First order problem, the hospitals have no beds. This means that ambulances end up waiting for hours and medics twiddling their thumbs at the ER until the staff can finally take the patient. Medics can't just abandon the patient because there legally needs to be a proper handoff. So your emergency can't be responded to quickly because we can't trivially spin up thousands of new medic units to spend all their time waiting in line at the hospital.
Second order problem, the hospitals have no beds because of a lack of long term care services. From the article...
> There is an acute lack of beds in the accident and emergency department, or A&E, as emergency rooms are called in Britain, which are overcrowded because of an inability to find room for patients elsewhere in hospitals. That is because patients ready to be discharged from the hospital often have nowhere to go as a result of dwindling social services — which have been hobbled by a lack of government funding and severe staffing shortages.
Now the question is why aren't there enough non hospital care services? Could be many reasons, but I'd speculate that it's a combination of a) an increasing population of old, sick people who need care in a society whose demographics are beginning to turn upside down, and b) because Brexit means it's drastically harder to import poor, foreign workers willing to do the shitty job of elder care for low wages. If this prognosis is correct, it starts to beg the question of whether Britain's world renowned health care system was only possible because it could extract excess, cheap labor from poor countries to take care of their old people, when Britain's own young people were never going to do that work for the wages offered.
Same for doctors, dentists, etc. too.
Too true. I’m from Canada where we worry nurses will go south of the border, but was recently in London at an NHS hospital and was talking about this with a nurse. Pay for nurses in Canada is on par with a Jr Developer here. (Still low for the hours and effort required!) By comparison, nurses in the UK make about as much as an intern or admin assistant. After all, single payer means there isn’t much pressure to raise wages from other sectors, you’ve a monopoly on nursing so you can set the wages at whatever level keeps staffing adequate, which isn’t the same thing as paying a living wage…
Doctors tend to be ridiculously overworked in the UK. This is much worse recently - first doctors were off sick / isolating due to Covid. That means less doctors to do the same jobs having to work harder. That drives more doctors to either leave or take long term sick leave - goto 1.
It's a very slow process that requires first the defunding, then some brainwashing via television. The American model.
https://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/nhs-...
What people have a problem with is that the problem seems to be tractable for some, and not for others, and whether or not those “some” are worthy of it.
Want a comparison? France's healthcare spending increased 0.3% yearly in the same timeframe. The UK is outpacing France's spending increases by 2,066%.
The spending argument is made from political propaganda, not from fact.
Could you provide a source for that? Such an increase would imply a doubling of the budget over that time period. I can't find anything that suggests the NHS budget has doubled since 2010.
From what I can gather, the NHS spending adjusted for inflation increased modestly over the time period.
Taking into account the fact that costs in the healthcare sector have increased more than CPI globally, that increase could well correspond to a decrease in purchasing power.
That doesn't yet take into account the UK specific issues around Brexit.
The spending argument is nuanced and complex. Declaring that it's "not from fact" just reveals your partisan leanings.
https://www.health.org.uk/news-and-comment/charts-and-infogr...
And yet, both of these trends can continue for quite some time, and one trend can outweigh the other for quite some time.
Ay, there's the rub.
For example, I spoke to a doctor that has to travel between multiple hospitals during the course of their work.
There used to be an in-house service that the NHS owned for transporting medical staff between locations.
That has been privatised as in a contract has gone out for tender and a company won to do the service.
The service used to be reliable. Now they often have to book Ubers out of pocket to get where they need on time.
The inhouse service is gone. So of course and renewals are going to cost more.
When people talk about the deterioration of the service, a common counterargument is that the money being spent is going up as a way to shut down conversation.
Salaries not increasing with inflation.
Staff finding it harder to stay in the UK after Brexit.
Closure of many hospitals, a gradual move (including the previous gov) to many more privatised services.
All these things have increased costs without improving the service.
But the problem isn't with the ambulances, it's with overcrowded hospitals.
I remember an article that some ambulance drivers are doing it as volunteering (they are trained). There could be a rideshare/gig-economy take on deploying more ambulances+drivers subsidized by hospitals/government: and drivers can be called in on-demand during surge - local community folks would be driving anyway.
I understand EMT are very well trained. You would want those techs to be as trained as possible. So that could be the limiting factor.
They literally did nothing. Contrast to Latvia where I bisected my thumb with an axe and they put it back together about 20 minutes later and charged me €9.
