At NHS hospitals across the country, when a patient has a cardiac arrest or other major medical emergency, we dial “2222” to summon the emergency team. Today we find the NHS itself is in a state of emergency – and my call here for an A&E general strike is the “2222” alert our health system desperately needs.
We don’t have enough beds in the NHS – in England alone we have lost nearly 17,000 since 2010. In fact in the last 45 years NHS beds have declined by 60%; there were 350,000 nationwide before Margaret Thatcher, about 127,000 as of last year. Conservative policy decisions have destroyed our bed capacity.
We waste billions on temporary doctors and temporary nurses to fill the gaps – and Brexit will make this even worse
We also don’t have enough staff. Current staff shortages require the recruitment of 10,000 new doctors, 40,000 new nurses and nearly 50,000 additional clinical, administrative, and facilities staff. Successive governments have been responsible for terrible planning, and other factors have made the situation much worse. Conservatives have slashed training budgets, increased tuition rates, scrapped the nursing bursary, started a contract war with junior doctors and then imposed one on us – driving many doctors away from the country, while burdening foreign doctors and nurses with onerous visa and health fees to work here. We waste billions on temporary doctors and nurses to fill these gaps – and Brexit will make this even worse.
We don’t have enough social care. Our social care system is dangerously under-resourced and this problem dramatically limits how quickly we can discharge patients and accept new admissions. Patients who are too healthy to be in hospital but too unwell to go home on their own will stay in acute medical beds at a system-wide cost to the NHS of £640,000 a day. There are 122,000 vacancies in social care, and severe neglect of this system has pushed many people to sell their properties so they can put loved ones in a care home.
We don’t have enough funding. For years, the UK has lagged behind other major economies in how much money we spend on healthcare. According to a 2019 study, when compared to other major western economies, we spend the lowest amount of money on healthcare per person and it shows. UK GPs spent the least amount of time with patients, the UK had far fewer doctors and nurses than average, and we had the lowest survival rates for breast and colon cancer among the group of countries studied. These are the consequences of years of Conservative underfunding of the NHS, which has required annual budget increases of about 4% on average to provide an excellent service, support a strong workforce, maintain facilities, and account for inflation. Over the last decade of Tory rule, the average annual budget increases have been a paltry 1.6%, with some years effectively seeing no increases at all. This slow starving of the NHS has caused care to be delayed and denied. Conservative promises of “record funding” are simply not enough.
Without beds we can’t admit new patients; without staff we can’t treat patients; and without social care we can’t discharge people. This is why our A&E departments, barometers of the overall health of the service, are on the brink of collapse with the worst waiting times in NHS history. Patients are waiting hours to be picked up by ambulances, and queues of ambulances are waiting hours to drop their patients off. More people have died waiting for care in ambulances or on A&E trolleys in the last four years than have died from terrorism in the UK in the last 50 years.
It’s time for nationwide A&E industrial action. I am calling on all staff of A&Es across the country – doctors, nurses, paramedics, healthcare assistants, medical students, administrators, porters, security officers, cleaners and volunteers – to stand together outside, at first just for five minutes of each of our shifts, to protest about the lack of beds, the lack of staff and the lack of social care.
No patients will be harmed by these actions – in fact, this might be the only way to help them. If such actions continued every day and the time were periodically increased, we could demand that the government declare a national emergency in the NHS and host an emergency summit with representatives of all major organisations responsible for delivering healthcare in the UK. A&E staff could continue to strike until the participants’ recommendations are incorporated into the next budget, on 11 March.
Our patients are suffering due to policy decisions being made outside our hospitals, outside our communities, and with our NHS colleagues experiencing profound trauma from working in a system that is collapsing around us, it is time to do something. For those dying on A&E trolleys, for those with cancer diagnoses caught too late and for the future of the NHS, it’s time to stand up and fight back – it’s time for us to strike.
• Andrew Meyerson is a junior doctor working at Worcestershire Royal Hospital. His views are entirely his own