Philip Collins
(Picture: Daniel Hambury)When Maria Caulfield, the junior health minister, replied to an urgent question in the House of Commons by Wes Streeting, the shadow health secretary, on the ambulance crisis, she said she did not want to play politics with the National Health Service. It is a lovely thought but wholly naïve. As Rishi Sunak and Liz Truss compete with one another to see who can brief nastier nonsense about refugees, one of the issues that could sink their premiership is getting worse, and now it is screaming out at them from all the front pages.
The Conservative Party is always vulnerable to a decline in health services. That is why the NHS was exempt from the worst of austerity during George Osborne’s time as Chancellor. In retrospect, Jeremy Hunt, the nation’s longest-serving Health Secretary, did a good job, for all that he inspired the enduring hostility of the doctors, in just keeping the Tories competitive on health.
There should be a prize for guessing the identity of the current Health Secretary. In fact, it is the erstwhile Brexit secretary and Boris Johnson’s chief of staff, Steve Barclay. Mr Barclay declined to attend the urgent Commons session and has said nothing to date on the fact that every ambulance service in the country is on the highest level of alert.
In London, though response times are in fact the quickest in the country, the ambulance service declared it was on high alert during the recent heatwave. In April this year, people with a life-threatening condition waited on average nine minutes two seconds for an ambulance to arrive. The Government’s target is seven minutes. The data from NHS England shows that the average wait for heart attack victims is now an hour. For some people, this is a fatal delay. The NHS ambulance trusts recorded 572 incidents in 2021-22 in which severe harm or death was caused. That was an increase of 89 per cent on the previous year.
This crisis has been a long time coming. The recent heatwave is not so much the cause of the problem as the occasion. Ambulance waiting times have been rising since the summer of 2021. The more difficult it is to find a place on the roster of a GP, or to get a quick appointment, the more people go straight to hospital. The NHS is under-staffed, which means ambulances are turning up at A&E departments and finding themselves unable to unload because there are not enough clinical staff to hand over to.
Last week, as Streeting pointed out in the Commons, one ambulance waited for 26 hours outside A&E at a hospital in the West Midlands. Then, because the Government has still, after more than a decade of pretending to act, not broached the problems of social care, hospital beds are full of people who have nowhere to be discharged to.
This is part of a wider crisis in the NHS. There are 6.2 million people on NHS waiting lists, the highest number since records began in August 2007. More than 3,000 people have been waiting for more than two years. The waiting lists for hip and knee operations is 46 per cent higher than it was prior to the pandemic. And today a committee of MPs says the health service is facing “the greatest staffing crisis in its history”. It is no wonder that Sunak declared the backlog of cases to be a crisis. It is exactly that, and it is a crisis that could consume the next stage of Conservative government.
It is common on the political Left to state that the NHS is not safe in the hands of the Conservatives. That makes for good political knocking copy but it’s not quite true in this stark form. The NHS has lived most of its life since 1948 under a Conservative government.
It is true, though, that the Tories have to try harder on health than Labour do. And though healthcare is not at the moment the top-ranked issue in the nation as it was during the pandemic — the cost of living crisis has supplanted it there — it would be a foolish government that thought it could get by while the waiting times for ambulances are going up.
We have had a dry run for what might happen. In 2017, Theresa May thought she could exploit the unpopularity of Jeremy Corbyn and win a large majority for her Brexit deal. She, in fact, lost her majority and one of the big issues in that election was not Brexit but cuts to school funding.
The Tory leadership contest, so far, has an air of fantasy to it. Somewhere far in the distance we can hear the sirens.
