This week, while doing my rounds in hospital, I came across a 93-year-old woman lying on a trolley in a corridor. Tailgating her was a 94-year-old man, also on a trolley, also suffering from a terminal illness, also largely unaware of where he was or what was going on. Further along the line of desperate patients was a heavily sedated and recently sectioned 88-year-old woman. She too was waiting for a bed. She may as well wait for Godot.
Most consultants will have similar stories. The practice is now so normalised that it has led to its own subbranch of clinical practice: “corridor care”. Doing the rounds sometimes even means treating patients in storerooms. If there’s a space, there’ll be a patient in it. Wes Streeting may lament that he’s “genuinely distressed” by the conditions facing patients, but the fact is that without corridoring, the NHS would collapse. Last month, some 54,000 people waited over 12 hours for treatment, stranded by toilets and drinks machines until ward space finally freed up. And if that’s not shocking enough, an even bigger scandal is that Streeting seems unable to respond.
Wherever you look in the NHS, it’s on the brink of disaster. In Liverpool, to give one example, the local NHS trust lately took the extraordinary step of declaring a critical incident as a flu outbreak put untenable strain on the system, with some patients waiting 50 hours to be seen. The move quickly prompted other trusts to follow suit. That’s despite historic pressure from NHS England to avoid such declarations because of worries around “reputational damage”.
There are many causes for this fiasco, and not all of them are medical. To be sure, hospitals were lately forced to grapple with a “quademic” of respiratory illnesses, quickly overwhelming A&E departments. I’m seeing this myself: patients are increasingly arriving with severe respiratory infections, often exacerbated by the simple inability to heat their own homes. Amid the chaos, the health secretary was notably vocal, though unfortunately not about hospitals. Rather, Streeting has spent much of his time attacking Elon Musk’s controversial comments on grooming gangs.
This lack of focus, coming just as Labour announced its intention to delay social care reform until 2028, has not gone unnoticed by medical professionals. Six months into his role, Streeting’s record on delivering concrete healthcare reforms remains notably thin. I’m not alone in noticing his careful cultivation of a public profile that appears designed to position him as a potential future Labour leader rather than a minister on a mission.
But Streeting’s aspirations for greater power shouldn’t come at the expense of addressing immediate healthcare crises. And he seems unwilling to confront the changing nature of British society, let alone the impact this has on healthcare. We have an ageing population, more single-parent families, more singletons and child-free families. At the same time, fewer and fewer people have the networks and resources to help them, not just in times of crisis but also to support them before their health spirals.
Demographics are squeezing the NHS in other ways too. There are children caring for alcoholic or drug-dependent parents, families supporting disabled relatives, and countless others managing painful chronic conditions without sufficient help. The social pressures here are bewilderingly multifaceted. And when the worst does happen, this assorted jetsam usually ends up in A&E, often because they can’t see their GP.
These issues are unlikely to be resolved soon. And what the Department of Health has announced doesn’t seem much better. Consider a new IT upgrade, trumpeted by politicians and hospital managers alike. In theory, it’ll make booking appointments easier, cutting waiting lists and bolstering treatment. But over my three decades working for the NHS, I’ve seen technological “solutions” come and go, even as the reality on the ground tells a story of exclusion and waste. The NHS’s track record here is grim in the extreme. The failed £11 billion National Programme for IT; the troubled NHS 111 app rollout; the recent Covid-19 contact tracing app debacle — all these represent just a fraction of the billions squandered on digital initiatives, often causing more problems than they solve.
One reason for this is the fundamental disconnect between policy and practice. Apps are all well and good for tech-savvy users comfortable with electronic devices. But they’re not the majority of people I see in A&E. Nor are the usual suspects — older patients or those who struggle with English — the only ones to suffer here. Think about the visually impaired, or else those in rural areas without decent internet. These aren’t edge cases either: 11 million Britons lack basic digital skills, while 1.5 million households don’t have any internet access at all. The irony is that these digital barriers often affect those most in need of healthcare services, creating a two-tier system. The saving grace, if you can call it that, is that some of those in my corridors are so far gone in terms of mental faculty that they have no clue what’s happening around them.
Meanwhile, Streeting likes to claim his personal experience as a cancer patient gives him skin in the game, and he’s fond of saying he’ll “save the NHS because it saved me” — but there’s growing concern among rank-and-file staff that this emotive narrative is being wielded as a political weapon than a catalyst for meaningful change. Where the Tories once gaslit the British public, Labour now makes promises it knows it can’t keep.
To be fair to Streeting, he’s only following the example of his predecessors. From John Hutton’s rating system to Andrew Lansley’s ill-fated changes a decade later, politicians have long heralded their reforms as the solution to the UK’s healthcare woes — without ever reflecting on the underlying social forces that actually shape the service. As for the NHS itself, managers have a stark record of rebranding failure without addressing fundamental issues. It’s like a bargain basement supermarket, constantly changing its brands to avoid acknowledging what we all know to be true: they’re cheap, unpalatable and not very satisfying.
The truth is that for too many, the NHS has become a kind of crutch, indulging unhealthy lifestyles without thinking dwelling on wellbeing. We’re facing an obesity epidemic, rising rates of type 2 diabetes, and increasing mental health issues, all of which begin at home. And, yet, we’re politically paralysed when it comes to discussing personal responsibility. You could say the same about end-of-life care. The current model of warehousing the elderly in care homes, while their children wring their hands about inheritance, isn’t just financially unsustainable. It’s morally bankrupt too.
Perhaps multigenerational households in some communities offer a potential model for reducing pressure on the social care system. Instead of seeing care as a burden, we should perhaps look at other ways of supporting families, who can then take some of the load off the system. Nor do we need to look exclusively to ethnic minority communities in the UK. Japan, for instance, has developed comprehensive approaches to ageing populations and social care, while Denmark has pioneered integrated community care models.
If nothing else, these alternatives make the leadership vacuum in Britain even more glaring.
And all the while, healthcare professionals see the results of Labour inaction each and every day. Patients stacked up in corridors are only the start: in my emergency department, staff are struggling to maintain basic standards of care. We just can’t wait three or four more years to clear the blockages. The NHS won’t survive, and not just over the medium term either. If the current cold snap continues, Streeting may be forced to declare a state of emergency, a measure that would surely test his ability to lead under pressure, and all without a carefully crafted script to help him along.
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Source: UnHerd Read the original article here: https://unherd.com/