Under the cover of Covid-19, why is the NHS moving away from its founding principles?

The warning by a senior health chief that the NHS won’t be the same as before, raises concerns that we’re being conditioned to accept a service which no longer meets all our health needs.

‘Protect the NHS’ has been the slogan of 2020 so far in the UK. It’s ostensibly all been about Covid-19, but could there be another agenda?

Back in March, the NHS did two things. There was a major hospital inpatient discharge programme, to make way for a deluge of Covid-19 patients which in the end never materialised. 

And there was also the cancellation of ‘non-urgent elective operations’ to take effect from April 15 at the latest, to last for three months.

The impact of both of these policies seems to have been disastrous. The combination of people being (a) encouraged to ‘protect the NHS’ by not using it for non-Covid problems and (b) patients being too scared to go to doctors’ surgeries and into hospitals because of fear of being infected with the virus, has created a huge backlog of cases.

Dr. Karol Sikora, a leading oncologist, estimates that around 20,000 cancer diagnoses were missed in April alone, going by the usual monthly averages.

Now, as we head towards June, and with the UK government’s deputy chief medical officer reporting a couple of weeks ago, “long, steady declines in admissions and the proportion of critical care beds occupied by Covid-19 patients,” you might think that it would be time to start getting our usually excellent health service back to normal. But it isn’t.

Earlier this week, Saffron Cordery, deputy chief executive of NHS Providers, a body which looks after NHS Trusts in England, said that while it was “absolutely imperative” that the NHS got started again, added: “We’ve got to be clear that’s going to come relatively slowly and it’s not going to be the service that people had previously.”

Cordery cited concerns over PPE supplies for staff, and linked the return of the NHS doing non-emergency work to a government Covid-19 Test and Trace programme being in place.

READ MORE: I've just opened a box of expired PPE with a new date stuck on it. As an NHS doctor, I never used to believe in conspiracies...

But while we all want to make sure hospital staff are as safe as possible and that hospitals themselves are safe for patients, the idea that non-emergency work is conditional on surveillance represents a significant moving of the goalposts. Remember, the aim of the hospital bed clearance programme and the suspension of non-urgent operations was to “free up” capacity for Covid-19 patients and to stop the health system being “overwhelmed.”

Now, even though the deluge never came (in April, it was reported that NHS hospitals had four times as many empty beds as normal), people are still being denied treatment. I have lost track of the number of people who have told me that they, or family members, have had hospital appointments cancelled. For the last two months, we haven’t had a National Health Service, but a National Covid-19 Service.

The worry is that Covid-19 is now being used as a cover to introduce longer-term reductions in services which the patients have never given their consent to – and which are against the public interest. In my last article, I highlighted how unfounded fears about the virus spreading on coins and notes have been used as a pretext to accelerate the moves towards a cashless society.

In addition, Saturday letter deliveries have been temporarily suspended in the ‘Age of Corona’. Will we ever get them back?

There are also concerns that the public library network, already threatened with cuts pre-Covid, will not return in the same form with local authorities facing bankruptcy. And is ‘Protect the NHS’ being used to get us accustomed to an NHS which will actually do a lot less than before – and thereby push people into the hands of private health care?

Let’s remind ourselves of the NHS’ three founding principles: 1. That it meets the needs of everyone, 2. That it be free at the point of delivery, and 3. That it be based on clinical need, not on the ability to pay.

We can see that not all of these are currently being adhered to. The NHS at present is not meeting the needs of everyone – and the care people are receiving, or more to the point not receiving, is not based on their clinical need. It’s worth adding that additional principles were added in July 2000. They included one to “provide a comprehensive range of services.” Again, that’s not being fulfilled at the moment.

READ MORE: UK government’s callous disregard for care home residents – old, sick people acutely vulnerable to Covid-19 – has been a disgrace

Most people appreciate that because of the virus, the NHS would be under special pressure, and no one has anything but praise for hospital workers, but the notion that Covid-19 should mean a reduction in the range of work the NHS does, and a move away from its original principles, cannot be accepted.

The NHS was set up to serve the British public, and not the other way round. But it seems that in the crazy world of 2020, everything is ‘Through the Looking Glass’.  

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