The NHS is not living with COVID, it's dying from it

[EmbarrassingHadrosaurus]

Most people (including many in the NHS) are so tired of it that they are wilfully pushing it to the back of their minds, but now is the time to face the fact that the nation’s attempt to “live with covid” is the straw that is breaking the NHS’s back.

In 2020 and 2021 the NHS coped with pandemic peaks by stopping or slowing much of its routine work. 2022 was meant to be the year of full speed recovery, when we would build back better and fairer, when record waiting lists in elective care, cancer diagnosis and treatment, and mental health would begin to reduce, and the workload on primary care would begin to ease.
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Above all, the government must stop gaslighting the public and be honest about the threat the pandemic still poses to them and the NHS. Being honest with the public will have two positive results, it will encourage the public to modify behaviour and, we hope, provoke urgent reflection about how the NHS is in such a mess so soon after the nation was applauding it on their doorsteps.

Joint editorial from major Health Services journal and the BMJ. Free to read: www.hsj.co.uk/coronavirus/the-nhs-is-not-living-with-covid-its-dying-from-it/7032824.article

What measures would you be prepared to support to get the NHS back to some form of functioning for everyone who needs it for non-COVID reasons?

Like you, the editors want an honest discussion about how to proceed in the current situation. Frankly their editorial is less likely to get a response than if you raised a campaign to review the NHS.

I disagree that wanting to implementing restrictions on other peoples businesses and livelihoods in this way is having an honest conversation. That's beyond their remit.

The nhs is a public service, one among many. Like all the others we need to clarify what it should deliver and how it should be funded. Covid has put additional strains on the service, yes, and we need to figure out how that's handled, but it is up to the nhs to handle it, rather than the rest of society to restrict their enterprise so the nhs doesn't have to.

That may involve massively more funding, or it may involve scaling down services, but it's not clear at all what people want the future of the nhs to look like. None of the political parties will tackle it head on either.

I think Covid may have simply exposed what has been happening for decades. Absolutely the last thing the NHS needs is more funding - it would be like pouring water into a bucket with a hole in the bottom, and many NHS staff will tell you this. It is badly managed and wasteful, and nobody takes any responsibility. It is not about individual staff, most of whom work hard, but the whole culture of the organisation.

What is needed is a Royal Commission to look at healthcare in comparable countries (France, Germany, Holland, Australia etc) and to come up with a better structure - preferably one where the population have to make some sort of contribution so that they stop taking the p**s and misusing the service. And politicians from all parties need to accept this and support this - at the moment, they are just too scared and hide behind the lie that the NHS is wonderful and must be "protected". No. It is 70 years out of date and needs to be changed.

Yes, this.

Even the Dept of Health nutrition messaging is totally out of date. They need to prioritise prevention.

Also, until health professionals are adequately trained to look at patients holistically the NHS will always fail.

It is NOT about money.

I disagree that wanting to implementing restrictions on other peoples businesses and livelihoods in this way is having an honest conversation. That's beyond their remit.
Well unlike you I have no fear whatsoever of the BMJ and HSJ getting any airspace or headspace with the Govt. Nobody is going back to lockdown, and even if the kill rate were to increase with another mutation, it'll take a while. Incidentally the NHS is not the BMJ or HSJ any more than you are whatever your trade rag is. Do you find that rattling the bars of an open cage gets exhausting?

It is 70 years out of date and needs to be changed.
No point banging the door of the NHS when the person you want is the Health Secretary or maybe try the PM. You'd think someone in Govt would have done something about it sometime in the last 70 years! It'd be different if they were elected... oops they have been, every single Gov for at least 70-years.

The NHS is struggling because it's not a very well run institution, and the British population is aging every year and is increasingly fat and in poor shape.

www.hsj.co.uk/coronavirus/the-nhs-is-not-living-with-covid-its-dying-from-it/7032824.article#.YtVLStk6bv8.twitter
Going through this article:

Existing public health advice to wear masks in crowded places,
People won't do this, and masks don't seem to very effective against the highly infectious latest varients

ensure good ventilation
How, short of retrofitting every damn building? With fuel bills going the way they will this winter, there is no way you will get the public to keep the windows open all the time

and test regularly need to be communicated much more powerfully and widely.
Who's going to pay for all these free tests in the current economy?