I also have a 8 week old child - zero checkups, no vaccination appointments available, no doctors appointments available. No follow ups for my wife after birth. Oh, and we had to do it all at home, as there is no space in hospital for childbirth - the beds are all full of people who should be in old people’s homes, but there are no spaces in homes for them to move to.
I am ridiculously glad to be back in Portugal as of today, and tomorrow I will take her to the village clinic, where she will finally have a medical inspection.
We see where the driver is on Doordash. Similarly there should be a text message confirmation with a tracking link to the ambulance on the way and the destination hospital.
I don't necessarily think it's a bad idea in general, but adding tracking to ambulances is not going to magically make them turn up faster.
An idea for ambulances shortages ^
This is a pretty shocking number. Where can I read more about this?
E.g. https://www.nytimes.com/2022/12/20/world/europe/uk-ambulance...
The waits are crazy long because hospitals are full, so the ambulances end up outside the hospital entrance for a long time, waiting for a free bed for their patient/passenger.
I did find this page[0] which says, referring to category 1 calls:
> In December 2022, the response time crossed 10 minutes, the worst performance on record.
So it certainly sounds like an _average_ wait of 48 hours for a category 1 call is not at all grounded in reality.
[0]: https://www.nuffieldtrust.org.uk/resource/ambulance-response...
<quote> For category one calls, the most urgent, where an ambulance is meant to arrive within seven minutes, several areas reported waiting times close to or more than 15 minutes.
The longest average wait for such calls was in Mid Devon, with a time of 15 minutes 20 seconds, almost three times as long as the average of 5 minutes and 48 seconds in Hammersmith, west London. </quote>
So the 48-hour average waiting time stat does seem completely made up.
https://www.theguardian.com/society/2022/dec/01/ambulance-wa...
Are you really telling me that we just decided to let people die for 2 days straight? Got any proof on that one?
Source: worked for the NHS, still alive despite there being 48 hour cat 1 waits and no ambulances in the entire country.
Then COVID came and routine treatment is paused, and now yes - we are in a situation where people aren't getting ambulances and at the same time ambulances are piling up outside hospitals as there is no space to take patients.
TLDR - yes, outlet government has been running down the health service to the point people are dying.
"In January, the average response time for a category 1 incident (where an immediate response is required to a life-threatening condition such as a cardiac arrest) was 8 minutes and 31 seconds. Although this is an improvement from the four preceding months, which were all over 9 minutes, the average across 2019 for comparison was 7 minutes and 12 seconds, and the ‘standard’ is 7 minutes.
This is even more pertinent for category 2 incidents, which include strokes and require rapid assessment and/or urgent transport and the standard is 18 minutes. In January this was over 38 minutes, and it passed 50 minutes in October and December. Although the standard was not regularly met pre-pandemic, the average across 2019 was still 23 minutes."
There's a muddled statistic from BBC News here[2]:
"Average waits of more than 90 minutes to reach emergency calls such as heart attacks - five times longer than the target time - with waits of over 150 minutes in some regions. Response times for the highest priority calls, such as cardiac arrests, taking close to 11 minutes - four minutes longer than they should"
(I don't know a difference between "heart attack" and "cardiac arrest".)
"The Royal College of Emergency Medicine believes up to 500 people a week could be dying because of the problems accessing emergency care."
But there are news articles of individual much longer waits:
"When Martin Clark, 68, started suffering with chest pains at home in East Sussex in November, his wife immediately called an ambulance. But none came. She phoned another three times before her and her son decided to drive Martin to hospital themselves 45 minutes later." - https://www.bbc.co.uk/news/health-64243044
"More than half of Staffordshire's ambulances queue outside Stoke hospital on New Year's Eve [...] Some Category One calls - like heart attacks or anaphylactic shocks - have taken him 25 minutes to respond to, compared to a target time of around seven minutes due to a lack of available vehicles because of the queues." - https://news.sky.com/story/more-than-half-of-countys-ambulan... -
"A Grimsby woman thought to be having a stroke had to wait eight hours for an ambulance - and spent a further eight hours in the back of it outside hospital waiting to be seen." - https://www.grimsbytelegraph.co.uk/news/grimsby-news/distrau...
"A Southend pensioner was left waiting eight hours outside a hospital after a 48 hour delay for an ambulance [for a fall and cut head]." - https://www.echo-news.co.uk/news/20205197.southend-pensioner...
[1] https://www.nhsconfed.org/articles/what-latest-data-tell-us-...
The target is 90% of patients reached in 15 minutes. Yet the reality is the average wait was 48 hours.
I can't see any way that kind of thing isn't contributing to a shorter life expectancy.