Why overpaid pen pushers AND shroud waving doctors are all deceiving us about the NHS crisis

THE headlines on the front page of yesterday’s Mail could scarcely have been more serious: ‘Winter Crisis Cripples NHS’, ‘ Up to 55,000 Operations Postponed.’

Not that you’d have guessed it from the health service mandarins who rushed to decry the Mail’s reports and give the news their own spin.

According to them, all is well in hand, thanks to a smooth- running management machine that is prepared for every eventuality.

Well, as a hospital consultant with more than 30 years’ experience, I beg to differ.

What we are facing, 70 years after the founding of the NHS, is a torrential crisis that threatens to wash away its very foundations.

Infuriating

When more than 50,000 planned surgeries are cancelled, those patients do not simply vanish from the system. Their operations must be rescheduled, which creates a mudslide of paperwork, consuming thousands of hours in management meetings and costing untold sums of money.

As these operations are shunted further down the calendar, other patients end up on ever longer waiting lists. It’s a domino effect, creating ripples of chaos for tens of thousands.

Whole families are being affected. Younger patients booked for surgery will have planned to take weeks off work and perhaps seconded childcare to relatives.

Older people will have been bracing themselves for months for that long-awaited hip or knee replacement.

To have all those arrangements negated with a single stroke of a bureaucrat’s pen at the last moment is deeply upsetting and infuriating.

In such scenarios, it does no good to have doctors politicising the crisis, shroudwaving on Twitter and elsewhere, and making ridiculous claims about British hospitals operating at ‘Third World’ standards, as one attentionseeker did this week.

For one thing, it simply isn’t true. The hospital in question, the Royal Stoke, has just undergone a £ 350 million refurbishment. To compare it with facilities in the developing world is an insult both to our medical teams and to the struggling care- givers in these countries.

Another doctor talked yesterday of ‘ battlefield scenes’ in A&E departments.

Such hyperbole damages the confidence of vulnerable patients in those who are treating them. It is cynically destructive and self-serving.

The truth is that this isn’t just a ‘winter’ problem. It’s a long-running crisis that no one — managers, doctors, individual politicians or their governments — will face up to.

Overcrowding, cancellations and emergency measures including mixed wards and patients being turned away from A&E, are part of daily hospital life all over Britain.

So it is a deception for various NHS chiefs to claim that these are exceptional circumstances, that they had planned for this winter ‘surge’, and that everything is under control.

Three chronic issues lie at the root of the crisis, and none can be blamed on factors such as a cold snap, the postChristmas backlog of people who put off seeing a GP, or an outbreak of Australian flu.

Britain is a growing population, boosted by a decade of uncontrolled migration, while the number of hospital beds has been falling for years.

These are the simple facts, but NHS managers seem steadily blind to them, refusing to plan for the future.

To tackle the question of bed shortages first: in the past five years, 15,000 beds have disappeared from our hospitals.

In the ten years from 2006, the overnight bed capacity was reduced by 20 per cent.

If we look back even further — the past 30 years, say — the statistics are even more staggering: the number of hospital beds in England has more than halved, from around 290,000 to 142,000.

The NHS has fewer acute beds, per head of population, than almost any comparable health service in the world. And that ratio will only get worse, because thanks to net migration and natural growth ( the fact there are more births than deaths), Britain’s population is expected to top 71 million by 2030.

That could be a low estimate. In just one year, 2014-15, our population expanded by more than half a million. In these circumstances, to reduce bed numbers is setting a deliberate course for catastrophe.

The Office of National Statistics (ONS) has more worrying news. In 1975, 14.1 per cent of Britons were 65 or older. By 2015, that statistic had risen to 17.1 per cent.

Not such an alarming difference, you may think. But look at the ONS projections: seven years from now, the percentage of those who are 65-plus will account for more than a fifth of the population. In 2045, it will be almost a quarter.

Given the intense pressure an ageing population — with its myriad medical and social needs — is already exerting on our health service, how much longer can it cope?

Against this backdrop, it is especially disconcerting that Jeremy Hunt, the Health Secretary, continues to insist that foreign patients — health tourists who come to the UK specifically to use the NHS — are welcome here, provided they pay for treatment.

Experience

Let’s put to one side the issue of how bad the NHS is at collecting payment — the Department of Health puts the bill at £110-£280 million a year, but I believe the figure to be much higher — what Hunt fails to understand is that the health service is not infinitely elastic.

And this is the core of the problem. He, like almost all the people running the NHS, is not a doctor. He has no bedside experience, no years of practice at dealing with patients and relatives.

I speak for many fellow consultants when I say that our daily encounters with the bureaucrats and pen-pushers who run our hospitals are deeply frustrating.

One of my surgical colleagues, who ran a specialist unit outside London, was driven to retire several months early.

‘The final straw,’ he told me, ‘ was when a 25- year- old sociology graduate with a second- class degree from a second-class university overrode my selection of cases for operations, which were based on clinical priority.

‘These cases were replaced with ones from the waiting list in order to meet the hospital’s targets, which was the management priority.’

Hospital management is now a career like banking or industry. The entrants rarely come up from the clinical ranks.

They arrive sporting irrelevant degrees and, after a graduate training scheme, go on to earn very considerable salaries — more than 100 senior NHS chiefs are paid upwards of £150,000 a year, more than the Prime Minister.

Diminished

It will take years to extricate our health service from the mire and I despair of the political will to do it.

In the meantime, there is one way in which we can all contribute to an immediate solution, and it has nothing to do with funding.

I would urge everyone to rally around their elderly relatives when they need temporary care. A mild illness is often better treated at home, not in hospital. But I fear too many people have rejected responsibility for their own parents and grandparents, believing it is the state’s role to nurse them.

It may be that GP services, especially the out- of-hours provision, have become so diminished that some relatives feel they can’t take the risk of offering care-at-home. But it is also true that many more are simply shirking their duty to family and society.

Britain has enjoyed a comprehensive health service, with everything free at the point of access and need, for so long that too many people are ignorant of the huge problems facing it, believing only too readily the lies of the Left that it’s all about Tory cuts and lack of funding.

The NHS needs our support and we need to remember our responsibilities.