People are dying waiting for treatment - can the NHS cope with rising demand?
In the first of ITV News' pieces exploring the top five issues Britain faces ahead of the General Election, Investigations Editor Dan Hewitt looks at problems impacting the NHS.
Ten years ago, I held my mum’s hand as she passed away.
She had lived with cancer - stage four, aggressive breast cancer - for almost five years.
She died at home, in her bed, surrounded by those that loved her most. My mum - Diane - was 56.
A decade on, it still haunts me. I never talk about, and have certainly never written about it. It is in every sense of the word the worst moment of my life.
The treatment she received on the National Health Service (NHS) was first class. They prolonged her life and gave her precious time she would not have had 20 years previously.
Nothing could have been done to save my mum. There are no questions left unanswered, no one failed her.
Last week I sat in the living room of a woman in Chester whose partner had recently died. Julian was 59, roughly my mum’s age.
He and Lesley had been together for 18 years. They were engaged. There are pictures of them all over their house.
Lesley was distraught, devastated, in the deepest depths of raw grief. She was also angry.
Julian didn’t die peacefully at home. It wasn’t expected.
On January 11th, just after 3pm, he experienced chest pains while on a work call at home. He called 999, and then messaged Lesley, who rushed home from work.
Neither of them knew it, but Julian was having a heart aneurysm. He needed help, and fast.
Every second counts with heart attack like symptoms, but as the minutes passed, there was no sign of an ambulance. Lesley called 999 again, and again. Julian was deteriorating.
As day turned to night, eventually the paramedics arrived - 90 minutes after Julian first called.
He was taken to hospital, but it was too late. He died that evening.
“We went straight into the hospital, into the resuscitation area, and Julian said he felt sick,” Lesley tells me, four months on.
“I had my arm around him, and reassured him.
“Then he sad he felt faint. And then he died.
“I’m angry that an amazing, wonderful man, never had the chance to fight for his life. He should have been in theatre, being operated on, and given a chance.
“I miss him dreadfully, and I feel that everybody that dealt with him that day failed him.
“Our health service is broken.”
Would Julian have survived? We don’t know for sure.
We do know that emergency calls like Julian’s, should be responded to within a target time of 18 minutes. Julian waited 90.
Lesley is left to live with a big question mark of Julian’s death. Did the NHS fail him? She certainly thinks so, and it’s made the loss that much greater - she cannot find peace.
Ambulance response times in England are consistently being missed.
In January, the month Julian called 999, NHS England data shows the average response time for category 2 calls, which includes suspected heart attacks, was 40 minutes.
In April, it improved slightly to 30 minutes. In 2019, the average response time was just under 23 minutes.
As part our coverage of the General Election, I am travelling around the UK looking into the issues that matter most to voters.
Healthcare is number one on the list of what matters most to voters, with 35% of people saying the NHS is the most important issue this election.
In the last few days, I have met patients at hospital and in GP surgeries, doctors and nurses, from across England.
Every single one expressed grave concerns about the state of the NHS and questioned its future. Not one said they believed the NHS was in a healthy condition.
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We were invited to spend a day at Ipswich General Hospital. Wherever you are in the hospital, it is extremely busy. There is a constant demand for staff and for space, and there is a serious shortage of both.
Chatting to patients, they all observe the same thing.
The care is superb, but the staff are overworked and there’s not enough of them.
“The nurses, the doctors, they need more money,” said Maureen, an inpatient who had been in the hospital for over week.
“They definitely need something.”
East Suffolk and North Essex NHS Foundation Trust, which runs Ipswich Hospital, has seen a 25% increase in the patients attending Accident and Emergency since 2019.
“We used to talk about winter pressures in the NHS, now winter is a 12-month period,” said Consultant Dr Lauren Hoare.
“I’m struggling to recruit consultants because I think sometimes they look at us and they think, I’m not sure I want to do that with my life.
“It certainly feels as bad as it ever had been, in my experience. The Covid pandemic, industrial action, trying to see if we can cover as many things as we can with a dwindling number of staff.
“Waiting times are getting longer by the day.”
The waiting list for treatment on the NHS in England now totals 7.5 million. Ten years ago it was three million.
The chief executive of the trust says the demand on the health service is not sustainable. He tells me now is the time for a debate about the role of the NHS in modern Britain.
“Is the NHS ready to look after a frail, old, population? I don’t think it is,” said Nick Hulme, Chief Executive of East Suffolk and North Essex NHS Foundation Trust.
“In truth I don’t think the NHS can continue to soak up the huge demand we’re seeing.
“The NHS was designed in 1948. Life expectancy was 68. We do need to step back, and we do need to see if the NHS is fit for purpose.
“We need planning for the next generation, not the next election.”
More people waiting for hospital treatment is placing pressure on GP surgeries, as people are living in pain and need to see a doctor while they wait.
We travelled 300 miles north of Ipswich to the Lancashire town of Fleetwood to spend the day with Dr Adam Janjua at his surgery.
Unlike Accident and Emergency, the waiting room is not bursting with patients. They have an online and telephone booking system, that staggers appointments throughout the day. It’s busy though, and as I chat to those waiting it’s clear what they think of the state of the health service.
“You used to be able to ring up in the morning and get an appointment that day, but now it’s almost like a game, a battle,” said Jan, who was waiting to see the GP.
“If you don’t hit the phone straight away, you’ve got no chance.”
I am invited to sit in on a few appointments. They range from arthritis pains to blood pressure checks to diabetes assessments.
I join Dr Janjua’s for an appointment with Phil, a pensioner who had just had a knee operation. He had to wait over a year for it, and the post-operation check is having to take place at here, because the hospital can’t fit him in.
In April 2019, there were 22 million GP appointments in England. Last month, there were 30 million.
Dr Janjua tells me he receives £165 for every registered patient, an increase of less than £10 since 2019.
If funding had risen in line with inflation, he would now be getting £192 per patient
“If the NHS was a patient, it’d be in a critical condition,” said Dr Janjua.
“We’ll be lucky if we have General Practice as we know it within a couple of years unless things change dramatically.
“There’s been sustained under-funding of general practice over several years.
“If we don’t get a sustained and sizeable amount of funding injected into general practice itself, I don’t see how it’s going to be sustainable. You’re going to see more and more practices closing.
“We’re in a paradoxical situation where you have unemployed GPs at the moment, but nobody can afford to hire them."
We all hope the NHS will be there when we need it, but an increasing number are having to wait, and some are not getting it at all.
One observation I made travelling around the country was the lack of faith in politicians from any party to fix it.
I felt a growing acceptance that there needs to be a national conversation about what the NHS is capable of.
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