Britain

By an NHS shop steward

The NHS is now looking at a huge winter pressures crisis. But instead of getting to grips with the problems, Wes Streeting has instead busied himself with reports and consultations, almost as if he has no idea what to actually do.

In his first month he commissioned a report, the Darzi Report, which told everyone, including him, what we already knew: that the NHS has been under-invested and starved of funds for 14 years, but that the fundamental model, of a public service, is still the right one. Now he has commissioned yet another huge ‘consultation exercise’ to develop a 10-year plan for the NHS.

More than likely the whole exercise will be pointless, as no-one really knows what therapies, diagnostics or medicines will look like in ten years’ time. Think back to 2015 – no smart phones, streaming channels were just starting and AI was confined to celebrity chess matches. Also, as part of developing this 10-Year Plan, the previous ‘Long Term NHS Plan’ – which took four years to develop and get the support of the Treasury, has been ripped up.

And then, on January 2, he announced his big idea on social care – an Independent Commission that will not report until 2028! The one thing all these reviews and consultations are good for is helping Streeting evade his responsibilities.

Pseudo-policies and meaningless slogans

So far he has done nothing about:

• Ambulance delays – which in December were double the levels seen in 2023.
• Waiting lists – stuck at 7.6 million.
• A million people in hospital that don’t need to be there
• And…social care…except the massive delaying tactic that his ‘independent commission’ represents.

Instead, he is behaving as if he was in opposition, announcing tabloid-friendly pseudo-policies, like the “return of the family GP” and even a clampdown on NHS staff who “support extremism”. The “family GP” is one of those sacred cows of British politics which bears little relation to the modern realities of healthcare.

The tabloid leader writers, and Wes Streeting’s advisers, are thinking back to the 1960s – maybe even to Dr Finlay’s Casebook on TV – when Britain was very different, with full employment, available housing and a much more basic regime of diagnosis, imaging and treatment. Nowadays most people would be happy just to see a GP, any GP. 

And the pledge to rob NHS workers of their right to free speech, to “deal with” NHS workers who “support extremism” is just an irrelevance to everyone except a few shady think-tanks and pro-Netanyahu newspaper columnists.

Meanwhile, those much-maligned NHS managers (who are very much not tabloid favourites) are left having to juggle the plates, to keep some sort of healthcare going in the face of staff shortages, crumbling buildings, an ageing population and a permanent shortage of beds.

Corridor waiting is now part of official policy

The latest idea is ‘TES’ – Temporary Escalation Spaces, better known as corridors. The authors of the official NHS TES guidance are doing their best to regulate and control this awful practice, but it hardly makes it any better. Most of us will be deeply shocked that this is now part of normal care in the NHS.

The TES guidance refers to “Spaces that are opened up as part of winter pressure planning and refer to care given in unplanned settings…such as corridors“. 

In such an awful situation it seems absurd to give guidance on quality, risk, escalation, raising concerns, reporting incidents, data collection, and measuring outcomes, but that is what the guidance does. And finally, the guidance passes the buck to the hospitals for creating their own detailed processes and incident reporting systems. That is to say, there will be no national data on the incidence or outcomes of corridor care.

Meanwhile, South-West Ambulance Trust had to take out 2,000 hours per week of ‘conveying resource’ to meet its financial plan while the average response time for Category 2 calls (such as suspected strokes and heart attacks) was a shocking 1 hour 40 minutes.

The NHS, and even more so Adult Social Care, needs action and resources, not reports, consultations, enquiries and reviews, and meaningless tabloid headlines. Labour will pay a terrible electoral price if real improvements are not evident, and quickly.

[Top picture: Wes Streeting announcing his new ten-year plan. From Wikimedia Commons, here]