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Covid: is it just a ‘feeling’, or is the NHS actually in danger of being overwhelmed?

07 January 2022

THE influence that party politics has over health policy ought not to be a surprise. After all, the funding of the NHS, its size, structure, staffing, and pay are all directed by the Government of the day. The ability to provide more hospitals with the money supposedly bound for the EU was a persuading factor in the Brexit vote, readers will recall. In the light of this, the Government’s declaration early in the pandemic that policy would “follow the science” came as an exception to the norm, albeit a welcome one. How quickly it followed, and how thoroughly, will be the chief concern of the public inquiry under Baroness Hallett, a retired Court of Appeal judge, which starts its work this spring.

Those who pressed for an early inquiry argued that its lessons were needed to inform the future management of the Covid outbreak. The Prime Minister resisted, arguing that those in the front line of dealing with the pandemic ought not to be distracted by having to account for past actions. The fact that the inquiry was likely to shine a light on his own poor performance was presumably a disincentive, too. The Omicron outbreak, however, is an indication that delaying the inquiry was another poor decision on Mr Johnson’s part. The management of Covid-19 will continue to dominate policy for months to come, even if no new variant appears, and definitive judgements on how best this should have been — and should be — done could be critical.

In the mean time, all now seems to hinge on the definition of the word “overwhelmed”. Mr Johnson promised to introduce more restrictive measures if the NHS was in danger of being “overwhelmed” by the spread of the latest variant. On Tuesday, he acknowledged that parts of the NHS would “feel temporarily overwhelmed” because of the sharp rise in hospitalisations together with staff absences because of infection. He offered no explanation of the difference between “feeling” and actually being overwhelmed, but there was clearly enough of a difference in his mind to justify inaction. Yet, as the number of Covid cases continues to grow (even if a peak has been reached in London, sharp increases are expected in the rest of the country), on top of the usual winter pressure on hospitals, the ability of medical staff to cope with the number of admissions is going to be seriously challenged — as evidenced by the declarations of “critical incidents” by NHS trusts. Patient safety is at risk, not to mention the thousands of people who would be patients had their treatment not been postponed.

A telling observation came from Sakthi Karunanithi, director of public health for Lancashire, who said on Tuesday that, from his perspective, the Government was using science as “a side dish that we can pick and choose”. Mr Johnson spoke on Tuesday of finding a way “to live with this virus”. Voices within the NHS and the care-home sector are again warning that people are in danger of dying — if not of the virus, then because of it.

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