Tuesday, 2 October 2018

Our NHS - still not safe in their hands

Before the 2010 general election, David Cameron infamously claimed that the NHS would be safe in Conservative hands. It wasn’t true then; it wasn’t true when he and Liberal Democrat Nick Clegg led the Coalition government, and it isn’t true now under Conservative Theresa May’s responsibility.
It was no more true than the assertion that Brexit would deliver an extra £50 million per day for the NHS, as prominently displayed on the Brexit Bus. To use a word most commonly used by one of those proponents, the assertion was ‘piffle’.
You would be right to ask me on what basis I make my claim about the Conservative’s stewardship -or, rather, lack of it - of our NHS.
It’s easy. I just need to refer to the NHS Key Statistics1 2 and the helpful commentary published by the excellent House of Commons Library3 .
Let me just provide some significant contrasts between what the Conservatives inherited in 2010 and what they are delivering today:
  • In 2010, one in fifteen hospital A&E attendees spent longer than 4 hours in the A&E department compared with one in six today. From December 2017 to March 2018, 15% waited more than 4 hours. In August 2010, just 3% waited more than 4 hours; in August 2018, more than 10% were doing so. There is no reason to believe other than that the proportion will rise to 15% and beyond this next winter;
  • In 2010, 87% of people (and rising) were seen at a consultant appointment within 62 days (the target) of an urgent cancer referral from their GP. Today it is 81% and falling. Two-thirds of hospital trusts in England are not meeting the target;
  • There has been a near 60% increase in the number of people waiting for a consultant appointment between 2010 and today. The 18 week target time (for 92% of patients) has not been met since early in 2016. The number of people waiting more than 52 weeks has doubled in the last year;
  • There were less than 4000 delayed discharges (average daily number) from hospital in 2010. By last year, that number had rocketed to some 6500 last year. It is not surprising that the number dramatically increased after the government cut the resources to councils for adult social care, resulting in a cut in the number of people receiving care, whilst the numbers needing it continued to rise. The number has fallen in the last few months, but still nowhere close to the inheritance;
  • In the year to June 2018, 84,881 elective operations were cancelled for non-clinical reasons on the day the patient was due to arrive. This is 5% higher than in the previous year. Of those who had their elections cancelled, 7,821 were not treated within 28 days of their cancellation – up 35% on the previous year. The percentage not treated within 28 days of cancellation rose from 7.2% to 9.2%;
  • There is a target that less than 1% of patients should have been waiting longer than 6 weeks for a diagnostic test (CT, MRI etc scans). Performance on this measure has declined over the past year. The percentage waiting over 6 weeks has not fallen below 2% since November;
  • The number of GPs has fallen consistently since 2015. This is being reflected in increased waiting-times to see a GP. More worryingly, the number of GP vacancies is rising, as many practices are struggling to recruit new staff.
Whilst there is such a focus on Brexit and migration, it is just worth noting how reliant we are on migration for our medical and nursing staff.
  • More than 6 out of 10 hospital medical staff gained their primary qualification outside the UK, with more than a quarter of those qualifying in India;
  • Between 2010 and 2018, the number of nurses per million population has fallen from 5,182 to 4,918. And, as the advert says, ‘every little counts’.
In Sheffield – with its teaching hospitals, many regional specialties, and major A&E departments – we are fortunate enough to have some of the best managed services, with exceptionally committed staff, anywhere in the UK. But even its performance has deteriorated against these key targets over the last 8 years. However, I am pleased to note that Sheffield Children’s Hospital A&E, despite the significant increased demand and attendance, delivers one of the best performances in the UK for patients being seen, with just 2.7% having to wait more than 4 hours for treatment.
Our NHS is not safe in Conservative hands and, as the record says, it never will be. For them, it has always been the case of ‘say one thing, do another’.
1 https://www.england.nhs.uk/statistics/statistical-work-areas/
2 https://digital.nhs.uk/search/document-type/publication/publicationStatus/true?area=data&sort=date
3 https://researchbriefings.parliament.uk/ResearchBriefing/Summary/CBP-7281