I'm not a supporter of the SNP but the situation is markedly better in Scotland. They settled the nurses strike and ambulance driver are not threatening to strike (I think)."

    Scottish nurses and paramedics rejected the latest pay offer and are threatening to strike in the new year: theguardian.com/uk-news/2022/dec/21/scottish-health-workers-threaten-strikes-reject-pay-offer-nurses-midwives-paramedics-nicola-sturgeon

    I don't know if the situation is better than in England, but it's certainly not good. 3,652 people waited more than 8 hours for an ambulance in Scotland last year:
    https://www.heraldscotland.com/politics/23017496.ambulance-scotland-3-000-scots-waited-eight-hours/

    Reply
  12. Howard Simmons

    I don't think the government is going to win this one. They have underestimated the sympathy felt by the public for the nurses and ambulance drivers. That, at any rate, is my subjective impression.

    Reply
  13. Dan Dennis

    The IFS is Britain's most widely respected independent think tank. Here is their latest report on the NHS (14th Dec 22)
    https://ifs.org.uk/publications/nhs-funding-resources-and-treatment-volumes

    This is from the press release:
    'The NHS has more funding and more staff than it had pre-pandemic. At the same time, across most types of care, the NHS is treating fewer patients than it was before COVID-19. This is a puzzle, with no single or simple explanation.'

    https://ifs.org.uk/news/nhs-2022-more-funding-more-staff-treating-fewer-patients-covid-impacts-linger

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