Patients pay the price for ‘saving the NHS’

Non-covid surgeries for serious conditions are again being cancelled to protect the health service

Many goalposts have shifted in this Covid crisis. A three-week lockdown designed to build NHS capacity quickly descended into months of severe restrictions to suppress the infection rate. Returning to normal after we “turn the tide” on the virus has morphed into suspending normal life until we find a silver bullet.

But in other ways, much remains the same. With a few notable exceptions, such as schools remaining open, England is back to square one. Much of the Prime Minister’s press conference at the end of October could have been lifted verbatim from his previous lockdown announcement eight months ago. The main message is identical: stay home, protect the NHS, save lives.

Throughout this pandemic many have highlighted the deep-rooted flaws in a healthcare system that requires us to protect it, not the other way around. Under the first lockdown A&E attendance plummeted, with millions of surgeries cancelled. Even as the NHS began to reopen for those patients, deaths in private homes have hovered above the five-year average for months, suggesting that many who would once have sought treatment from professionals have suffered at home instead. Over the summer a government report revealed a scenario of 50,000 Covid deaths in the first six months of the pandemic – an underestimate based on data from the Office for National Statistics – and a staggering 200,000 deaths from the impact of lockdown and missed treatments for other illnesses.

While top officials avoid saying plainly to the public just how disastrous lockdown policies were for these patients, the impact on them and the future of public health is well known – hence why the NHS is so adamant this one will be different. The revitalised “Help Us Help You” campaign is designed to keep patients accessing treatment during lockdown.

During a Covid press conference last week, Sir Simon Stevens, chief executive of NHS England, pleaded for patients to come forward in the winter months. But how is this panning out in practice? When many do take up Sir Simon’s call, local hospitals turn them away. Up and down the country, “elective surgeries” – a contentious term given the chronic pain often associated with these ailments – are being suspended again, and even some operations and treatments for lifethreatening diseases as well.

Several weeks ago, Cabinet Minister Michael Gove told Andrew Marr that if capacity became an issue, NHS England had “detailed plans” to cancel elective surgeries if need be. NHS England disputes this, asserting that there is “no national plan” to pause elective care and that these decisions will be taken locally. The buck is passing from government, to bureaucracy, to local trusts, while patients lose out yet again.

The Government squandered opportunities to build capacity over the summer, denying funding for “Seacole centres” where Covid patients could rehabilitate outside of hospitals. Instead, it funnelled its hopes (and our money) into a defunct test and trace system. Since the first attempt at a silver bullet didn’t work, the Prime Minister tells us we should expect to be living under restricted conditions until March at the earliest. It’s a safe bet that of the four million patients now waiting for surgery, many will be waiting well into the new year.

On Thursday, Sir Simon quoted a top ICU doctor who he said summed up the situation perfectly: “In the here and now, we can’t stop cancer developing... we can’t immediately prevent heart attacks or strokes... but we can reduce the spread of coronavirus in the community and that is what we need to do.” What he meant was that suppressing the virus gave the NHS a better shot at treating non-covid patients. But his words were also a reminder that we can, in fact, prevent cancer from developing – and the surest way to do this is by treating patients in a timely and efficient manner. The first lockdown stopped that from happening. The second lockdown risks doing the same.

In some ways, these problems are nothing new. Britain’s treatment of serious conditions such as cancer has trailed European countries for years. Waiting times are unforgivably long, and patients often lose out due to rationing. Our leaders are not owning up to these failings. But for how much longer can they continue to prioritise the NHS over its patients, whose health the system is meant to serve?