NHS set for “perpetual winter of Narnia”

That’s the standard technique of privatization: defund, make sure things don’t work, people get angry, you hand it over to private capital.”

Noam Chomsky,

“The NHS is missing so many of its key performance targets that it has entered “the perpetual winter of Narnia”, a medical leader has said, after figures revealed the highest ever number of patients on waiting lists.

Claire Marx, president of the Royal College of Surgeons, criticised the NHS’s failure to give patients planned care in hospital within the required 18 weeks, such as surgery for cataract removals, hernia repairs and hip and knee replacements.

The number of people in England who are awaiting such treatments has climbed to almost 3.9 million.

Demand for NHS care is dangerously high, says thinktank
Hospitals are meant to treat 92% of patients on the “referral-to-treatment” (RTT) waiting list within 18 weeks, according to guarantees in the NHS constitution. However, they did so in just 91.3% of cases in July, NHS-wide performance data released on Thursday shows. It was the service’s worst RTT performance in more than five years.

Hospitals met the 92% target in nine categories of RTT patients, including those requiring treatment for eye problems (92.7%), cardiac care (92.7%) and gynaecological problems (92.3%). However, it missed the target in 10 other categories. It treated barely four of of five (81.7%) of all those awaiting neurosurgery within 18 weeks, 86.9% of those needing plastic surgery and 88.9% of trauma and orthopaedic patients.

“It feels as if the NHS has stepped through the wardrobe and into the perpetual winter of Narnia,” Marx said. “We cannot forget that behind these statistics are potentially very ill and anxious patients who are being made to wait far too long for treatment. This is the true impact of the serious financial pressure we’ve seen the NHS come under in recent months.”

The NHS also missed targets covering A&E, ambulance response times, diagnostic tests, two forms of cancer treatment and rapid first treatment for those experiencing psychosis for the first time.

Dr Mark Holland, president of the Society for Acute Medicine, said: “This data reflects a system which is close to breaking down.”

Bed blocking has reached record levels. In July a total of 184,188 bed days were lost to delayed discharges – when patients are fit to leave but social care support is not in place – up sharply from 147,376 in the same month last year, and the highest number since records began in August 2010.

At midnight on the last Thursday in July, 6,364 patients who were fit to leave were still in their beds, up from the previous record of 6,105 patients the month before.

“For every 100 people who come to A&E, around 30 are admitted and, of these, 20 come under acute medicine. That number is increasing and our front-of-house workforce is depleted,” Holland said.

However, performance is most significantly hampered due to our inability to discharge people at the backdoor of our hospitals. Failure to get people home is, in my view, a national emergency.”

Medical leaders want ministers to urgently pledge more money for the NHS to tackle its growing problems.

Marx said: “The forthcoming autumn statement offers an opportunity for the government to provide more money for the NHS and social care, and to agree to a cross-party commission to review how we can make the NHS sustainable for the long term. Without a serious look at what the NHS needs in funding, we will remain in a state of constant winter.”

NHS England said that despite missing so many targets, its performance was still very good by international standards.

“As the NHS responds to ever increasing care needs, hospitals are continuing to look after more than nine out of 10 A&E patients within four hours, and more than nine in 10 patients are waiting less than 18 weeks for their routine operations,” said Matthew Swindells, its national director of operations and information.

“While this is probably the best performance of any western nation, these figures underline the pressures facing the NHS, and the obvious risks to patient care posed by weeks of further drawn-out industrial action.”


3 thoughts on “NHS set for “perpetual winter of Narnia”

  1. I don’t have any sort of philosophical aversion to privatisation. If privatisation and “market forces” worked for what were traditionally public organisations I would be supportive.

    But the reality of this is that there is ZERO evidence to show that a privatised NHS will be more efficient and able to treat the growing number of patients within the existing budget. But there is a LOT of evidence to show that privatised industries succeed in what the private sector does best – generating profits for its shareholders and large salaries for its senior officers – but FAILS miserably in delivering a better, more cost effective service to the public.

    In essence, as soon as you privatise, you should expect to pay (say) 10% more in order to create the profit margin which funds the dividends to shareholders. Indeed, all the evidence suggests that previous privatisations have had this built in – we may all remember how electricity and gas prices rose sharply immediately after privatisation, and the shares would have been far less attractive had it not been abundantly clear to insiders at the time that this was going to be allowed to happen. In short, in order to get the one off receipts from privatisation, the government ensured that we (the public) have paid for it several times over in increased prices ever since.

    Worse still, over time most of the energy companies have been sold to foreign companies – so profits leave the UK (worsening our balance of payments deficit), and decisions on vital new infrastructure are made by foreign companies, often state controlled. We can argue all we like about whether leaving the EU will give us back our sovereignty, but if our national infrastructure is owned by e.g. companies controlled by the French or Chinese governments, how much sovereignty do we actually have even once we have left the EU?

    Similarly evidence shows that the privatised sectors milk their assets to get the maximum short-term profit whilst avoiding the need to invest in replacement assets for when the original ones are no longer productive or cost effective. So electricity companies have failed to invest in new generating capacity even as they close down coal-fired plants – leaving the UK with a forecast deficit on electricity generation. The government’s reaction to this is to invest heavily in a new ultra-expensive nuclear power plant, built and owned by the French & Chinese. So much of the construction costs will flow abroad, as will the profits on the full construction costs as will the operating profits.

    Similarly, PFI deals (a different type of privatisation) are now entirely discredited etc. etc.

    No – all the evidence suggests that privatisation is a disaster in the medium- to long-term, typically used to solve a short-term issues without regard to the future impacts.

    Just where will this end?


  2. Well the way things are going, we will not have to worry about the 18 weeks wait. I know of instances in this area where patients are being told that the hospitals are instructing doctors not to send more referrals. So problem solved!
    But this has to stop; enough is enough.


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