In the early hours of this morning, our front lounge was illuminated by the blue flashing lights of an ambulance that had pulled up nearby. In our immediate neighbourhood we have a number of residents with ongoing health issues, so in days past such an event wouldn’t have seemed that unusual. Now, the sight of an ambulance actually outside someone’s house is not only becoming a rarity, but it’s the hot political issue of the moment.
Here in north Wales the situation is particularly tough – even in relatively urban areas such as ours, only half of ambulances are reaching emergencies within the eight minute target time, though the 35% of patients who then have to wait in E&E for more than four hours is actually better than in many other regions of the UK. The reason for this undoubtedly that in Wales ambulances have further to travel and random traffic issues are common, hospitals have tended to be fairly well-staffed and patient numbers are generally manageable.
However, a look through the latest stats from NHS England shows that in December the average wait time for an ambulance in England was 90 minutes (five times longer than the target time) and – much as in Wales – more than a third of patients are waiting in A&E for more than four hours before being seen.
Yesterday’s tragic story of 68-year-old Martin Clark, who started suffering with chest pains at his home in East Sussex on 18th November (before any strike action started in the NHS), has been cited as an example of the brokenness of the system.
Mr Clark’s family rang three times for an ambulance as his condition worsened, but no vehicle was available. After 45 minutes – and against medical advice – they put him in a car and drove him to the hospital, where the father-of-five went into full cardiac arrest, and died despite every frantic effort to save him.
Here in Wales, 79-year-old great gran Pamela Rolfe,79, fell and broke her hip badly whilst out walking her dog on 29th December. After putting a duvet over her to protect her from the wind and rain, her daughter was told that ‘due to the current crisis at the moment’ her mother ‘didn’t qualify’ for an ambulance. Luckily her son-in-law, who happened to have recently hired a white van, had the presence of mind to rip the plastic lid off a nearby gritting bin for a makeshift stretcher, and transported Mrs Rolfe to Wrexham hospital where she needed immediate surgery.
Closer to home, my brother-in-law went into sudden cardiac arrest at home in Colwyn Bay last October. Despite being unconscious and with no signs of breathing, emergency services said there was a three hour wait for the next available ambulance. Thankfully to God his life was saved by a young man in the building who went onto Google – and found that there was a defibrillator just over the road in the porch of the Catholic Church!
There has been a significant increase in the number of Catholic churches across England and Wales that now have a readily available defibrillator on-site that the community can access. Most have been obtained thanks to parish collections or generous donors – the equipment and its security cabinets costs around £1,500, a small price for saving a life. But we need to do more; as a matter of social care we could do with a concerted campaign to get this equipment at every Catholic Church. Being a building at the heart of its community, it’s an obvious place to remember and always easy to find.
(As an aside, if you have got a defibrillator at your parish, please do let us know. We are about to launch a new support website for the annual Catholic Directory and we’d like to mark-up parishes that do have one.)
Listening to government ministers responding to the worsening crisis in the NHS, it’s easy to think that the present calamity is merely the product of a series of uniquely negative circumstances – the Covid pandemic, a bad winter flu outbreak and economic woes brought about by President Putin’s invasion of Ukraine.
Most of us know better – since 2013-14, when the latest targets were set, the four-hour A&E waiting time has never been met nationally. In England it has been missed every month since July 2015. Legislators like to talk about increased admissions, staffing issues and pressure being put on the system by older people living longer and presenting more problems. There’s even been a claim that, in the face of this, the Conservative government has been investing substantially in new hospitals and increasing capacity generally. And who could forget the notorious ‘Boris Brexit bus’ that trumpeted – “We send the EU £350 million a week – let’s fund our NHS instead.”
The real reasons for the crisis are twofold, and very simple – chronic under-investment over sustained periods of government, and a failure to recognise that decent healthcare is the foundation-stone of a successful economy. It is difficult to understand why legislators don’t recognise the basic principle that a healthy society is a productive society, as this must be obvious to even the most brutal capitalist. Yet we have government still clinging to bloated, pointless projects like HS2, while the country sinks into ill-health, mortality, economic inactivity and increasing demands on sparse resources.
Between 1987 and 2020 the number of hospital beds in England & Wales has more than halved, and to our shame we now have one of the lowest rates of hospital beds per person (just two per 1,000 people) in the developed world. Add to that the chronic under-investment, and an absolute failure to manage the NHS structure itself, and you can see why decades of deterioration has led us to this point.
It’s also worth adding that much of the pressure on hospitals is being driven by a similar lack of vision and coherent action on medical provisions within the community, especially in social care, mental health provision, rehabilitation services and the GP network. Churches and charities can well testify to a virtual collapse in care in the community, and support for the most vulnerable.
Going back a few decades there was a great deal of concern that government was only making a minimal investment in health provision, and an increasing expectation was emerging that churches and charities would pick up the burden of care and rehabilitation. It was also mooted that private care protection and provision was the way forward. Such attitudes just reinforced a suspicion that legislators were viewing effective healthcare as an economic liability rather than an asset. It has been a strange, but not entirely surprising irony that the UK was the inventor of the public healthcare concept, but has become the country least able to manage and develop it.
From a moral or theological position, it’s not hard to argue that healthcare should be the primary concern and place of investment for governments. One only has to look at developing countries to see that the establishment of an effective and comprehensive healthcare system is ever the basis of economic development. But for some inexplicable reason, we just don’t get that. Maybe the sad truth is that UK government just doesn’t place the human person at the centre of everything, unless of course it’s the self!
Joseph Kelly is a Catholic writer and theologian, and founder of www.thecatholicnetwork.co.uk