Senior doctors have drawn up a major dossier refuting Sajid Javid’s claim that the pressures on the NHS were created by the Covid pandemic, amid continued warnings over patient safety, scarce beds and staff morale.
The health secretary has repeatedly suggested that the problems around record waiting lists and ambulance waiting times have been prompted by the pandemic. Last week in parliament, he accused shadow health secretary Wes Streeting of having his “head under a rock for two years” for not seeing that the pressures stemmed from Covid.
However, in a major review of evidence shared with the Observer, doctors pointed to issues around funding, bed capacity, staffing and recruitment that pre-dated the arrival of Covid. The dossier, drawn up by the British Medical Association as it gathers for its annual conference this week, finds that the UK’s health services were ill-prepared for the pandemic as a result of “historical underfunding and under-resourcing in the decade preceding the virus”.
In 2019, the UK was spending around 10.2% of GDP on healthcare compared with 11.7% by Germany and 11.1% by France.
While the latest data for 2020 suggests this has changed, the report finds that this was largely down to increased spending during the pandemic and the impact of Covid on the overall economy, as the UK had the largest drop in GDP of all G7 countries. It states that waiting lists had already hit 4.43 million in February 2020. Meanwhile, its analysis found that the average daily total of available beds contracted by 8.3% in England between 2010-11 and 2019-20 and 14.9% in Wales. In Scotland, the daily average available staffed beds for acute services also fell by 8.3% between 2010-11 and 2019-20.
The average number of beds per 1,000 people in OECD EU nations is 4.6, but the UK has just 2.4. It also identified a major issue with GPs. “The equivalent of 1,348 fewer fully qualified full-time GPs were working in the NHS when the pandemic hit in March 2020 than there were in 2015,” it found.
Denise Langhor, an emergency medicine consultant in the north-west of England, said that the pandemic had “laid bare” the health service’s problems, but did not create them. “Those problems and those holes already existed,” she said. “It is entirely disingenuous of this government to claim the waiting lists and the difficulties people are experiencing with NHS care at the moment are due to Covid. They have been building for a decade.
“Every day, I have patients that I wish I could have treated sooner. It’s an awful thing as a doctor to be trying to look after patients on a corridor, and knowing they are not getting the standard of care that you want to give them.
“Frequently it feels like we’re operating by choosing the least worst option rather than the best option.”
Lisa Rampersad, a junior doctor on the south coast, said she had been seeing issues with waits for surgery before the pandemic. “Before Covid, we have waiting lists over a year for patients to get surgeries on things like gallbladders,” she said. “The longer you wait to get that out, the more complications you have. And we’re currently at a two-year plus waitlist. Covid has added to it, but it was happening way before. We don’t have enough staff or theatres, we don’t have enough doctors to operate. Patients get bumped.”
A Department of Health and Social Care spokesperson said: “It’s evident the pandemic placed unprecedented pressure on the NHS and had a huge knock-on effect on our health services.
“We estimate that around 11 million people didn’t come forward for treatment during the pandemic who otherwise would have. We’re doing everything we can to bust the Covid backlogs, grow our workforce, reduce waiting times and expand health infrastructure, backed by record investment.”
