The NHS was a national treasure – but not any more

I love the NHS and with good reason: it saved my dad’s life twice, it saved my friend’s sight; and two weeks ago, it saved the life of my friends’ five-year-old daughter. At its best, the NHS is remarkable. But the post-pandemic NHS is anything but. It was this side of the health service – stressful, inefficient and downright upsetting – I experienced when I waited hours for urgent treatment for chest pains last week. It's also a side of the NHS more and more Brits are seeing, as waiting times soar and hospitals resemble war zones.

Is that an exaggeration? The A&E waiting room in Ashford was certainly no advert for the NHS. A lady who had burned her hand on hot oil and winced in pain waited for hours to be seen; a young girl in tears had to be brought a bowl in case she vomited; an elderly lady, hospitalised after a fall, lay on a trolley moaning in pain in front of the entire waiting room. Paramedics hunted in vain for more comfortable transport for her but none was available; in the end, another patient was asked to give up his wheelchair for her. When it was returned, he tried to struggle back into it alone, as there was no nurse in sight; he plainly could not, and it fell to another patient to help him.

As someone who has suffered from an irregular heartbeat for much of my adult life, I am no stranger to hours spent in NHS waiting rooms full of incapacitated people. But it is hard to witness suffering, especially when it seems avoidable. By the time I was eventually seen, now also wildly anxious, I was on the verge of tears. And guess what? I didn’t need the blood tests. The doctor concluded that my symptoms were the result of something else entirely. Had my GP seen me himself instead of phoning me, he would doubtless have concluded the same thing.

Few would agree that this constitutes ideal or even satisfactory care; but why is it happening? Is it down to underfunding? According to OECD data, the UK spent 10.4 per cent of GDP on public health in 2020, more than every other country measured except Germany and the United States. Understaffing? Certainly: the NHS has lost the equivalent of almost 1,600 full-time GPs since 2015, according to the British Medical Association. 

But there also seem to be issues of efficiency and approach – of a disorganised bureaucracy in which not only does the right hand not know what the left hand is doing, but all ten digits seem to be doing their own thing. 

What is the point in GP surgeries sending me and two other patients I spoke to in the waiting room to wait for hours to be reassessed by a different GP? Why are our GPs either not seeing us themselves, or not just sending us straight to the phlebotomy department? 

Why were the parents of a baby with conjunctivitis spending most of their evening waiting to be seen when all that was needed was surely a routine prescription? Why was the clearly anxious mother of a child with a 40C fever sent to the urgent care unit by NHS 111, only to be told she had been misinformed and was in the wrong place? Why is an urgent care unit half full of people with neither minor injuries nor medical emergencies? Shouldn't they be dealt with through routine GP care so that those who do need urgent attention are not left waiting in discomfort and pain?

I will defend the principles on which the NHS is run – care free at the point of use, with no regard to who you are, your wealth or status – forever. When my irregular heartbeat started, I had just lost my job; I dread to think what would have happened under a different system; one where I might have decided that going to A&E that first, frightening time, when I was not sure there was really anything wrong, was not something I could afford. I am an ardent enough supporter to have campaigned for a single-issue pro-NHS political party in the 2015 general election.

But to believe that the NHS does not have serious problems, you would have to be deluded. In February 2020, 4.43 million people were on an NHS waiting list. In February this year, the figure was a record 6.1 million, two million of whom have been waiting more than 18 weeks. 

Cancer targets are being missed; A&E targets are not being met. A survey by the gp-patient.co.uk website found that, at my own surgery, almost one in three patients say they do not find it easy to get through on the phone; only one in five usually get to see or even speak to their preferred doctor.

'If you are ill enough, you’ll wait', or 'It’s better than having to pay' are the responses one often hears to criticism of the NHS. But these are not, or ought not to be, the choices that face us. 

The golden principle of free care at the point of use does not outweigh the equally golden principle of timely and dignified care. Not paying in money does not make it okay to pay in time, lost wages from hours spent waiting to be seen, stress, anxiety or unnecessary discomfort. 

I am loath to make such public criticism of the NHS. I do not want it seized upon by those who claim that somehow asking people to pay directly for care will make everything better. But I am also aware that the NHS needs tough love if it is to survive. Being unwell or injured enough to need medical attention is bad enough in itself. The last thing your treatment should do is add to the misery.