A few weeks ago I wrote that removing those Covid regulations that have a minimal cost, such as face-masks and self-isolation of symptomatic cases, was pointless and harmful.
Others made similar comments. Dr Kit Yates, for instance, argued that living with Covid should not mean closing our eyes to it (BMJ 21 March), and a number of healthcare leaders urged our Government to adopt a more cautious approach.
Following the decision to lift all the Covid mitigations, the number of new cases reached record highs at the end of March. The number of deaths has also went up to more than 200 per day, whereas the number of Covid admissions rose to more than 2,000 per day.
NHS in crisis
This has exacerbated the NHS crisis. NHS staff absences have increased, whilst the number of people on NHS waiting lists has reached a new record high in March. Patients are now facing long waiting times in A&E departments, which is harmful. Hospitals in the North East are also under severe pressure.
Furthermore, even mild infections are best avoided when possible, given the potential for long Covid. Data from the Office for National Statistics have shown that, as of 31 January 2022, 1.5 million people in the UK were suffering from long Covid, which can be debilitating.
Another consequence, that we have now identified, is the increased risk of thromboembolism and bleeding in the months after a Covid infection: most cases occur after a mild infection.
Not enough health care professionals
The NHS crisis is not just due to Covid. The main cause is the failure of a sequence of Conservative governments to address the manpower crisis. We just do not have adequate numbers of doctors or nurses or other healthcare professionals.
When the current government submitted the Health and Care Bill to Parliament, the Conservative MP Jeremy Hunt put forward an amendment, which would have required an independent assessment of the workforce needs every two years. The amendment was backed by more than 60 healthcare organisations but was rejected by the Conservative majority.
There are costs associated with training more doctors and nurses but, equally, forcing the NHS to hire large numbers of agency staff – as a consequence of unfilled vacancies – is also expensive and fails to meet the needs.
One paradox is that three new medical schools are being set up in the UK but will train primarily non-UK medical students paying extortionate fees, as they are not allowed to train more UK medical students.
Another paradox is that whilst we do not train enough new doctors, we are also discouraging older doctors from carrying on working as punitive pension arrangements and excessive workload result in poor staff retention.
We need to talk about workforce, has said the Editor of the BMJ (26 March) whereas Adele Waters has argued that the Government has missed an important opportunity to alleviate the workforce crisis (BMJ 17 February).
The problem is not just the Health and Care Bill. Even the recovery plan for elective care, aimed at tackling the long waiting lists, is compromised by the absence of a credible plans on how to increase critical staff number (Richard Murray, BMJ 17 February).
These are worrying times for the many of us who may need to use the NHS.
In the short-to-medium term we will be heavily dependent on healthcare workers coming to work in the UK, but Brexit and other policies hostile to immigration have made it more difficult to recruit from abroad.
As a cancer patient I am worried about the fact that the UK has worse cancer survival rates than many western countries: this is in part due to long waiting times, which are now getting even worse, and to inadequate numbers of specialists.
Even the current maternity care scandals, with associated deaths of baby and mothers, are in part due to inadequate numbers of midwives. Other contributing factors have been a reluctance to perform caesarean sections and governance failures.
As showed by a recent inquiry into a failing maternity unit, it was difficult to find any part of the hospital which was not under pressure.
Boris Johnson and Rishi Sunak are setting up the NHS to fail.
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