The leader of Britain’s doctors today warns of the impact of “the triple whammy of the non-COVID backlog, the ongoing risk of a second spike, and winter pressures” and calls on the Chancellor Rishi Sunak to fulfil “the promise of his words and gives the NHS ‘whatever it needs’”.
In a speech delivered to grassroots doctors and medical students this morning, Dr Chaand Nagpaul, chair of council at the British Medical Association, will say that the “citizens of this nation must no longer be punished from a failure to properly resource our health service”.
He will highlight that, as the NHS entered the pandemic without sufficient capacity, regular services were forced to be halted during the pandemic, during which it became “primarily a national COVID service”. As a result, an estimated 12,000 patients died during the pandemic from non-COVID causes.
Dr Nagpaul will emphasise the need for clear and consistent public messaging, and adherence to infection control measures and “a fit for purpose test and trace system in the here and now with capacity, agility and accessibility” to identify those with the infection and stop further spread.
Dr Nagpaul will be speaking at the BMA’s Annual Representative Meeting1, held remotely for the first time, where doctors and medical students from across the UK will discuss and debate the crucial issues facing the profession at a critical time in the fight against COVID-19.
His speech will reflect on the last six months – including the tragic loss of healthcare staff and the virus’s disproportionate impact on BAME healthcare workers and communities – and consider the lessons learned and how the NHS can rebuild for the future.
The conference is held as the number of daily cases in the UK continues to exceed 3,000, and as a BMA survey reveals that a second peak of COVID-19 in England is doctors’ biggest fear this winter – with 86 per cent who responded saying the outcome was likely.
On NHS resources, Dr Nagpaul will say:
“The pandemic was a shock to the world, but as coronavirus reached our shores, our overstretched NHS already had record waits for operations, cancer treatments and GP appointments. We had 10,000 unfilled doctor vacancies, and only a quarter of Germany’s critical care beds.”
He will add: “This lack of capacity forced the NHS to halt so many services during the pandemic, resulting in collateral damage to millions of neglected patients. More than 10 million fewer patients attended hospital for operations or clinic appointments between April and June compared to recent years2. In March alone 50% fewer patients were treated in A&E for heart attacks. Indeed, for over three months we didn’t have a National Health Service but primarily a national COVID service.
“The BMA blew the cover on this hidden impact of the pandemic which in part explains the tragic levels of excess mortality in the UK with an estimated 12,000 of these deaths being attributed to non-COVID causes.
“The triple whammy of the non-COVID backlog, the ongoing risk of a second spike, and winter pressures makes it imperative that the Chancellor Rishi Sunak fulfils the promise of his words and gives the NHS ‘whatever it needs’. The citizens of this nation must no longer be punished from a failure to properly resource our health service.”
On protecting doctors and the lack of sufficient PPE for healthcare workers:
“We have the nation’s back, but the Government must have ours or we will all fall down.”
He will add: “Tragically, significant numbers of our colleagues were not adequately protected. At least 34 have paid the ultimate sacrifice and succumbed to the infection.
“We owe each doctor who has laid down their life our gratitude, and their loved ones our profound sorrow. Never ever again should doctors and healthcare workers fail to be adequately protected in the course of their duty.”
He will highlight the disproportionate impact of COVID on BAME doctors, with at least 90% of the doctors who have died during the crisis having come from an ethnic minority background, and the need for BAME healthcare workers to be properly protected. He will also note the immense contribution of international medical graduates to the NHS throughout the pandemic and the need for these doctors to be valued, saying that: “The Government owes our international doctors a debt of gratitude, and we must welcome them, not present them with hostile barriers.”
On confusing public health messaging:
“The Government’s messaging has been utterly inconsistent and confusing – it’s no wonder that the public haven’t adhered to infection control measures.
“The BMA called for the public to wear face coverings in April, yet the Westminster Government rejected the need – despite this being policy in most comparable European nations. Two months later it changed its mind but only for public transport despite the virus patently being just as infectious in a shop as on a bus. In July the rules changed yet again now to include shops but not cinemas or museums yet in August it U-turned once more to include those.
“On the eve of schools reopening, in the morning Ministers insisted there was no need whatsoever for secondary school children to wear masks. By the evening they were advocating their use.
“The public need coherence and adherence – not the continued flip-flopping of decisions, which make a mockery of ministers claims of being led by the science, which clearly doesn’t change from hour to hour.”
On the need for a functioning test and trace system:
“The Government is now shooting for the moon promising to deliver mass continuous testing with a test that doesn’t yet exist at a cost nearly as much as the total NHS budget.
“Down here on planet earth, we need a fit for purpose test and trace system in the here and now with capacity, agility and accessibility that doesn’t require 100-mile journeys that disadvantage some of the most vulnerable.”
On outdated technology in the NHS:
“The pandemic showed how political will can result in transformative change. Thousands of ventilators were built from scratch in record time, new hospitals erected in less than two weeks. GP practices like my own received a dozen new NHS secure laptops in four weeks for staff to work remotely – which no amount of pleading could have achieved in the four years prior.
“We must not return to an NHS still widely using obsolete Windows 7 PCs wasting hundreds of hours daily booting up and crashing.
“We demand fit for purpose modern IT, interoperable between GPs and hospitals so that patients’ care is visible in real time rather than archaically waiting for letters, and which enables hospital doctors to electronically prescribe drugs for patients to collect from their local pharmacy and request investigations in the community with a keystroke.”
On the future of the health service:
“This pandemic has been a window into a different world which demands a different NHS. We can’t simply go back to a National Health Service which was so patently under-staffed, under-resourced and totally under-prepared for a difficult winter, never mind a pandemic. A country so plagued by inequality. A profession set up to fail.
“Our vision is of an NHS which is resourced to give us the time, tools and facilities to care, where doctors feel valued and rewarded for serving the nation in a caring, supportive culture of equal opportunity.
“It was from the ruins of the second world war that our health service was born. From the ruins of today’s national health emergency, we must seize the chance to rebuild the NHS anew on its founding principles of being there for all at times of need.”
Notes to editors
The BMA is a trade union and professional association representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.
- Dr Nagpaul will give his keynote address at 9:30am on Tuesday 15 September. For more information on the ARM and to watch proceedings on the day, go to bma.org.uk/arm2020
- BMA analysis based on NHS England data.