As attention has focused on the NHS winter crisis, the media has rarely pointed out that the health service in England is in year-round crisis.
The chart below shows the number of people waiting longer than four hours to be seen at Accident and Emergency (A&E) departments. The red lines show times when the numbers outside the winter period were similar to or higher than the preceding winter:
The chart also shows that the lowest A&E crises in recent years have been as high as – or higher than – the ‘winter crisis’ peaks up to and including 2014.
The number of nurses in the NHS is now around forty thousand below its full complement. The abolition of training bursaries and the stress of trying to cope are making that situation worse, with around ten percent of the nursing workforce leaving the NHS last year.
In spite of Jeremy Hunt’s boasts about staff numbers, NHS hospitals are also facing a doctor crisis. The chief executive of Colchester hospital told the BBC late last year:
We are 50 junior doctors short on our rotas across the hospital. Every day is a constant struggle.
Staff shortages in radiology and other areas are endemic.
One response by the government and NHS England to this crisis has been rationing of treatments.
Rationing has become rife in the English NHS:
- patients who need cataract surgery have been denied treatment at greater levels through the imposition of visual acuity thresholds.
- greater numbers of patients who need skin excision are being denied, according to the BMJ
- IVF treatment has been rationed under the Tories, with 80% of CCGs now refusing to fund the 3 cycles of IVF that NICE recommends
- hip & knee Surgery is now being denied to patients who smoke or are obese in over 1/3 of Clinical Commissioning Groups
- CCGs have begun to restrict free hearing aids on the NHS for those suffering hearing loss
- elderly patients have been charged £30 “fall fees” as a call out charge for a healthcare worker to come and help them up
- increased number of patients being referred for varicose vein surgery, or carpal tunnel surgery are being denied
- increasing numbers of patients referred by their GP for mental health treatment are being declined
This rationing inflicts misery on many thousands of people – and costs lives, as suicide rates among those suffering mental health issues are far higher than those receiving suitable ‘early intervention’ treatment – and numbers of deaths among people held in custody under the Mental Health Act have tripled.
The Tories deny, of course, that they are working to end the NHS. The reality is that, in any sense of a universal system free at the point of need to all who need it, they have already ended it.
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