Richard North, 07/08/2020  

It is about bloody time that someone "in authority" said this and, at long last, it is being said.

"The NHS will be inflicting pain, misery and risk of death on tens of thousands of patients if it again shuts down normal care when a second wave of Covid-19 hits". So say doctors' and surgeons' leaders. They add: Hospitals should not leave patients "stranded" by again suspending a wide range of diagnostic and treatment services.

"We cannot have a situation in which patients are unable to access diagnostic tests, clinic appointments and treatment which they urgently need and are simply left stranded", says Dr Chaand Nagpaul, chair of council at the British Medical Association (BMA).

He adds: "If someone needs care – for example for cancer, heart trouble, a breathing condition or a neurological problem – they must get it when they need it".

At last, then, serious people are urging "NHS bosses" not to use the same sweeping closures of services that were introduced in March to help hospitals cope with the huge influx of patients seriously ill with Covid.

"The NHS must never again be a Covid-only service. There is a duty to the thousands of patients waiting in need and in pain to make sure they can be treated", says Prof Neil Mortensen, president of the Royal College of Surgeons of England.

Given the scale of the problem, it is too late to say that this should never have happened first time round, but better late than never. As it stands, one million fewer patients underwent planned surgery in England in April, May and June.

Some 30,000 to 40,000 could not start cancer treatment as hospitals discharged thousands of patients and suspended many of their usual services to concentrate on treating those with Covid-19.

Unavailability of care, in tandem with patients’ reluctance to go into hospital, have been linked to the fact that in England 12,000 more people than usual have died of illness not linked to Covid in recent months, such as heart attacks.

One cancer expert, the Guardian says, has estimated that anywhere between 7,000 and 35,000 patients could die over the next year as a direct result of missing out on NHS care in recent months.

"The NHS had to stop almost all planned surgery at the beginning of the Covid crisis, and we just cannot let that happen again. Things will need to be done differently in the face of any further spike", Mortensen thus tells the newspaper.

Nagpaul adds: "While not publicised in the daily briefings, these [12,000] excess deaths are just as much a tragedy and loss to loved ones as those occurring from the virus".

If we dwell on that figure, and reflect on the recent events in Beirut, where the dead are numbered in their hundreds, there is real anger in the streets and those suspected of being responsible have been locked up.

And here we have twelve thousand dead – twelve thousand unnecessary deaths because bloated, over-paid and basically incompetent NHS planners and civil servants did not do their jobs properly, while the politicians in charge did not have the wits to intervene.

Only now are a few beginning to talk sense, calling for the sort of plans that should have been in place right at the beginning. Mortensen suggests that hospitals, should set up more "Covid-lite" sites to enable surgeons to resume common operations such as hip and knee replacements and cataract removals.

Nagpaul says more use should be made of the NHS's £400 million-a-month deal with private hospitals. The NHS should also look at using the seven Nightingale hospitals it created early in the pandemic as extra capacity for non-Covid care.

The NHS, we are told, is trying to arrange care for the large number of patients who missed out on care in recent months, many of whom are facing a long delay before they can get seen.

But, says the Guardian it could see its treatment waiting list soar if there is a repeat of the shutdown that NHS England chief executive Sir Simon Stevens (pictured) ordered in March.

But there is no could about it. Patients, already stuck on over-long waiting lists, have had their treatment peremptorily delayed, with no new dates and not the slightest indication when they might expect treatment. There is a total communications vacuum to the extent that the NHS might as well not exist. In functional terms, for many patients, it already has ceased to exist.

You don't have to be a rocket scientist to know this. All you have to be is a patient who has been well and truly abandoned by the system, while shitface ponces about on TV pumping iron and telling us to lose weight, giving £355 million to companies in Northern Ireland to help them complete their Brexit paperwork that he said would never have to be done.

Thus we have Nagpaul saying: "Aside from the individual distress, pain and potentially life-threatening impact that delaying care would have on individuals, there's a risk that increasing the backlog further would have a grave consequence for the NHS in the future".

"The knock-on of not addressing this now and delaying further care during a potential second wave could mean that we are constantly trying to catch up with the missed care", he says.

No shit, Sherlock! No f**king shit!

Needless to say, we have the apologists and the bureaucrats sticking their oars in. The NHS Confederation, which represents hospitals, has graciously acknowledged what it calls the service's "unprecedented pausing of normal care" involved "a terrible cost" for patients needing non-Covid care.

What a great pity they didn't think about that when they were setting up their contingency plans, when they allowed their obsession with flu to distort planning priorities.

Niall Dickson, the NHS Confederation chief executive, gobbles away in newspeak, saying: "The NHS can flex and will be there for patients again if there is a second wave. The challenge this time will be to run both Covid and non-Covid services in parallel as far as is possible".

The "challenge", he calls it. What does he call dying because the NHS has totally failed to perform?

We are told that hospitals "are working hard to clear the backlog that built up", but we also hear that there are wards empty and specialists unable to do their work because operating theatres and other facilities have been turned over to Covid.

And all Stevens can do is tell hospitals to get back to providing 80 percent of planned operations by September and 90 percent by October, in order – he says - to reduce the backlog as far as possible before a second wave hits.

Apart from the fact that this is easier said than done, does this facile little man not even realise that, pre-Covid, the NHS was not meeting its targets? Working at 80 percent, or even 90, isn't going to see the backlog reduce. It is going to increase – the numbers tempered only by those additional patients who die for want of treatment.

But then, we're only plebs, and what do plebs matter? As long as Sir Simon Bloody Stevens can keep trotting out his tractor production statistics, he will stay in post long enough to get a peerage from a grateful prime minister. He can then retire with a generous pension, and a few directorships in big pharma on the side.

Ours is not to question why. Ours is but to do and die, as quickly and silently as possible, doffing our caps politely as we expire.

Also published on Turbulent Times.

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