The Government’s plan to divert billions of pounds away from hospitals will put lives at risk, experts have warned – and could worsen conditions in struggling A&Es.
Wait times at accident and emergency departments across England and Wales are at an all-time high – with more than 1.5 million patients forced to wait at least 12 hours before being seen by a doctor last year.
But Health Secretary Wes Streeting revealed earlier this year that Labour would not be injecting more money into struggling hospitals.
Student nurse Zoe Bell died after 12 hours waiting in A&E
Instead he plans to ‘shift the focus of the NHS out of hospitals’ – by redirecting a portion of the existing funding for acute care centres to GP practices.
Now medical professionals are warning that this plan could be disastrous for an already damaged health service.
Last week, Mail on Sunday columnist and GP Dr Ellie Cannon described inundated A&Es, and shared a story about a patient of hers who had to be treated in an ambulance because the A&E unit was too busy. Dr Cannon asked readers how their local hospitals were coping – and we were flooded with emails and letters.
One reader, Sheila Poole, described spending 20 hours waiting in casualty for her seriously unwell husband to be admitted to a ward.
Another said that once she didn’t even attempt to bring her 89-year-old father to hospital after being warned by paramedics they would be stuck in the ‘noisy and chaotic A&E for days’.
And Professor Julia Lawton’s 82-year-old mum waited in an A&E in Liverpool for 33 hours before she was found a proper bed – despite having multiple blood clots in her lungs.
‘For those 33 hours she was unable to sleep and scared – we knew that something was seriously wrong with her,’ Prof Lawton said. ‘You expect this sort of problem in December and January during the height of flu season, but to have a system that is so congested at the end of September is truly scary.’
These testimonies come just weeks after a 28-year-old student nurse was found to have died of sepsis after waiting in A&E for almost 12 hours. Zoe Bell, from Buckinghamshire, had been taking on extra shifts to finance her studies when she fell ill. Despite coughing up blood in the A&E waiting area, Zoe was left there all night – and died of heart failure the next day.
In another case, 39-year-old Inga Rublite died this year after waiting more than eight hours in casualty at Queens Medical Centre in Nottingham. She was found on the floor by staff the next morning, huddled under her coat.
‘Every winter over the last decade the danger has been that NHS A&Es could become overwhelmed,’ said NHS intensive care consultant Dr Ron Daniels. ‘And if Labour disinvests from hospitals, that will become an ever more real threat.
‘All it will take is a bad season of flu and the fragility of the NHS acute system will become exposed.’
Inga Rublite, right, died this year after waiting more than eight hours in casualty at Queens Medical Centre in Nottingham
A&E waiting times are considered a key barometer of health service performance – with treatment delays associated with increased mortality and illness.
In the early 2000s, Labour introduced the four-hour standard, which set out that 95 per cent of patients should be admitted, transferred or discharged within that time frame.
But the NHS has not met the four-hour standard since 2015 – with waiting times steadily increasing over the past decade.
And since the Covid pandemic, long wait times have spiked even higher. Data from the health think-tank the King’s Fund shows a rapid increase in 12-hour or more waits for admission – with more than 140,000 waiting in emergency units for more than 12 hours in March this year compared to just 1,400 in 2019.
Stagnating A&Es have in turn led to an increased number of people being given emergency treatment in ambulances parked outside hospitals.
Close to one in four ambulance patients waited more than an hour before being admitted to A&E last year – which, in turn, caused longer ambulance waiting times.
In a landmark independent investigation released this summer, the Labour peer Lord Darzi deemed the NHS to be ‘in critical condition’ amid surging waiting lists and an overall deterioration in the health of the nation. The report pointed to four interrelated causes for the Health Service’s steady decline: austerity and funding constraints, the impact of the pandemic, a lack of patient voice and staff engagement, and inadequate management structures and systems.
Lord Darzi also highlighted a £37 billion capital spending shortfall over the past 15 years, meaning that the Health Service was failing to renovate hospitals, expand facilities or buy medical equipment.
The UK has the lowest number of hospital medical scanners per million people compared to any other developed nation. This means patients wait longer to undergo crucial scans. Experts say long casualty wait times are the result of these pressures – with the pandemic further pushing hospitals to crisis point.
‘There are long waits in emergency departments because hospitals are now too full – and are unable to discharge people quickly enough,’ explained Dr Adrian Boyle, president of The Royal College of Emergency Medicine (RCEM).
