The crisis in the ambulance service is the latest sign that intense pressures on the NHS and care system show no sign of easing
The pressure on the NHS, and the UK’s wider health and care system (including services delivered by councils), has been so intense for so long that the public has got used to it. Even before the pandemic, staff and hospital bed shortages were leading to serious problems. Underfunding throughout the 2010s meant that the service was increasingly ill-equipped to cope with the rising prevalence of chronic illnesses and demographic pressures. In November 2019, several months before Covid-19 hit, NHS England was described by senior leaders as being “on its knees”, “in a downward spiral”. Calls by ministers to “protect the NHS” during the pandemic were an explicit instruction to the public to limit demand, in the hope that a meltdown could be prevented.
It worked, in the sense that people did stop seeking treatment for non-urgent conditions. Up to a point, this made sense: in a pandemic, some resources should be reallocated on a temporary basis. But the release of pent-up demand over the course of this year has created a vast backlog. The waiting list of 5.8 million people in England is the longest since records began in 2007, and the other nations of the UK face their own problems. In Scotland, 600,000 people are waiting for treatment, with a similar number in Wales and about 350,000 in Northern Ireland, where more than half of patients wait more than a year for a first consultant appointment.
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