Editor Jaimie Kaffash on what the critical state of the NHS and wider public services reveals about David Cameron’s slogan of solidarity
It was around 15 years ago that the Conservatives adopted their slogan, ‘We are all in this together’. At the time, it seemed at best a vacuous soundbite, at worst an act of cynicism. The current state of the country proves it to be the latter.
Our story on the cost-of-living crisis shows how patients are seeing their diabetes worsen because they can’t afford healthy food, those with asthma are facing life-threatening attacks as they cut back on medicines and heating, while practices are repurposing rooms to serve soup to patients who need it, and people’s mental health is getting worse because they are unable to pay their bills.
Meanwhile, as our cover feature shows, the emergency services are in the worst state the country has ever known. A respiratory arrest is no longer enough to guarantee an immediate ambulance. Response times are worse than they have ever been, and this doesn’t even account for the horrific January we have just lived through. The NHS has collapsed. Sadly, that is not to say it can’t get worse.
All these issues affect GPs. Because of course they do. Our public services – and especially the healthcare sector – are on such a knife edge and are forced to run on such a shoestring budget that issues in one service will inevitably cause significant knock-on effects across all the others. For example, GPs find themselves transporting patients to hospital as they despair of an ambulance arriving in time.
We only have to look at the number of professions that have taken or are considering industrial action: nurses, ambulance staff, junior doctors, rail workers, postal workers, barristers and teachers. Yet, for some reason, professions still have a tendency to snipe at one another, and – once again – this is especially true of the healthcare sector.
GPs are suffering because they are not getting any help from secondary care, which instead offers up rejected referrals, long waiting lists and workload dump. There is a temptation to blame consultants or get frustrated at the paramedics who ignore your clinical judgement and refer patients back to you, or your local trust for rejecting your referral, or even the housing service that would not support your patient so they turn back to you. But these professionals are not the problem here. The problem is a government that has stood by and allowed all public services to degrade and has mismanaged the economy.
These are systemic issues. The issues facing general practice are replicated everywhere. And, while I do think that GPs have a particularly hard deal in bearing the brunt of the public’s anger at these systemic issues, all the striking professions have been demonised at some point themselves, even if to a lesser extent.
Our January issue featured a pastiche of the Che Guevara poster, so I am a month late in preaching a message of solidarity. GPs need to support their fellow professionals who are taking a stand; send the message that it is not your fault that patients are having to wait to see their GPs, but equally it is not the fault of consultants or junior doctors that they are waiting so long for a referral.
Public services – especially general practice – are in crisis. So yes, with the notable exceptions of this government and the uber-rich, we now really are all in this together.
This column originally appeared in the February 2023 issue of Pulse