A staggering 78,981 operations were cancelled in the last year, according to the data gathered by the Labour party through freedom of information (FOI) requests. Worryingly, now almost 10% of patients who have had their operations cancelled have not had them rescheduled within 28 days, a figure that has doubled in the last 10 years. These painful statistics reflect the grim future that we can expect for the NHS if it has to survive another five years of Conservative rule.
The Labour FOI asked hospitals to respond with information about the cause of cancellation. All of the data is for surgeries that were considered urgent or were for elective operations (like routine hip surgeries) which were cancelled on the day, sometimes even after the patient arrived. Some of the most commonly given reasons for cancellations were staff shortages (nearly 11,000 cases) and equipment failures (about 5,000) with both of these having increased by a third in just the last two years.
It seems likely that this is as a direct consequences of health policy. In the late 1990s, nearly 20-25% of patients hadn’t had their operations after 28 days post cancellation, a situation which had developed after nearly 20 years of Conservative neglect of the NHS. Cancelled operations then went into rapid decline during the New Labour years, to a situation where in the 2010-12 period, only 5% of patients hadn’t had their operation within 28 days.
For all of New Labour failings, it did manage to pump huge amounts of money into the NHS and the trend had been moving towards almost eliminating waiting lists. Unfortunately, you can trace the reversal in this improvement to the introduction of the Health and Social Care Act, the 2012 bill introduced by the Conservative-Lib Dem coalition which changed the way that funding in the NHS works. After the 2012 act, all health funding regions dramatically went into debt. The numbers started trending back up and have continued to do so year on year – and look likely to continue under further Conservative rule.
How did we get to a situation where surgeries are increasingly being cancelled due to equipment failure? Simple – lack of investment in the NHS. The year-on-year budget ‘savings’ and apparent ‘efficiency measures’ forced by the change in funding are a false economy. Cuts to NHS capital budgets mean that cost savings are found in not buying new equipment or not paying for the upkeep of what’s there – and even then we’re still left with a £6.5bn repair bill. The outcome? Investments in equipment have fallen by 54% over a four-year period, and your grandmother’s hip operation has had to be postponed.
The same logic is apparent in staffing gaps. With over 100,000 current staff vacancies in the NHS, only serious investment into the NHS could make a change. A shortage of 43,000 nurses today is only the tip of the iceberg, as future forecasts mean that we will be requiring an additional 100,000 nurses alone in 10 years’ time if things don’t change.
There are several reasons for this. The cutting of the student nursing bursary led to a decline of new applications by a third, and that’s in a situation of recruitment decreasing from overseas, in part due to Brexit. Worsening work-life balance, falling wages, increasing bureaucracy and hospital reliance on ‘bank’ systems of working rather than permanent staff mean that senior nursing staff are quitting in droves, leading to a younger, less experienced senior team – a trend being reported across the health sector. No wonder then that we’re seeing ever greater staff sick days as the stress of the job leads many to feel unable to continue working. The bottom line is that we’re not training enough staff, and shortages are meaning that we’re not holding on to the staff we have – a vicious cycle. As financial and social pressures come to bear, it seems we’re reaching a tipping point.
Of course, from the Tory cabinet’s point of view, all this is according to plan. The standard technique of privatisation is to underfund a service, let it fail, and then cause a scandal – using that scandal to hand the service over to private enterprises. This is and always has been the goal of the Conservative party, meaning only a change in government can save the NHS. Otherwise, it won’t be long before Donald Trump and international corporations come to carve it all up and you and I are looking at the last days of the NHS as we know it.
Nick Carpenter is a junior doctor working in the NHS.