As Steve Topple’s excellent article for The Canary yesterday showed, the government has exploited the distractions of Brexit and Olympic parades to slip out news of the biggest ever new wave of NHS privatisation – additional contracts worth over an incredible £8 billion, more than 7% of the entire NHS budget, in one fell swoop.
At the same time, information in the latest NHS statistical release shows that the crisis in Accident and Emergency (A&E) departments – always the most visible part of the NHS crisis ‘iceberg’ is reaching unheard-of levels that will mean that excessive A&E waits will have risen by over 600% since the Tories took office.
Even BBC News covers A&E crises each winter, but while it’s clear that things are getting worse, it’s not always clear how much worse or how quickly. These graphs will change that.
As pictures paint a thousand words, the following graphs (with some explanation) should make clear to any reader that the crisis in our NHS is reaching a scale that we’ve simply never seen before.
Year on year
The first graph is pretty straightforward. It shows the percentage of people attending A&E that had to wait more than 4 hours to be discharged or admitted. This measure was introduced by the Labour government in the early 2000s. The numbers waiting longer than 4 hours has been on a continual upward trend since the effects of Tory government kicked in, so the graph below just shows 2015 (full year) and 2016 year to date:
The increase from 2010-2015 was fairly steady. But look at this year compared to last year. In any year, July/August are always the period with the fewest excessive waiting times and in most years, December is the month with the most.
The lowest percentage in 2016 – August this year – exactly matched the highest in 2015. Figures for Sep-Dec 2016 are not yet available, but those months are always higher, so the very best our decimated NHS has been able to manage this year is higher than the very worst it could achieve last year.
July yearly and July v Dec
The next graph is a little more complex, but hopefully not impossibly so. In almost every year since 2010, July is the lowest month for excessive A&E waits. Whether it’s good weather meaning fewer accidents, less staff sickness or some other reason, it’s consistently either the best month or close to best. So a comparison of July in each month provides a baseline for the trend in A&E waits.
Since December is usually the worst month of the year, a comparison of the ratio between each July and the preceding December gives any idea of the rate of acceleration in the decline of A&E performance under Tory predations. The following graph shows the percentage of >4hr waits and how that July measures as a percentage of the figure from the preceding December. The results are shocking:
The final, orange column is a project for the coming December. How that projection is calculated is explained in the next section, but it’s solid.
As you can see, the blue columns for the percentage of excessive A&E waits shows significant rise across a 6-year period.
Even more worryingly, the graph shows that in two out of the last three years, the figure exceeds 100% – in other words, in both those years the figure in July has exceeded the December figure. December, when bad weather, increased risk of infections etc put extra strain on A&E resources: things are getting worse so quickly that the most-strained time in one year is better than the least-strained in the next.
This line graph shows the waiting figures since the beginning of 2015 through to the end of 2016.
To create this graph, I compared the actual figure for each month in 2016 with the same month in 2015, to calculate the relative percentage increase. The figures showed a minimum 16v15 increase of 28% (January), with a jump in the rate of increase after that. For the projected figures, I averaged out the increase (excluding Jan) and applied that to the 2015 figures for Sep-Dec to project a 2016 monthly figure.
The results of this are even more damning of the Tories’ abuse of our NHS, with the waiting figures increasing to over 19% waiting over 4 hours by the end of the coming winter – against a target (which the Tories lowered under the coalition) of 95% waiting less.
That 22% figure represents an increase of 545% on what the Tories inherited from the last Labour government.
In case you doubt the validity of my projections, here’s a graph compiled by the Royal College of Emergency Medicine. The figures are quarterly rather than monthly:
The purple line is the one we need first. Its projection for the final quarter of 2015/6 shows excessive A&E waits of around 18% – in line with my monthly projections.
The other thing you need to note are the light blue columns.These show the total visits to A&E in each period – and they’re broadly flat.
The government’s and media’s preferred narrative for falling A&E performance is that increasing demand because of immigration is the root of the problem. But the most radical deterioration has happened during a period of flat demand.
Immigrants are not the cause of the NHS’ struggles. Tory spending cuts and their demoralisation of the NHS workforce are – and those cuts are happening even as the Tories lie that they are not, straining the NHS and its people to breaking point and beyond.
And, since Mrs May has stated that she has no intention of providing any additional resources, it’s crystal clear that she has no intention of doing anything to improve the situation for patients or staff, whatever weasel words she might use.
Except, of course, selling it off. She’s clearly ‘deeply relaxed’ about that.