What would politicians do if 19 jumbo jets crashed in a single year?

Very occasionally, a catastrophe of epic proportions occurs which politicians can claim was truly unprecedented. They can dress in sombre suits and take to the airwaves with careful words and a careful stance, to provide an image of strength and stability in the face of disaster.

More frequently, however, as new information comes to light, we find that these catastrophes weren’t unprecedented at all. They were in fact entirely predictable; the culmination of years of neglect and underfunding - of a thousand political decisions adding up to put the public in harm’s way.

As I’m typing this, I’m thinking about the Grenfell fire; an inexcusable human tragedy, one which lit up the sky with the reckless and callous behaviour of the ruling classes…

But there are of course many other examples, and perhaps another is on your mind right now. And I’m sorry, because this is a horrible, desperate thing to talk about on a day in June- but we need to talk about another crisis immediately. It’s a crisis which is unfolding right under our noses.

This situation hasn’t come out of nowhere, with the shock of a plane crash (although if you calculated the number of people involved, they could have filled almost 20 jumbo jets in 2025 alone).

No- this is much more insidious. It is the daily crisis unfolding in local communities all over the country, the appalling, terrifying crisis unfolding in our A&E departments.

We must ring the alarm about what’s going on immediately…

A new report has come out from the Royal College of Emergency Medicine (RCEM), and here’s a quote from the press release they issued:

As a doctor by background, I often wish that healthcare experts could be more dramatic in their descriptions about what’s going wrong in the NHS. I often wish that words could be found to truly convey the horror when crises occur. As a group, us medics become so hemmed in with statistics and probabilities, and with the fear of scaremongering, that we don’t do a good job at alerting the public when disaster is imminent.

But this quote, from RCEM, needs no bombast or sky-high lettering to spell out its meaning. Last year, there were 305 avoidable deaths *per week* in emergency departments in England, linked to long waits. The number has come down slightly from the year before, but compared to a decade ago, the figures have multiplied by 10.

Despite RCEM and others talking about this relentlessly, publishing reports and speaking up, our politicians fail to act appropriately. Despite reams of recommendations, quotes in the press about the scale of the problem, and the gathering and publication of heartbreaking testimony from healthcare staff working in these departments, our elected representatives in parliament fail to act appropriately.

Despite the A&E departments creaking under pressure, social care collapsing under the weight of need, and “corridor care” becoming normalised in our hospitals, still the politicians act slowly and ineffectively to fix the problems…

And crucially, this isn’t a problem isolated to our A&Es. Despite the best efforts of various politicians, the problem cannot be pinned to one group of incompetent staff, or one group of patients who are attending the emergency departments ‘inappropriately'. It is a system-wide problem, culminating in deaths at the front door of our hospitals.

A&Es are not stand-alone facilities. They are an intrinsic part of the hospital pathway, providing a filter through which very unwell patients pass, and they often serve as the canary in the mine when the service isn’t functioning properly. When a patient arrives at an emergency department by ambulance, or of their own accord, they must be safely processed through that department as efficiently as possible. They’ll receive the urgent treatment they may require by the Emergency Medicine specialists, and then either be discharged home, or admitted for further treatment.

The pressure within the A and E department itself is influenced by various factors: number of staff, their relative experience and exhaustion levels, the number of patients turning up. However, by far the most crucial factor in all these variables is the ability to move patients on and admit them to a hospital bed.

A&Es are often overcrowded because of pressure elsewhere in the system. Hospital beds have been cut over the years by canny politicians seeking to make “efficiency savings”, which mean that our healthcare facilities run at a capacity which doesn’t allow for the natural rise and fall of patient demand.

Politicians have told us for many years that they’ll “fix the social care system” too, and then they haven’t. There have been endless delays, which has led to far too many people being stuck in hospital once they’re better. Those people are unkindly referred to as “bed-blockers”, as if they’re to blame.

RCEM’s new report spells out the extent of this problem - here’s a quote:

“Hospital occupancy is driven in part by keeping patients in hospital who don’t need to be there. On average 12,906 patients per day were medically fit for discharge but remained in hospital, restricting bed availability and patient flow.”

When the emergency department is busy, there’s often a delay for a hospital bed to be found (sometimes a very significant delay). This delay is not neutral, it’s not like waiting at a bus stop. Patients cannot simply be “patient”. Many treatments for extremely sick people are time-critical. On many occasions, a delay can be dangerous.

When the A&E is busy, ambulances struggle to drop patients off, as frequently, there is no one to hand over to, or no space to offload a new patient. This means that care is happening in inappropriate places, and it also means that ambulance resources are occupied at the hospital, rather than getting back out on the road to attend to new patients (which is why ambulance response rate have deteriorated so enormously in recent years).

So what does all of this mean? Well it means that tackling the problems in the NHS is a complex task - one requiring proper thought and design, from people who know the system intricately and could re-design things to put patients at the forefront of all decisions. And for many years, healthcare experts have been offering to assist politicians to do just that. They understand the problems and they have offered solutions.

Here are some of the recommendations that RCEM have made to the government in their new report. I’m sharing them here because I am constantly, wrongly, accused of not suggesting solutions by trolls online, and it’s important to demonstrate that these solutions are being shouted from the rooftops by healthcare experts:

So why aren’t the politicians acting on these recommendations? If we know what’s happening, and we know how many avoidable deaths are occurring, then why have they gotten away for so long without sorting this out?

Unfortunately, I think that politicians have got away with this simply because they’ve always got away with this. Every time a group of politicians comes in, they tells us all they intend to “fix the NHS”; but, inevitably, their fixes do not involve the right people - the senior healthcare staff who have the sensible answers.

Instead, politicians surround themselves with policy-makers who are not experts in this area, and private companies, who have a separate agenda to enrich their shareholders. They then construct plans for “reform”, which conveniently embed new ways for private companies to make a hefty profit, while ignoring practical solutions that require immediate investment into publicly-owned services.

In the end, there is little or no accountability, just a public who feel their NHS services do not work and a narrative from those in power, through the media, moving the blame to those on the ground. And what’s the cost of all of this? Well, to put it bluntly, the cost is the loss of human lives.

The cost is the lives of the public. And on some level, a political calculation has been made that these lives are expendable. Expendable in their hundreds every week. Expendable in their jumbo-jets-full. Expendable in their thousands.

Let’s be clear - the only thing that will stop this continually unfolding human tragedy happening in A&Es is our outrage; because the one thing politicians care about above all else is the attainment and retention of power. Threaten their power, and they will act. And what’s the first step to threaten their power? Public awareness.

So please share this piece by clicking below. I’m sure you know someone who deserves to know what’s going on…

Share