This week, Liz Truss told a Conservative Party leadership hustings in the West Midlands that she would divert billions of pounds earmarked for tackling NHS backlogs into social care.
Of course, any sane person would tell you that is rearranging the deckchairs whilst the ship sinks – or in this case the NHS collapses. Because everything is pointing to a need not to divert funds but to fund properly.
And one of the starkest features of the near collapse of the NHS is the continued rise of excess deaths that we are seeing across the UK (by which we mean a rise in the number of ‘usual’ or expected number of deaths at any given time).
Excess deaths
On 11 August John Burn-Murdoch wrote in the Financial Times about the unexplained excess deaths we are now seeing in England. Yesterday he put it more bluntly tweeting that “the collapse of emergency healthcare in England may be costing 500 lives every week, a close match for non-Covid excess deaths”:
During the height of the pandemic, excess deaths could be easily explained and indeed were clearly recorded on most death certificates that showed Covid as a cause or contributor to death. But as the severe impact of the virus recedes here, deaths have not.
Between July and December 2021, England recorded 24,000 more deaths than in a typical year. But once you look into the detail, it’s clear that only two-thirds of these could be attributed to Covid. Since May this year, less than half of the 10,000 excess deaths were Covid-related.
Looking just at non-Covid excess deaths across the two periods, they amount to just over 12,000 people.
So, what is the problem?
Burn-Murdoch points to a recent British Medical Journal (BMJ) study plus a report in the Independent of the impact on outcomes for those who have extended waiting times in accident and emergency.
Is the NHS crisis now resulting in thousands of deaths?
Rebecca Thomas in the Independent claimed on 2 August that “almost 700,000 people have waited more than 12 hours in accident and emergency (A&E) in the first seven months of 2022, according to leaked NHS data”. In 2019 that figure was 37,000, rising to 51,000 in 2021 – an increase of 144%.
The BMJ study drew on previous research that used a large NHS database to confirm or disprove an increased risk of death in patients with increasing lengths of stay in A&E before hospital admission. Their conclusion? “A time-associated linear increase in all-cause 30-day mortality for patients who remain in the emergency department for more than 5 hours from their time of arrival”. PLUS, “One extra death occurs for every 82 patients who are delayed for more than 6 to 8 hours”.
That latter figure may not seem very much but then if, as Burn-Murdoch reckons, “during June this year 102,000 people waited 12 or more hours in A&E, almost four times the pre-pandemic average for the same month”, you suddenly get a lot of deaths. He goes on to say, “A further 441,000 waited between four and 12 hours, double the typical number” and concludes that “the total number of additional A&E-linked deaths since waiting times rocketed is an almost perfect match for the missing 12,000”.
People simply can’t get the treatment they need
The latest Office for National Statistics (ONS) shows similar trends. The latest figures show, “The number of deaths registered in the UK in the week ending 12 August 2022 was 11,782, which was 10.1% above the five-year average (1,082 excess deaths)”.
Covid was responsible for just 674 of those deaths, which was 128 fewer than in the previous week. But “the number of deaths was above the five-year average in private homes (21.6% above, 525 excess deaths), hospitals (9.0% above, 381 excess deaths) and care homes (3.1% above, 60 excess deaths)”.
The Spectator, analysing the ONS statistics, picked up on the fact that “since the start of the year there have been 6,000 fewer deaths than we’d expect in hospitals and care homes but over 17,000 more in people’s homes in England and Wales alone”. According to Michael Simmons, the data analyst at The Spectator, people who need treatment are struggling to get it which could well explain the rise of deaths at home:
“Waiting lists are larger than ever, it takes six minutes for 111 to answer your call – 20 times longer than it should — and getting an appointment with your GP is a total lottery.”
So NHS backlogs are literally killing us.
Current government has no political will to support the NHS
Of course, it wasn’t always like this. In 2004 the then Labour government introduced the NHS four-hour operational standard for emergency admissions. It lasted for more than a decade before it started to fall apart. In other words, if there is a political will there is a way.
Up to a point Truss is right. The lack of social care funding, the inability to get people out of hospital beds and into social care, is partly responsible for the backlog. But it’s not that simple just to take money out of the NHS and give it to local authorities as she suggests. As soon as you go down that route it means you have to stop funding something in the NHS. And that is an impossible task when you have surgical and medical backlogs (can you imagine having to choose what service to cut?).
Of course, the real tragedy is that whilst this is being kicked about like a political football people are dying. We think we have survived Covid when in fact we could be struck down by the most avoidable death of all – failure to resource our NHS.
