17th February 2021

A cunning plan indeed

Saving the NHS comes at a terrible price for those it should save. With this thought in mind, many may not be aware that there was a plan, it is the UK Influenza Pandemic Preparedness Strategy 2011. 

In many ways this is the plan that has been followed, that is until it was not. 

I will not list the ‘was nots’ here as I think you should read all 60 pages and work these out yourself. 

However, the section on “Ethical principles for pandemic preparedness” is well worth a read at the very least

17. 3.17  In preparing for, and responding to, an influenza pandemic, governments, organisations and individuals will face difficult decisions and choices that may impact on the freedom, health and in some cases prospects of survival of individuals. Decisions will be needed on how to make the fairest use of resources and capacity, in proportion to the demands of the pandemic alongside other pressures that may be in place at the same time and in order to minimise the harm caused by the pandemic as a whole. Many people are also likely to face individual dilemmas and tensions between their personal, professional and work obligations

17. 3.18  Given the potential level of additional demand, capacity limitations, staffing constraints and potential shortages of essential medical material, including medicines, hard choices and compromises may be particularly necessary.

Once you have digested the ‘Preparedness Strategy’, you should then turn your attention to the “The NHS constitutional values hub”.

The hub mission statement makes it clear that “The NHS belongs to the people and is founded on a common set of principles and values that bind together the communities and people it serves – patients and public – and the staff who work for it”. 

The page goes on to list in detail those NHS values and guiding principles. They are well worth a ponder.

But are these working for the people as they should, given the UK Influenza Pandemic Preparedness Strategy 2011 after almost 12 months of lockdowns, bounce-backs, firebreaks, eat outs, border ? 

A recent report from the Institute for Economic Affairs said “there is no rational basis for the adulation the NHS is currently receiving” and it accused politicians across the board of “trying to fit the pandemic into their pre-existing world-view” in a new report.

Do the following six values in the NHS Constitution ensure the best possible care for patients is the reality that we clapped for:

• Working together for patients- only if you have Covid
• Respect and dignity given that so many have and are dying alone, refused next of kin visitation rights or if elderly have been sent home with Covid to care homes to clear at crisis outset some 30,000 hospital beds? I think that is a no.
• Commitment to quality of care- only if you have Covid.
• Compassion- see ‘Respect and Dignity

Improving lives- New activity data for November and December 2020 lay bare the continued disruptive impact of the COVID-19 pandemic on NHS care. The new data indicates that the shutdown of most non-COVID-19 services in the first wave, combined with drastic changes in patient behaviour, mean the NHS is now facing a large backlog of non-COVID-19 care, storing up greater problems for the future.

The BMA estimates that between April and November 2020 there were 2.57 million less elective procedures and 18 million less outpatient attendances.

• Everyone counts- only if you have Covid or assume that the word ‘counts’ relate to data, and this goes full circle back to only if you have Covid

The website then goes on to lay out the founding principles of the NHS

1. The NHS provides a comprehensive service, available to all
2. Access to NHS services is based on clinical need, not an individual’s ability to pay
3. The NHS aspires to the highest standards of excellence and professionalism
4. The patient will be at the heart of everything the NHS does
5. The NHS works across organisational boundaries
6. The NHS is committed to providing best value for taxpayers’ money
7. The NHS is accountable to the public, communities and patients that it serves

These founding principles are honourable, the frontline staff fantastic, but for the last year, based on endless Covid data, not one of the seven principles listed above has held firm or delivered as it should have. 

Instead, even now, we are being asked to save the NHS.

The price paid by the UK population manifests itself with waiting lists now almost at 5 million, now exceeding pre-pandemic levels* and untold levels of invisible mental health problems.

To make matters worse, there are a very large number of NHS patients still waiting to be referred onto those waiting lists. Therefore, this estimation probably skims the surface of the actual volume of unmet care, as evidenced by the BMA backlog estimates.

Most economists expect unemployment to continue rising for the rest of the year. Tweny percent of the population have not worked for nine months, either due to furlough or loss of employment.

UK unemployment is likely to reach 2.6 million in the middle of 2021, according to the government's economic watchdog, the Office for Budget Responsibility (OBR). That is 7.5% of the working-age population.

The OBR estimated in November that borrowing would be £394bn for the current financial year (April 2020 to April 2021). That's the highest figure ever seen outside wartime. To put that into context: before the crisis, the government was expecting to borrow about £55bn for the whole financial year.

Something is not right here, economic life remains the same for those employed by the state. For those who are not, furlough continues, mortgage payment deferrals continue, rent deferrals continue, car loan payment deferrals....... the slogans may change: “ Stay home, protect NHS, saves lives”, “Stay alert, control the virus, save lives”, “Wash your hands, cover your face & make space” but the problem remains the same. It is even worse for those SME’s and self employed who have had no state support at all.

Lockdowns do not work, we have tried three. 

The government should revisit the 2011 cunning plan and get the country, unlocked, schools back, get those that are not working back in the workplace and the NHS waiting lists dealt with!

*Source Govt UK, BMA & NHS Health Education

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