Broken promises
The betrayal of public services since the 2015 election is far worse than any ‘betrayal of Brexit’. At least the Conservatives managed to deliver their manifesto promise of ‘a straight in-out referendum on our membership of the European Union.’ That same manifesto made a number of promises about health and social care that were ludicrously fanciful at the time, given we were half way through the toughest period of austerity pubic services have ever seen, and have since failed on a grand scale. The Tories promised, in no particular order; ‘We will offer you the safest and most compassionate care in the world… We will improve standards in all areas of care… We will ensure you receive the best healthcare… We will ensure that people can grow old in comfort and dignity… We will guarantee that you will not have to sell your home to fund your residential social care… We will provide 7-day a week access to your GP and deliver a truly 7-day NHS, so you know you will always have access to a free and high quality health service when you need it most…’ These promises were as nonsensical as anything the Brexiteers conjured up a year later, the same reckless use of power to gain yet more power.
Fast forward to the 2017-2018 State of Care Report by the Care Quality Commission, published in October. ‘The safety of people who use health and social care services remains our biggest concern. 40% of NHS acute hospitals’ core services and 37% of NHS mental health trusts’ core services were rated as ‘requires improvement on safety’ at the end of July 2018… 1.4 million older people do not have access to the care and support they need. In two years, the number of older people living with an unmet care need has risen by almost 20%, to nearly one in seven older people. Friends and family carers must often fill the gap, and in a recent survey three-quarters of carers had received no support to help them have a day’s break in the previous 12 months.’
To no-one’s surprise, the CQC notes that ‘the GP workforce is increasingly stretched.” According to NHS data, 5 million patients a month are waiting more than 3 weeks for a GP appointment . A further 1 million are waiting 4 weeks between booking an appointment and seeing the doctor. This has provided a huge boost to private GP services. The CQC adds that the number of patients waiting to start hospital treatment 18 weeks after referral rose by 55% from 2011 to 2018. Some people who need inpatient mental health care travel long distances to obtain it. As of 31 July 2018, around one in six adult social care services and one in five NHS mental health core services needed to improve, almost a third of NHS acute core services were rated as requires improvement and three in 100 were rated as inadequate.. In adult social care, the highest vacancy rates were for registered nurses, allied health professionals and social workers. They reached 16% in the East of England and 15% in London. In children and young people’s mental health services, low staffing levels were the most common reason for delays in children and young people receiving care.’
Recent CQC reports show how far some care is falling below standards the government promised to get elected. Urgent and emergency services have got worse at Bedford Hospital. Shrewsbury and Telford Hospital Trust was rated “inadequate” overall with over 200 serious incidents being investigated in its maternity unit alone. South East Ambulance Service has been rated inadequate and put into special measures, and Norfolk and Suffolk NHS foundation trust – on health secretary Matt Hancock’s doorstep – has been rated inadequate three times in a row, with patients harming themselves and taking overdoses while waiting to be seen. It needs “immediate changes to keep patients safe”.
The dangerous and complete shutdown of the NHS email service on December 1due to an Accenture cock up whilst upgrading the software largely passed unnoticed and England’s breast screening programme is running on IT systems with “multiple practical issues and risk associated with their operation”, according to an official investigation. On December 4, the Royal Free hospital in London hospital declared an internal incident, with all non-cancer surgery and training cancelled, as it struggled to cope with an ‘unprecedented demand for beds.’ 80% of doctors in a Royal College of Emergency Medicine survey believe in emergency care is getting worse, with widespread staff shortages. The President of RCEM declared ‘we are entering winter with the worst state of emergency performance for 20 years.’ The annual GMC survey of 2600 doctors found unsustainable stress and 21% of 45-54 year olds, and two-thirds of 55-64 year olds, intend to take early retirement by 2021. Meanwhile, Hapless Hancock has been interviewed in an Evening Standard advertorial sponsored by, and heavily plugging, Babylon Health. He then claimed that his endorsement had ‘helped Babylon’s competitors.’ And he was also forced to delete a tweet claiming of a “terrific” increase of 1,000 GPsjoining the NHS in just three months, after being censured by the government statistics watchdog. The crisis of trust in politics may have peaked with Brexit, but it was born in the NHS. Merry Christmas.