There is no doubt – the NHS is now in a more dire state than at any point in its history.  As the population begins to numb to the anecdotes of “war-like” conditions in our hospitals there is no longer a guarantee that people will get seen in an emergency.  And now, with the Oxford population set to surge with returning students, its healthcare systems are braced for things to get worse than ever before.  Understandably, people are scared.

It is worth reminding ourselves just how bad things are.  The stories of wait times and abhorrent conditions from nurses and patients are countless and well-documented but it is easy to normalise them – this is not normal.  Doctors “examining testicles in cleaning cupboards” is not normal.  Sheets being hung around beds in corridors for intimate examinations is not normal.  Staff returning for their next shifts 12 hours later and seeing the same patients waiting on the same floor is not normal.  Speaking to ‘The News Agents’, one brain surgeon laid out just how dire the situation is: “I’ve worked in India, I’ve worked in the US, I’ve worked all around the world – this is the worst health service I’ve ever seen.”  We need to stop thinking that ‘Our NHS’ is special or unique.  In the last week with published data, more than 16 300 people waited longer than an hour to be handed over from an ambulance to hospitals (up 31% on the week before).  Seven million people are on waiting lists, three million have been waiting more than 18 weeks for treatment and another 400 000 have waited a year or longer.  Perhaps most shockingly, 44 000 people in A and E waited more than 12 hours to be seen – that is an increase of more than 11 000% on three years ago.  The only thing that makes our health system stand out at the moment is that it is in a worst state than any other in the developed world.  

24% of Oxford’s population is made up of full-time students and those 30 000 people are returning to a health service already under strain.  Quite understandably, people are scared about whether the city can cope.

In a survey conducted by Cherwell, 78% of people said they were worried about the health service in Oxford ahead of returning.  71% of students said that the university should be doing more to offer reassurance about the systems in place and, on average, people said they would be ‘concerned’ about calling an ambulance on a night out next term.

These concerns are built largely off scarring experiences over the winter break and stretching back far further than that in many cases.  An astounding 67% of people said they experienced the crisis first-hand over Christmas with some respondents sharing harrowing stories that have become all too commonplace.  One student said that their GP made a mistake on their prescription that it was too overwhelmed to resolve – as a result she had to go without her medication for three months.  Another person’s grandmother waited over 30 hours for an ambulance after a fall.  The reality is that these kinds of experiences are not quickly forgotten.  Trips to hospitals are life-defining events that most people will remember in detail long into the future, the total lack of dignity that patients are suffering right now will live long in the memory.

For their part, a spokesperson for the Oxford University Trust responded to Cherwell saying: “Students form a large and important part of our local demographic.  We are familiar with the patterns of term times and know what to expect.

“Health services are under a lot of pressure at the moment.  We are asking the public, including students, to help us to help them by keeping Emergency Departments (A&E) for genuine emergencies.  If people need urgent, but not life-saving, care, then the teams at NHS 111 can give advice and signpost them to local facilities such as Minor Injury Units, pharmacies, and their GP.”

Elsewhere on their website the trust warns that patients should “Expect long waits at Emergency Departments (A&E) at all hospitals in the Buckinghamshire, Oxfordshire and Berkshire West area”.

As clear as the problems are for all to see, the solutions are of course extremely complex.  In the short term, urgent efforts are being made in Oxford to discharge patients “wherever possible”.  The reality of course is that the crisis in the NHS is exasperated yet further by a social care sector that has been left in tatters by years of underinvestment.  In mid-December over 14 000 people were in wards unnecessarily, largely due to congestion in the social care system.  Now, individual trusts are being forced to consider discharging patients into hotels rather than care homes at an average cost of £1000 a bed compared to the normal £525.  The problems are everywhere and the solutions hard to come by.

The opinion of students is clear with almost all respondents saying that the answer was increased funding and a change of government.  Examples included calls for “funding, attracting foreign workers, improving work conditions”, and “funding, funding, funding!!!!”.  Some even took a harder line with three people saying that privatisation is the answer.

Clearly though, money and staffing alone aren’t the answers.   Although much of it has been eaten up by inflation, there genuinely is more funding and there are more nurses in the NHS than ever before.  What is really needed is complete restructuring and reform.  Problems from outdated IT systems (one trust says it can’t even tell how many free beds it has) to antiquated red tape and management structures need complete and total re-evaluation. 

What worries me is that it seems incredibly unlikely that any politician is brave enough to go far enough.  Whispers from Wes Streeting showed some positive signs but the government itself still refuses to acknowledge that there is a crisis at all.  Neither Starmer nor Sunak had anything substantial to offer in their New Year speeches either.

None of this though helps in the short term.  For now, pupils are returning to Oxford and other parts of the country worried about the care they are going to receive.  Only time will tell as to whether hospitals are ready for the surge.

Image: CC2:0//Ron Adams via Flickr.