This should include a return to mask wearing in healthcare settings and on public transport,
Go ahead then. But most spread has always happened in indoor socializing, workplaces and the home. You won't get people to wear masks there. There's never been much spread on trains and buses in the UK, probably because most Brits don't talk much there. I agree masks in hospitals are a good idea.

as well as the re-introduction of free tests for the public.
How can we possibly afford this in the present economy?

Vaccination is the fourth pillar of action. Large sections of the population, particularly ethnic minorities and younger age groups, are still not fully vaccinated.
Sure, I agree with continuing to push the vaccine. Flu vaccines too.

Other measures might include working from home when possible
People are already working from home loads--it's one of the few things that has stuck around long-term from COVID. We're probably at the practical limits of how much and what kind of work can be done remotely.

and restrictions on some types and sizes of gathering.
People aren't going to go along with this. We're facing a cost of living crisis and incredibly high levels of stress and anxiety. People NEED friends and fun right now, especially after the last two years of misery.

There is too much bureaucracy in the nhs. Too many high paid posts that aren't really needed.

I'd rather bring restrictions in than limit service to those deserving or who qualify. I'm conscious that if the nhs isn't free at point of access or people start being shamed then others will not go and won't get the help they need. I don't think there are enough covid restrictions that could be brought in now to save the nhs.

I would wear a mask again if it helped and i would/ do vaccinate. Other than that I'm not sure what else could be done without seeing some businesses go under and people lose their jobs. I'd happily test also but unsure as to how this would be funded.

The NHS exists to help us, not the other way round. If it can't deal with us living normal lives, it has to be changed, not our lives. That's the bottom line.

Surely it should be both, people should also take some responsibility for their health instead of expecting the health service to pick up the pieces. I know it's not always that easy so think preventative initiatives and support in the community should be more heavily invested in.

Well unlike you I have no fear whatsoever of the BMJ and HSJ getting any airspace or headspace with the Govt.

Well there is that. It's still pretty presumptuous however.

Incidentally the NHS is not the BMJ or HSJ any more than you are whatever your trade rag is.

I for one never said it was

Do you find that rattling the bars of an open cage gets exhausting?

Its a discussion forum. I'm reacting to a post. If I found it exhausting I wouldn't be here.

The health, social and economic consequences of restrictions are not even mentioned. Let alone explored thoroughly.

Pretending they don't exist. This is as bad as what they accused the government of. The writers have no credibility in my eyes.

Exactly how is the Government supposed to increase pay and working conditions for social care to try and encourage more people to work in the area ?
It is predominantly a privatised industry, so surely the only thing the Government could do at the moment, would be to raise the minimum wage ?

Social care provision or the distinct lack of it at present, is having a huge knock on effect on the NHS's ability to function.

Yes, it's an inherently untrustworthy take.

I have just spent weeks in NHS hospital following a brain bleed then stroke.....I was not overweight or anything...o had blood pressure taken once a day not even basic teeth cleaning and NO therapy. Was sent home with no care plan or therapy in place and it took me over an hour to write this

NHS is not only broken it does not work!

So they're no worse than everyone else who strangely can't quite cost up options for what must seem like simple decisions, especially if you have no constructive or practical options either, only at best partially informed basic level questions.

I consider that the editors of both journals, and the Chief Editor of the BMJ Group in particular, have access to a wide range of expertise and would be better placed than most to provide a starter for 10.

They've requested discussion and reflection that involves the public. This is a discussion that involves the public. There are obviously several contributors here who work within the NHS and who provide their perspective and that's helpful. I'll be interested to see if there are emerging themes both about their suggested measures and COVID-19 and their wider points about the NHS.

What tax changes would you propose to cover this? Complete removal of the personal allowance and raising the basic rate to 30%?

Or maybe we pick only one of these and knock 20% off the state pension, and stop all in-work benefits.

We spend £140 billion a year now, and the country is getting further into debt every year, borrowing ever more to fund it.

Additionally, nobody is forcing anyone to write articles in the BMJ and most people in this discussion are not doing so. Recommending a return to measures that have already failed and suggesting they're actually going to do anything to assist the situation in the NHS now, providing no evidence at all and not even deigning to acknowledge that restrictions have downsides too, is a choice.

