The NHS: COVID-19’s next casualty

Abstract

COVID-19 is a rising tide capable of sinking all ships.¹ Health, economy, the arts, possibly even Sweden, all swept away from here to Timbuktu.² Adaptation is forced on us. Remote working and schooling via Zoom are the realities of everyday existence. Some of the keenest changes were felt in primary care and public health, where the working lives of health professionals have been transformed in an instant.³

Priorities must be reset.⁴ Acute services have innovated, refashioned and repurposed, with the most visible example being the sudden creation of a series of Nightingale hospitals to cater for increased demand during the pandemic.⁵ Those NHS capacity needs are yet to be exhausted, which is a feather in the cap for the service planners, but success is being achieved partly because people with other conditions who require care are staying away from hospitals.

The NHS has coped but that has come at a price. The human cost of lives lost by health professionals and patients. The workload and strain of responding to a pandemic. The extra pressure on staff covering for sick or shielding colleagues. And the disruption to existing services and care pathways.

Despite all this, despite all the years of running a service creaking at the seams, the response of the NHS and its workforce is one of utmost dedication, resourcefulness and even bravery when considering the government’s failures on personal protective equipment and testing. In the face of extreme adversity, the NHS has reconfigured itself to meet the immediate threat of COVID-19.

Hence, it is hard to be calm about the government’s intention to reorganise the NHS to reassert central and political control. Both these aims are undesirable. Indeed, the primary failures of England’s pandemic response have been both central and political. Instead of taking responsibility, and in the absence of an inquiry, the government has shamelessly blamed scientific advice, Public Health England and, now, the NHS.

Mistakes were made and that is inevitable, but the blame game is unbecoming. Scientific advice from high-level committees is for the government’s benefit. Public Health England and the public health system are creatures created by the current government’s own party. And the NHS is battered and bruised after years of political mishandling.

It would be fake news to suggest that all three entities are blameless.⁶ But the burden of responsibility rests with the government, and another reorganisation of the NHS is a cynical political game designed to distract our attention from the people responsible for tens of thousands of excess deaths. When the good ship NHS is sunk what will be left?

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