Plea for no return to pre-pandemic era of under-investment in NHS

by Tim Tonkin

Facing the future can be a daunting prospect.

Location: UK
Last reviewed: 13 September 2021
Chaand Nagpaul

For doctors, patients and the NHS, however, anxieties relating to the uncertainties of a post-pandemic future must not distract from arguably even greater concerns, that of returning to and repeating the failures and inadequacies of the health service’s past.

Such was BMA council chair Chand Nagpaul’s overriding message to doctors in his opening address to this year’s annual representative meeting online conference.

In his address, Dr Nagpaul spoke of the horror the UK and the world had endured in the last 18 months of a pandemic which has claimed the lives of more than 130,000 people in the UK alone.

In criticising the Government’s approach to COVID-19, Dr Nagpaul told conference attendees that inconsistent public messaging on the pandemic by government ministers, along with indefensible decision-making, saw the abandonment of all social restrictions on ‘Freedom Day’ – a gamble that contributed to almost 40,000 hospitalisations and more than 4,000 deaths since 19 July.

Grave errors

In acknowledging these failures and mishandlings, however, Dr Nagpaul emphasised the importance of recognising these grave errors were not simply owing to unavoidable misfortune, but the result of years and years of underinvestment in the health service and disregard of medical workforce.

It was the policies of successive governments, not COVID, Dr Nagpaul warned, that was responsible for 90,000 staff vacancies within the NHS, for a £5m cut to Public Health England’s operational budget in the years leading up to the pandemic, and a scandalous lack of critical care beds.

In the face of an unprecedented waiting list backlog for elective care procedures, Dr Nagpaul told the ARM that whatever form the NHS’ future took, it was critical that it did not involve a return to the scandalous neglect of the pre-pandemic era.

Paying tribute to the dedication and sacrifices of doctors and their healthcare colleagues during the pandemic, Dr Nagpaul said the awful realities of COVID had time and again allowed the NHS to demonstrate its critical importance.

Citing the vaccination roll-out as a case in point, Dr Nagpaul said this GP-led programme, which had been negotiated by the BMA, had been the most successful public health intervention of its kind in the UK’s history.

Moving forward

Highlighting the recent pledge to increase funding for the NHS and social care through a new tax levy, Dr Nagpaul said there were signs the Government was starting to listen to concerns of healthcare professionals.

He warned, however, that there needed to be honesty and realism as to what extent this funding could address years of under-investment or help the NHS tackle the crisis in understaffing and patient waiting lists.

In facing the challenges of the future Dr Nagpaul said, doctors must firmly reject and leave behind the inadequate status quo of the past.

‘We will not accept a return the old pre-pandemic NHS,’ he said.

‘[One] which was so patently under-staffed and under-resourced, where nine in 10 doctors are afraid of medical errors daily. We will not accept an NHS running at unsafe bed occupancy and without spare capacity.

‘We will not accept an NHS unprepared for a pandemic, without vital personal protective equipment to protect the health and lives of health and care workers.

‘We will not accept an NHS in crisis every summer, let alone every winter. We will not accept a nation bereft of public health staff, facilities and testing capacity, with ministers then paying billions to private companies who were unable to deliver.’