Murder by a thousand cuts

As the NHS is gradually dismembered in the interests of privatisation, the rate of avoidable deaths is soaring.

The Office for National Statistics has highlighted the fact that in the UK some extra 55,000 people a year are dying prematurely of preventable diseases, i.e., more than 1,000 every week. The effect is most dramatic among the middle-aged:

“…excess deaths since June 2022 have been concentrated in middle-aged and younger adults. Over the past year, deaths have been 15 per cent above normal in those aged 50 to 64.

“Deaths from cardiovascular disease such as heart attack and stroke are 33 per cent higher among this age group, with diabetes deaths also up by 35 per cent…” (Eleanor Hayward, ‘Hundreds more middle-aged adults dying a month since Covid pandemic’, The Times, 13 December 2023).

The bourgeois media have been forced to admit: “Experts believe that difficulties in accessing GPs since lockdown and record NHS waiting lists mean that middle-aged patients are missing out on life-saving preventative treatment such as blood pressure medication” and also “Long delays in ambulance waiting times and intense A&E pressures have reduced survival chances from emergencies such as heart attacks and strokes. NHS hospital waiting lists have reached a record 7.8 million, up from 4.4 million before the pandemic”. Still the media do typically try to do their bit to at least partially blame the victims: “Unhealthy lifestyles, obesity and widening health inequalities are also contributing to a rise in avoidable deaths” (ibid.).

There is, however, no evidence that unhealthy lifestyles and obesity have suddenly worsened in the last few years. In fact, with the reduction in smoking, lifestyles, one would have thought, had on average become healthier. What there is, on the other hand, is all the evidence in the world that, in the name of ‘reform’, the NHS has been gutted and can no longer offer various aspects of the service that it was able to do only a few years ago. And still the flunkeys of the bourgeoisie keep bleating on that what is needed is yet more reform, always in the direction of more privatisation.

With all the ‘reform’ there has been over the past few decades, the situation we face now is (1) that low pay is driving medical staff to leave the NHS; (2) that the consequent staffing shortages are making the work burden of the remaining staff intolerable, again leading to staff resignations and recruitment difficulties; (3) that the refusal to concede reasonable pay rates is leading to entirely justified strikes by doctors and nurses alike; (4) that well over 10% of the British population are stuck on  lengthy waiting lists, often for years, for an operation they need; (5) it has become very difficult to see a GP, either in person or by phone link, with a four-week wait now becoming very normal. At the same time the cost of the NHS is soaring to accommodate a massive accumulation of management consultants, bureaucrats and bean counters many earning more than the most skilful and experienced medical consultants, while millions of pounds go out to pay for ‘financial services’ because hospitals have been required to borrow money for new buildings, to pay interest and service charges out of their income from government and to pay profiteering privateers to perform medical and other services that hospitals used to provide for themselves profit free. One would have thought it was obvious that the privatisation measures that have been steadily forced on the NHS since the days of Prime Minister Margaret Thatcher have lethally (literally) undermined the service.  It is only the dedication and devotion to duty of doctors and nurses that the NHS still delivers as much as it still does, but their ability to do so is being remorselessly eroded. The ever-dwindling army of GPs has been struggling hard to cope:

An NHS spokeswoman said: ‘General Practice teams are seeing and treating record numbers of people – over a million a day – with half a million more appointments delivered every week compared to before the pandemic’.” However, their tireless efforts come at a price:

NHS and medical leaders said that problems could worsen amid falling GP numbers and suggestions that many surgeries could close. As of October, there were the equivalent of 27,368 full-time, fully qualified GPs in the NHS in England. This was 761 fewer than in December 2019, when the Tory manifesto promised an extra 6,000 GPs by 2024.

“More GPs now work part-time, saying the job is unmanageable full time. A report by the Nuffield Trust said that the NHS had to train two GPs to produce one full-time family doctor as a result. In a survey by the Royal College of GPs, 37 per cent said they were unlikely to still be working in general practice in five years. Five per cent said it was likely their practice would close, or hand back its contract, in the next year” (Emma Taggart and Kat Lay, ‘Rise of the month-long wait just to see your GP’, The Times, 16 December 2023).

Just as GPs are over-reaching themselves attending to an increasing number of patients every day in an attempt to give their patients whatever care they need, hospital doctors too are trying to respond to the crisis that has been brought down on their heads to try and do the best they can for their patients.  The Times of 10 December 2023, for instance, has reported that surgeons at Guys and St Thomas’ Hospitals in London have instituted a form of conveyor belt surgery for dealing with routine cases which has turned out to be remarkably effective:

“Surgeons at one London hospital are performing an entire week’s operations in a single day as part of a ground-breaking initiative that could help tackle the record waiting lists in the NHS.

“Guy’s and St Thomas’ NHS Foundation Trust has already slashed its own elective backlog in certain specialities by running monthly HIT (High Intensity Theatre) lists at weekends.

“Under the innovative model, two operating theatres run side by side and as soon as one procedure is finished the next patient is already under anaesthetic and ready to be wheeled in.

“Nurses are on standby to sterilise the operating theatre and instead of taking 40 minutes between cases it takes less than two, the only delay is the 30 second it takes for the anti-bacterial cleaning fluid to work.

“Kariem El-Boghdadly, the consultant anaesthetist who designed the programme with his colleague Imran Ahmad, compares it to a Formula One pit stop. ‘They’ve got one person doing the rear right wheel, one person doing the front left wheel. It’s the same thing. The operating theatre is effectively like that.’

“The lead consultant surgeon ‘is bouncing from one theatre to the next doing the critical phase of the operation with more junior surgeons assisting, he added.

“At St Thomas’ hospital on Saturday, a third of the gynaecological oncology backlog was cleared in a morning during the latest HIT list. The surgical team got through 21 operations on 20 patients and finished by lunchtime. Normally they would do six such procedures and be working all day. All the operations were diagnostic, to find out whether the patients had signs of cancer.

“There were two teams of theatre staff on duty, including six surgeons, four anaesthetists and 18 nurses. By 10am the surgical team were on their 13th operation. One patient had already gone home, two more were in surgery and another couple were being prepared in the anaesthetic room. ‘We’re flying through,’ said Ahmad, the consultant anaesthetist. ‘We’re not rushing, we’re being efficient’” (Rachel Sylvester, ‘London hospital cuts waiting lists with innovative system’).

It should be noted that this initiative came from doctors, not from overpaid non-medical administrators, and that the doctors and nurses involved in bringing such much-needed relief to patients are giving up weekend days that might otherwise have been spent with their families in order to provide this service.  In other words, it is only the selfless dedication of doctors and nurses that keeps the NHS functioning in spite of government attempts to bring it to its knees the better to deliver it to privateers.

Nevertheless, despite the heroic efforts of medical staff, deaths over the past year have been 15 per cent above normal in those aged 50 to 64. The signs are that this rate cannot but increase in the near future. Nobody can be sure that it won’t be you or yours who will be next. So when your middle-aged family member dies, such as Dad in the prime of life, because of untreated diabetes or heart disease, this effectively amounts to premeditated murder committed by those who are recklessly dismembering the NHS. The booze-ups partaken, the mounds of McDonalds and chips, or various equivalents, may well have been the cause of illness, but the unnecessary death will still be purely attributable to the unavailability of medical treatment when it was needed. The money-grubbing privateers and the bourgeois governments, Labour as much as Tory, who work to forward their interests must not go unpunished.

In the meantime the only advice we are given in this uncaring bourgeois world is, in the style of Marie Antoinette, to ‘Let them go private’!

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