One year on and three steps backwards: Covid-19 and the NHS revisited (part 1)

byPeter Ellis 07-03-2021 11:30 - Updated On 13-12-2021 22:31 in Health, Politics Reading Time: 9 mins

https://yorkshirebylines.co.uk/politics/one-year-on-and-three-steps-backwards-covid-19-and-the-nhs-revisited-part-1/

Historic structural and cultural barriers within the NHS, the ‘one size fits all’ mentality of Whitehall, and the ‘blame-game’ culture of politics, were several factors that stifled innovation and success.

Last year, as Covid-19 took hold, it became clear why, as a country, our poor performance in managing the pandemic was to be anticipated. Historic structural and cultural barriers within the NHS, the ‘one size fits all’ mentality of Whitehall, and the ‘blame-game’ culture of politics, were several factors that stifled innovation and success.

After a much-delayed call to action, we had a brief respite and a reduction in both deaths and cases during the spring months. Rather than seize the opportunity this presented, the lobbyists within government met it with a laissez-faire attitude, believing that herd immunity would be best for the economy. There have since been two further surges, in the autumn and after Christmas, thus crystallising the UK’s unwanted status as the country with the highest mortality rate among major OECD nations.

This 3rd surge in the pandemic has been by far the worst in both total number of cases and mortalities. The total number of deaths in the UK (from all causes) for 2020 was 91,000 higher (ONS) than the average of the previous five years. This figure demonstrates the full consequence of the pandemic, as opposed to ‘deaths within 28 days of a covid diagnosis’, as it includes the additional deaths caused by delays and limited access to care.

The figure of deaths from Covid-19 (within 28 days of a positive test) now stands at 124,000. This figure, unfortunately, will likely approach 140,000, or, 180,000 if consequential deaths are included, measured by ONS.

Errors will always occur. But we need to be transparent about them so we can learn and highlight areas to improve; the ‘blame game’ culture, on the other hand, leads to avoidance and obfuscation. That the UK continues to have the worst outcomes among both major European and developed OECD nations, should alert the government to the underlying structural issues.

A recent study by four of the UK’s most respected and non-political, research foundations, pointed out that the UK performs worse than similar countries “on the overall rate at which people die, when medical care should have saved their lives”.

Canada is a good point of reference, as both Canada and the UK have publicly funded health systems. Corrected for its population size, Canada, with 58 percent of the UK’s population, had only 18 percent of the UK’s deaths from Covid-19. Similarly, Germany, with a population 24 percent higher than the UKs, has a death toll 45 percent lower.

Canada and Germany, with federation origins, allow their respective provinces and states to develop their own health care (along with education and economic development). The UK on the other hand, with the world’s largest healthcare delivery system managed as a single entity (NHS England), grants devolved responsibility to Scotland (5.4 million population), Wales (3.15 million) and Northern Ireland (1.9 million), but denies them to Yorkshire and Humberside (5.4 million).