Record number of deaths amid NHS strikes
Health service faces its ‘hardest January ever’ as doctors walk out for six days
BRITAIN experienced a record number of excess deaths last year amid repeated NHS strikes and the continued cost of the pandemic.
Nearly 53,000 more people died in 2023 than normal – the highest figure recorded in a non-pandemic year since the Second World War, Daily Telegraph analysis shows.
Doctors went on strike for 38 days last year and experts fear that the disruption caused contributed to the high number of excess deaths.
Junior doctors start the longest strike in the health service’s history tomorrow and officials have said the walkout will mean “the most difficult start to the year the NHS has ever faced”.
Prof Carl Heneghan, director of the Centre for Evidence-based Medicine at the University of Oxford, said patients had been “abandoned to look after themselves” while doctors and the Government were “at a standoff ”.
He said: “Patients are being rung up with diagnoses for cancer over the phone, left abandoned to look after themselves while the strikes are worked through, and it’s patients that are ultimately suffering.”
Experts have also said that the impact of the pandemic, lockdowns and the resulting long waiting lists, have all contributed to excess deaths. Prof Karol Sikora, a leading cancer specialist, said: “A tunnel vision focus on one virus led to millions and millions of patients suffering delays in diagnosis and treatment for every single aspect of healthcare.”
Prof Sir Stephen Powis, the NHS medical director, said tomorrow’s strike, lasting six days, would cause a “serious impact in the weeks after” as services tried to recover and deal with extra demand.
The British Medical Association (BMA), the doctors’ union, has also been warned by NHS chiefs that the patients at greatest risk of harm this week, based on an analysis of previous strikes, are those with fast progressing cancers, time-critical inductions and urgent “elective” C-sections and corneal transplant surgery.
Analysis by The Telegraph of Office for National Statistics (ONS) figures for England, Wales and Scotland shows that 52,698 more deaths than would have been expected had occurred by Dec 8 2023 based on a five-year average of deaths before Covid.
Official ONS analysis to calculate the five-year average excludes 2020 but includes 2021, which was still heavily affected by Covid. The total number of deaths last year was 595,789.
It means there were more than 1,000 additional deaths every week, surpassing last year’s total of 50,200 and the peak of 51,200 during the 1951 flu epidemic. It is the highest figure since 1940, before the NHS existed, when there were about 96,000 extra deaths. During the pandemic, 82,000 and 60,000 extra deaths occurred in 2020 and 2021 respectively.
Prof Heneghan said: “We’re at a tipping point in the NHS. People are dying on the waiting list, those who require emergency care are not being sought and seen quick enough, and social care is almost non-existent.”
He said many GPS had not worked for seven of the last 10 days owing to a quarter of them being junior doctors.
Prof Heneghan said that cancer patients normally seen in a clinic and starting treatment were being called by overstretched consultants instead, and everything was being pushed back because of strikes. “Consultants are covering the junior doctors’ work and so there is a displacement, and basic care is going out the window,” he said. “I would implore at this time of year that both sides need to just get around the table and call this strike off.
“Both sides seem to be at a standoff where they’re almost holding a gun to each other’s head. This should now be a job for the Prime Minister to act because it is patients that will suffer and suffer in
many different ways. It is completely unacceptable to play with people’s lives in this way.”
Dr Tim Cooksley, the former president at the Society of Acute Medicine, said the strikes “reflect the stress and pressure and frustration that [staff] can’t deliver the care they want”. He added: “Industrial action increases pressure on services and this can lead to adverse effects and harm for patients.”
Dr Adrian Boyle, president of the Royal College of Emergency Medicine, said it was “vital” to remember that each death “represents an individual person with a family and loved ones” and that it was “heartbreaking to think that any one could have been avoided”.
“The NHS has had to deal with a series of significant challenges in the past 12 months. Last winter was the most difficult the service has ever experienced,” he explained, citing “excessively long waits” across all services.
“All of this in addition to a series of strikes,” he added. “We cannot definitively say that all – or any – of these issues have contributed to the rise in excess deaths, but what they do reflect is a health system which is not functioning properly.”
Britain’s excess mortality was worse than any other developed country as of mid-october 2023, when comparable international data was available.
The death rate of 8.6 per cent above the expected amount for the year significantly outpaced the next worse country, Israel, with 5.5 per cent.
Excess deaths in Britain were around four times higher than Germany’s 2.2 per cent. New Zealand had 1.4 per cent more deaths than normal, while France had 1.7 per cent fewer than expected, a separate Telegraph analysis of the World Mortality Dataset revealed.
Junior doctors have been asking for a 35 per cent pay rise since they first walked out in March 2023. The NHS backlog has continued to grow since, rising to a high of 7.8 million before dropping slightly last month.
Doctors walk out at 7am on tomorrow and will not return to work until 7am on Jan 9. Prof Powis said: “This January could be one of the most difficult starts to the year the NHS has ever faced.
“Six consecutive days of industrial action comes at one of our busiest periods,” he added. “Our colleagues across the health service are doing their very best for patients every day with extensive preparations in place, but there’s no doubt they are starting 2024 on the back foot - not only will action impact next week, it will continue to have a serious impact in the weeks after, as we recover services and deal with additional demand.”
A Department of Health and Social Care spokesman said: “We urge the BMA junior doctors committee to call off their strikes and come back to the negotiating table.
“We know how distressing it is for patients who have had appointments and procedures cancelled, and we have provided £800 million to ensure patients continue to receive the highest quality care this winter and ease pressure on hospitals impacted by industrial action.”