Whenever government ministers open their mouths to say something about the NHS, what comes out are lies. The commitment to recruit 5,000 extra GPs? A lie. The promise of 40 new hospitals? A lie. The claim now that the NHS will perform 30% more operations a year under the Covid-19 recovery plan? The latest lie: it is manifestly not possible to achieve this sort of increase. The facilities do not exist in sufficient numbers, and crucially nor do the staff. HANNAH CALLER reports.
Staffing crisis
In the year to September 2020, around one in nine hospital staff, 140,000 in all, left the NHS. While this rate has slowed, nonetheless, in the year to February 2022, over 400 workers were leaving the NHS every week. Pension-age staff who stayed on during the pandemic are now leaving. There has been a near-doubling in the proportion of doctors contacting a recruitment agency or applying for work outside of medicine. It is not just that staff are leaving. Covid-19-related figures show that England’s 219 NHS trusts lost about 1.82 million days in staff illness due to Long Covid between March 2020 and September 2021.
The promised 5,000 extra GPs turned into a net loss. Over the last eight years, almost 800 GP practices have closed, hundreds of GPs have moved abroad and the number of fully-qualified, full time-equivalent GPs in England fell by 1,486 in the four years to 2020, and has continued to fall since. This has meant significant disruption to patient care as two and a half million people have had to be moved to other practices.
The lack of staff in the NHS and consequent unfilled shifts means a locum/agency bill of £.6.2bn every year. Increasing numbers of nursing recruits are choosing part-time agency rather than full-time NHS work, and almost 800 doctors, the highest figure ever, qualifying in August this year, will be on a waiting list for a job, despite the shortage of 8,158 doctors higher up the chain. Overall, there are 40,000 too few nurses and midwives, and 50,000 too few doctors.
Covid recovery plan
In early February, NHS chief executive Amanda Pritchard and the Health and Social Care secretary Sajid Javid set out the Delivery plan for tackling the Covid-19 backlog of elective care. NHS England will expand capacity and invest in additional space as part of a £700m plan for recovering elective services post-Covid-19. The money will go to over 180 NHS trusts, split between 870 schemes. This Plan assumes that ten million people did not come forward for treatment or diagnosis during the pandemic and that half of them will do so over the next three years.
The promise includes building more than 100 community diagnostic centres, one-stop-shops giving patients more choice of where to go for quicker treatment, faster access to test results to allow for earlier clinical advice. 66 will be in use by the end of March. This, it is claimed, will help increase capacity to deliver nine million more procedures and scans by 2025, a 25% increase compared to the three years before the pandemic. In addition:
- New surgical hubs will ensure the longest waiting time for surgery by March 2025 will be a year.
- No one will wait longer than two years for an operation by July 2022, or wait more than 18 months by April 2023.
- 75% of referrals for suspected cancer will be seen and diagnosed within 28 days.
Overall, the Plan claims, there will be around 30% more operations by 2024/25 than before the pandemic. But the notion that NHS productivity will increase by 30% in three years beggars belief. According to the University of York’s Centre for Health Economics, ‘… [the NHS] … provided 16.5% more care, pound-for-pound in 2016/17 than they did in 2004/05, compared to productivity growth of only 6.7% in the economy as a whole.’ In other words, it took 12 years to increase productivity by 16.5%; now apparently it will nearly double this figure in three years. And this while the Treasury demands efficiency savings of 5% per annum, double the target in the past. Where are the staff to come from to achieve this, or the beds given that nearly 17,000 out of 101,000 beds are currently occupied by Covid-19 patients? The Royal College of Anaesthetists say that eight operations a year will be cancelled or delayed in Britain by 2040 unless the anaesthetic workforce shortage is addressed. By 2040, the anaesthetist shortfall, which is currently 1,400, could reach 11,000. Javid claims that 15,000 extra staff will be recruited by the end of March, 12,500 from overseas. But it takes months to complete the recruitment process for overseas staff given the visa requirements, and presumes that there are those willing to come post-Brexit. It is meaningless.
Nonetheless, contracts worth millions of pounds have been awarded to firms such as Deloitte, KPMG, McKinsey and PriceWaterhouseCooper, whose consultants demand daily fees of several thousand pounds, to provide system planning support for the Plan. Meanwhile, Trusts which miss their elective activity plans will suffer financial penalties. NHS England has proposed that if hospitals exceed their agreed activity targets they will not be paid 100% of the agreed rate for extra operations, but only 75%. But if there is a shortfall, then they will be penalised financially, at a rate of 75% for every operation not carried out. Javid has also proposed that failing hospitals will become ‘reform trusts’, like academy schools, and possibly run in chains by leading NHS managers or outside sponsors.
In Liverpool government posters have appeared stating ‘Levelling up means a new Royal Liverpool Hospital’. The truth is that the hospital was planned in 2009, and was supposed to be completed by 2017. But the bankruptcy of Carillon, the prime contractor in the PFI consortium, and the need to repair structural failings, have added years of delay to its commissioning, and it is not going to open before summer this year. Linking its completion to the ‘levelling up’ programme is pure invention. The Recovery Plan is lying on an industrial scale. Fight for the NHS!
Fight Racism! Fight Imperialism! No 287, April/May 2022
