Britain is great in a crisis, but useless in a crisis. Just look at the NHS | Martha Gill

IIf Britain were a person, it might seem like a familiar type to you. They are the type that sinks into the couch, causing problems to pile up. There’s that rising damp that they have to get a handle on, and there’s that long-lasting nagging cough. Their marriage has been on the rocks for months, they should really look into counseling. However, they don’t. They’re sitting there procrastinating.

But when a sudden crisis occurs—a main pipe bursts and floods the street, or a neighbor collapses with a heart attack—a change comes over them: a spark in the eye and a blush in the cheek. They become decisive, selfless and competent. They are stoic when faced with danger, generous to others, skilled at giving directions and following orders. They are good in a crisis.

Britain is good in a crisis and bad in a recession. Our national life is littered with evidence. For example, Liz Truss’s mini-budget was a crisis. The effect was immediate: the pound fell to its lowest level ever against the dollar, and government bond yields soared. What happened next? Universal outrage and decisive political action. The budget was summarily reversed and Truss was absent within the lifespan of a supermarket vegetable. In short, we had a very functioning political body.

In retrospect, this sequence of events seems inevitable given the scale of the problem that Truss and her chancellor have created. It wasn’t. Bigger economic mistakes go unnoticed. The difference is not in the scale, but in the speed. Brexit has caused greater damage, but Brexit is not a crisis, but a slump. The effects have crept in and set in; Little by little we have become accustomed to being poorer. Truss pushed us into a cold bath; we made it out, albeit a little worse for wear. But Brexit tempted us to swim out to sea on a sunny spring day. We are now drifting, a little too far from land, and no longer feel the cold. We vaguely realize how many problems we have, but we can’t seem to motivate ourselves to swim to safety.

Or take our attitude towards asylum seekers. When crisis strikes abroad – when war broke out in Ukraine, when Kabul was evacuated, when Syrians fled persecution in 2015 – the British are immediately transformed into generous hosts. Where there is drama, Brits are quick to take on the mantle of hero. We throw open our homes and demand that these dispossessed people be immediately granted exceptions to all the anti-asylum laws we normally vote for. However, once the crisis crosses an invisible time threshold, attitudes return to normal, even as wars drag on and refugees still cry out for help. The feeling of distress passes. The government is reviewing its expensive measures and quietly phasing them out. Voters generally have no objections.

It’s the same with the NHS. Covid dropped it into crisis. Donations soared. Armies of ordinary people offered to help. The government has made many unnecessary mistakes, but has taken action. It gave hospital trusts extra funding and set aside space for care homes to ease pressure on hospital beds. It arranged a system of emergency volunteers to oversee those discharged from the hospital. It oversaw a major and effective public health campaign.

Covid has subsided, but the NHS is still in deep trouble. Yet we have become accustomed to it. The NHS has been in trouble for as long as most of us can remember. New goals missed, new records of underachievement reached; These are also well-known alarm bells. The emergency siren is now background noise. The NHS crisis is now chronic. Things have gone into a slump.

For example, last week the news broke that although waiting times have fallen, the number of people in England has fallen waiting more than 18 months for a referral has grown by 10,000 since December. Waiting times for cancer remain a disaster. Since 2020, more than 200,000 people have not had life-saving surgery, chemotherapy or radiotherapy within the NHS’s assumed maximum waiting time of 62 days.

At the beginning of the year, a Telegraph analysis found that nearly 53,000 more people than normal died in 2023 – the highest figure since World War II, excluding pandemic years.

Amid all this, a fight arises over a group of workers brought in to close the gap between physicians: physician assistants (PAs), or physician assistants, who didn’t go to medical school. This started out as a good idea; There is a lot of work in hospitals that does not require highly trained doctors and nurses. But perhaps it was inevitable that in a long-term NHS doctor staff would operate outside their remit.

There are now reports that these employees are illegally prescribing medications and requesting test results for which they are not authorized. In 2022, a The 30-year-old woman died after a PA mistook a pulmonary embolism for anxiety. Her mother said she was not informed that the person who diagnosed her was not qualified to do so. Last week the British Medical Association called an extraordinary general meeting to discuss what the government wants expanding the roles and uses of PAs; according to some reports it descended into anger and farce.

The NHS is in crisis but it is not treated that way. In fact, like the Observer Unveiled last month, plans to double the number of doctors trained in England by 2031 have come to a dramatic halt. What threshold must be crossed and by what measure must the NHS fail before there is an emergency? The British are good in a crisis. When is the government going to announce one?