*Exactly how is the Government supposed to increase pay and working conditions for social care to try and encourage more people to work in the area ?

It is predominantly a privatised industry, so surely the only thing the Government could do at the moment, would be to raise the minimum wage ?*

They could give more ring fenced funding to local authorities for Social Services. It’s Social Services that impose discounted fees on care homes, by virtue of their mass purchasing power. If Social Services were willing to allow care homes to charge reasonable amounts, to cover costs and some, then they could pay their staff more.

IMO, there should be no profit in the provision of care, because all it does is take taxpayers’ money out of the care system, to pay dividends to shareholders. There needs to be a national system of care, to enable more planning to meet needs - it shouldn’t be left to the vagaries of the private sector. A national care service could ensure decent pay and training for care staff.

I would look at how the German system works, with an additional social care levy on wages. It’s probably not perfect, but it sounds better than what we have!

This, 100%! We should be able to do normal, not particularly dangerous things, like work, go to school, shopping, hell, maybe even do something fun like go to a pub or the theatre without the NHS buckling under the pressure!

Is the current situation, where people are stuck in hospital much longer than necessary due to shortage of care, actually cheaper than increasing state funding and carer wages? Genuine question, I don't know the answer.

They've requested discussion and reflection that involves the public

Are we reading the same article? They've requested a return to pandemic measures. They've addressed none of the details of how or if this will be effective and not considered the unintended consequences. Whilst accusing the government of burying their heads in the sand!

The 'vaccine plus' strategy they mention and link to includes, amongst other things, a recommendation for effective find, test, trace, isolate and support. I wonder if the authors of this piece envisage a return to isolation rules, and therefore by necessity some form of test and trace programme too?

I'm not happy with the intergenerational unfairness of continuing to pile on restrictions which mainly shaft young people and disrupt their lives and their milestones, in order to protect availability in the NHS which is mainly for older folks.

Especially considering that older people in the NHS seem to get an awful lot of free stuff chucked at them and are never put under any pressure to stop wasting resources. We've already have comments from posters about the number of older users who keep ordering meds they don't need or see doctors' appointments as a sort of social thing.

The numbers of young people meeting partners, moving in with partners, getting married, having babies and being able to buy a home has tanked throughout COVID. Who's going to take care of them when they're old? Where are all their nurses and medical care staff going to come from, 40 or 50 years from now?

I'm not happy with the intergenerational unfairness of continuing to pile on restrictions which mainly shaft young people and disrupt their lives and their milestones, in order to protect availability in the NHS which is mainly for older folks.

This is an excellent point.

One thing that should have been more acknowledged during the restrictions was that for younger people, the benefits of restrictions were much lower and the costs of restrictions much higher than for older people.

The impact was a double whammy.

Absolutely the last thing the NHS needs is more funding - it would be like pouring water into a bucket with a hole in the bottom, and many NHS staff will tell you this. It is badly managed and wasteful, and nobody takes any responsibility. It is not about individual staff, most of whom work hard, but the whole culture of the organisation

Really? my DD works in Vascular, all her problems & delays with treating patients is down to lack of beds, staff, equipment AND most importantly, 6 week plus delays to get medically fit patients some sort of care package in the community so it can discharge patients.... all of which can be resolved with by money.

When independent bodies have reviewed the NHS and compared it with other major health services, they find the NHS to be efficient and well managed but poor outcomes.

We have less Doctors, Nurses/AHP's Equipment and beds compared to other European countries.

so whilst the Govt is now putting in comparable funding, it has traditionally been underfunded by 1 or 2% for decades and that has all added up.

Social Care has seen huge numbers of staff leave, not least after Brexit and again as fuel costs rose, who is going to drive their own car for 20p per mile?

One thing that should have been more acknowledged during the restrictions was that for younger people, the benefits of restrictions were much lower and the costs of restrictions much higher than for older people.

What about the costs of long Covid? Aren’t there two million plus with it; and the number will be going up all the time? If those people in their 20s, 30s and 40s suffer long term disability and some never recover enough to return to full time work, then the cost of supporting them for up to 50 years will be tremendous?