A STUDY of NHS data by the BMA tells a story of how the NHS is struggling to cope with the backlog of patients and procedures that was caused by the various lockdowns and restrictions in response to the Covid pandemic.
The government was repeatedly warned by Recovery and many healthcare specialists that this would be one of the substantial costs of lockdowns and the evidence is beyond dispute. Take what the BMA’s Chart #1 on cancer referrals tells us:
“The proportion of patients seen by a specialist consultant within two weeks of an urgent GP referral for suspected cancer remains worryingly low. The 93% target for patients to be seen within that time frame has not been met since May 2020.
“The percentage of patients receiving their first treatment within two months of attending a screening service dropped dramatically during the initial few months of the pandemic. It has since picked up, but remains below the operational standard. Activity is low compared to pre-pandemic levels. The decline in these key indicators shows the level of pressure the system is under.”
The BMA argues more capacity is required to deal with the backlog – if that comes about it will take time. The obvious conclusion is that people have died already because of the absent or delayed diagnoses and unavailability of consequential treatments during the lockdowns – and more shall continue to die because the scale of the outstanding consultations and procedures is so large.
The BMA has another chart on consultant-led elective care, which also tells its own story:
Up to the Covid pandemic in February 2020 the waiting list for consultant-led elective care was already 4.43 million people. With lockdown the number of people joining the waiting list initially dropped, but this has since been rising and reached a record 6.18 million people in February this year.
The BMA also reports the total number of patients waiting over 18 weeks for treatment now exceeds 2 million, while the number of patients waiting over one year for treatment stands at almost 300,000. This is 186 times the number waiting over a year pre-pandemic in February 2020 – in other words it was previously less than 1700. By February of this year the average patient spent 13.1 weeks (over three months) waiting for treatment.
The BMA argues there is a hidden backlog that is growing. This is because the waiting list represents a visible backlog, but the shutdown of most non-Covid-19 care in the first wave meant that thousands of patients that required care had not presented or had referrals cancelled.
Procedures now vs pre-COVID illustrates the impact of the Lockdowns
Between April 2020 and February 2022, compared to pre-COVID averages there were:
• 4.51 million fewer elective procedures
• 31.39 million fewer outpatient attendances.
Add to this that despite the NHS performance improving in 2021 against 2020 the amount of electives and outpatient attendances currently being carried out is still well below pre-pandemic levels. In other words the NHS is not yet able to cope as well with past levels of demand as it was before the pandemic – never mind eat into the backlog. Obviously this simply stores up greater problems for the future. The resources and capacity needed to deal with the backlog as well as ‘normal’ demand does not currently exist. It is very difficult to overestimate the scale of the problem the NHS now faces.
Emergency care is faring just as badly
Turning to emergency care, readers will possibly recall that before the pandemic demand at A&E was already climbing and the percentage of people being seen within the four-hour target reached an all-time low over the 2019/20 winter. Due to the lockdowns and fear of catching Covid A&E attendance fell significantly which led ironically to an improvement in performance times. Naturally, once the lockdown was eased demand began to rise again reversing the performance gains. The BMA reports that “demand in A&E departments has significantly worsened in March 2022, with the highest levels of total A&E attendances (2.17 million) seen since December 2019 (2.18 million).”
Were the lockdowns to save the NHS worth it?
The final chart is to give context to what we did to the NHS in its name. It is from a just published study of excess deaths worldwide by WHO. Of course it comes with the caveat that data is collected differently in different countries, nevertheless the same data was being used regularly by the media and lockdown cheerleaders to call for the Government to introduce lockdowns sooner, to make them harder, to keep them going longer, and to keep returning to them or their variants of “circuit breakers” and “local lockdowns”.
What we can see now is that as time provides us with a better historical perspective the clamour for lockdowns was grossly misplaced. The UK, derided by our media constantly as the worst at handling the pandemic – and thus needing more authoritarian measures – has fared better than many other countries that were being lauded because of their lockdowns – especially those that relied on stricter lockdowns – and worse than countries such as Sweden that did not turn to lockdowns. Lockdowns did not “save” us or the NHS.
Indeed the lockdowns and the propaganda required to sustain them delivered tens of thousands of people too scared to go to hospital even for urgent conditions; there was a huge amount of unused hospital capacity during lockdowns; normal hospital operations were seriously disrupted as many health staff had to isolate, leading to levels of absenteeism as high as 40-50% at times (also in part a consequence of the measures). Lockdowns have also triggered long-term health problems by massively boosting obesity, depression and other mental illness.
The pro-lockdown lobby says the growth in waiting lists was an inevitable consequence of covid – but it did not need to be that way or at that scale. Targeted protection and care was the answer, not closing down the NHS to regular services or shutting up economic activity that would pay for it.
For me the story is quite clear: we were told that we needed a three week lockdown to “flatten the curve” – to give the NHS time to deal with a surge that it could not cope with and yet what we find is that other countries that did not use lockdowns as much or at all have often fared better – while others that did them sooner, harder and longer – like Peru – have suffered terribly. But the NHS has not been saved, it now cannot cope with the repercussions of the backlogs. We had a government that told us the lockdowns were vital and an opposition that told us they should happen sooner, harder and longer – only a few MPs stood up to give sceptics about lockdowns a voice.
The fear must remain that the government – any government – will turn to lockdowns again unless we convince the majority of MPs and the media that influences them that they were a self-inflicted disaster we can never return to.
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Brian Monteith is a former member of the Scottish and European Parliaments and managing editor of the Time for Recovery blog.