‘As a result, we spend a long time waiting for beds to become available – and patients spend a long time waiting in A&E.’
Yet despite the growing crisis, Labour has refused to commit to investing further in NHS hospitals. Following Lord Darzi’s report, Sir Keir Starmer said the NHS would receive ‘no extra funding without reform’.
Meanwhile, Conservative government plans to build 40 hospitals by 2030 have been shelved.
And speaking on his first official visit to a GP practice, Wes Streeting promised to divert billions of pounds from hospitals to primary care practices to improve preventative care and potentially reduce pressure on A&Es.
‘My first visit as Health Secretary was to a GP practice because when we said we want to shift the focus of the NHS out of hospitals and into the community, we meant it,’ said Mr Streeting.
Health Secretary Wes Streeting revealed earlier this year that Labour would not be injecting more money into struggling hospitals
‘I’m determined to make the NHS more of a neighbourhood health service, with more care available closer to people’s homes. Because if patients can’t get a GP appointment, then they end up in A&E, which is worse for them, and more expensive for the taxpayer.’
Pledging to deliver a ‘prevention first’ revolution, Labour hopes to stop public spending for the NHS rising in the long term by treating health conditions early.
In January, the party announced plans to introduce supervised tooth brushing in schools for children aged three to five-years-old as part of its scheme to boost the health of all youngsters.
And over the past few months, other proposed preventative tactics have ranged from promising better GP services to disincentivising cigarettes by banning smoking in pub gardens and outside schools.
But experts warn that cutting funding from hospitals risks exacerbating a system that’s already under serious pressure.
Dr Boyle of the RCEM says: ‘While we strongly support the need for improvements in primary care services, including GPs, developments must not take the focus away from the dangerous crisis happening in emergency departments across the country.
‘We currently have the second lowest number of beds per head in Europe and nearly one in ten people are spending 12 hours or more in A&E. As the Darzi response stated, emergency care is in “an awful state”.
‘Action to tackle this must acknowledge and prevent the thousands of avoidable deaths each year that are linked to extremely long A&E stays.’
Dr Daniels, who also acts as executive director of the UK Sepsis Trust, agrees.
‘While I fully support a move toward preventative medicine, I’m sceptical that a reinvestment in primary care services is going to be truly preventative,’ he said. ‘Hospitals are already massively challenged. They can’t recruit enough doctors and nurses and we have huge waiting times for elective surgeries.
‘We’re already missing diagnoses because of the high patient case-load and a lack of skills amongst healthcare workers.
‘Until we fix all facets of the healthcare system, what’s seen as a quick fix could actually make the problem a whole lot worse.
‘We risk losing the ability to guarantee rapid care to the sickest patients. Sadly, this will mean almost rationing care.’
Devastatingly, some are already falling through the cracks.
Just last week, a coroner found that a woman who spent 39 hours on a chair in a busy A&E unit waiting for a hospital bed, died of neglect which was entirely preventable.
Marina Young, 46, was suffering from an acute asthma attack when she was taken to the Royal Preston Hospital in Lancashire.
Doctors quickly realised she would need to be admitted – but the hospital was full, with more than 50 people waiting in A&E for a bed on a ward.
Instead, Marina spent two nights in a chair and – at around 10am the next morning – she was found dead, still fully clothed and wearing her shoes. Her sister said she was even soaked in her own urine.
A senior doctor had ‘refused’ to see Marina for five hours after a senior nurse had asked them to, despite tests revealing her illness was in a ‘life-threatening category’, the coroner said.
To prevent such tragedies, Dr Boyle says hospitals need to be funded alongside primary care services – and more work must be done to improve social care so that patients can be discharged more quickly.
‘There needs to be social care reform so that patients can go home,’ he says.
‘People stay in hospital for a long time after they should be discharged, which is particularly bad for old people who risk picking up illnesses on the wards.’
A Department of Health and Social Care spokesman said: ‘We’ve inherited a broken healthcare system that has failed patients and staff for too long – and we are committed to growing the proportion of NHS resources going to primary care services.
‘If patients can’t get a GP appointment, they end up in A&E, which is worse for them, and almost ten times as expensive for taxpayers. We will reform the NHS and shift the focus of healthcare into the community so that more patients can be treated without going to hospital.’
