An analysis of NHS data reveals shocking backlogs of postponed operations, while junior doctors and the British government are still fighting over pay. Can the next strike help in the long run – or will it only make matters worse?
The British NHS truly is in shambles, it seems – the bad news won’t stop coming. An analysis of NHS data obtained by the Liberal Democrats reveals that a record-breaking 14,628 pediatric operations had to be postponed or cancelled in England over the last year. That’s 2,758 more than in 2021. Thus, thousands of children experience unacceptably long waiting times – some individual patients have even waited more than a thousand days for their surgery, the data reveals. This might still only be the tip of the iceberg as only 77 of 219 NHS trusts provided their complete data.
The President of the Royal College of Pediatrics and Child Health, Dr. Camilla Kingdon, warns that this mounting backlog could lead to serious consequences for the affected children: “For children and young people, many treatments and procedures need to be given by a specific age or developmental stage. Missing the right window to treat a child or waiting too long can have a lifelong impact on a child’s healthy development.” The result might be even more medical care being required further down the road. Delaying interventions could also have concerning knock-on effects on the childrens’ ability to socialize and go to school. “The decision to cancel operations and procedures is an extremely difficult one for pediatric teams”, says Kingdon.
The figures are bad enough as is. Now, the second walkout by junior doctors is set to worsen the problem. Starting today, junior doctors will strike for four consecutive days, which could result in around 250,000 appointments and operations needing to be rescheduled. This won’t affect just pediatric procedures, but pretty much all patients in England: As in their first round of strike action last month, the British Medical Association (BMA) chose not to offer any exemptions for any areas of care, to increase the disruption and thus the pressure on the English government. As a result, remaining resources will be focused on emergency cases – elective surgery patients will have to wait.
Speaking to the The Guardian, three senior cardiologists at Royal Brompton and Harefield hospitals and St Thomas’ hospital in London urge the BMA to at least exempt areas of life-and-death care from the strikes, just as the Royal College of Nursing did when it pursued industrial action in December (DocCheck reported). They warn that some critically ill patients will “inevitably die” due to delaying hundreds of elective procedures. “We cannot, in all conscience, stand by and just let this happen without advocating for our current and future patients”, says Dr. Richard Grocott-Mason, Chief executive of Royal Brompton and Harefield specialist heart and lung hospitals.
Those patients – referred to as “P2s” – are the NHS’s second highest priority group who need surgery within 28 days. In the cardiological field it encompasses patients with extensive coronary artery disease, severe aortic stenosis or aortic aneurysms, for example. The longer they wait, the higher their risk. “These patients are sat waiting for an unpredictable and potentially fatal cardiac event to happen”, explains Dr. Mark Mason, medical director for heart, lung and critical care at St. Thomas’ NHS trust. “It is no exaggeration to say that delaying surgery for this group will result in harm”, affirms Grocott-Mason.
The cardiac experts urged both the government and the BMA to hold talks to avert the strike. Dr. Mario Petrou, Brompton and Harefield hospitals’ clinical director for cardiovascular services states: “This isn’t about taking sides. This is a dispute between the unions and the government. But as an advocate for patients and consultant of 20 year standing, it’s extremely distressing to know that […] I won’t be able to carry out these operations.”
The first walkout of junior doctors last month (DocCheck reported) already led to 175,000 outpatient appointments and operations being cancelled in England – on top of the already existing backlog. That one is not on the Unions’ industrial actions, however: these numbers are a result of the general workforce crisis the NHS finds itself in. The very crisis the strikes seek to end. As a result of continuously worsening working conditions and dwindling real term pay, healthcare professionals have been leaving the sector in droves.
The result are staff shortages, which account for a sizable chunk of cancelled operations. Of the aforementioned nearly 15,000 pediatric surgeries, 2,894 had to be cancelled due to a lack of staff. A further 4,000 were postponed due to a lack of available hospital beds; 1,100 due to a lack of operating theatre time. Opposition politicians blame the current government, as it has been repeatedly warned about these issues. Liberal Democrat leader Sir Ed Davey calls the “shocking scale” of cancelled pediatric operations a “badge of shame for this conservative Government”. He puts it bluntly: “Years of neglect by this government have led to chronic staff shortages and a lack of hospital beds, with communities across the country paying the price.”
If the British government is committed to its declared goal of cutting waiting lists and growing the healthcare workforce, it is now under more pressure than ever to resolve the current pay conflicts with the healthcare unions. The BMA has broken off talks with health secretary Steve Barclay and blame ministers for the strike this week, as no “credible offer” was put forward in response to the junior doctors call for a 35 % pay rise. BMA spokespersons said: “We are not going to stop until we are paid what we are worth.”
However, their defiance might pay off. Nurses’ and ambulance strikes already made a difference: The government budged on its previous stand that this year’s pay deal would not be reopened and that any pay rises for the next year would have to be funded through efficiency savings and reprioritizations in existing NHS budgets. Instead, they offered the Royal College of Nursing and other health unions a pay rise of 5 % from April on plus a one-off bonus payment of up to 8,2 % for this year. For this, new money would be made available, the Treasury confirmed.
Will this offer be enough? That remains to be seen. And only time will tell, whether the BMA and the British Government can settle their dispute and avert any further strikes and patient harm.
Image source: Kamran Abdullayev, Unsplash
