There were no 40 hour waits for ambulances prior to May 2010, and no 24 hour waits in A&E: very few patients exceeded the 4 Hour A&E wait target, until George Osborne’s austerity regime halted the decade of investment in the NHS – and ushered in a decade of decline.

Latest figures show nearly 40% of A&E patients who need admitting face a trolley wait of four hours or more waiting for a bed to be found. Around 10% are waiting over 12 hours. To put that in context, in England there had been more 12-hour trolley waits in January-November 2022 than in the past 10 years combined. Similar pressures are being reported in other parts of the UK.

It was not strike action or Covid that almost doubled England’s waiting list from 2.5m in 2010 to 4.6m at the end of 2019; nor have strikes been the cause of the subsequent rise to 7.2 million. It was not industrial action, but systematic government under-funding and lack of NHS capacity that meant 2.91 million patients had been waiting over 18 weeks for treatment in October, 410,983 of them waiting over a year.

Most cancer treatment is exempt from the RCN’s strike action – but even before the ballot for action shortages of staff, beds and cash have meant key cancer performance targets have not been met since 2014: and when Boris Johnson called the general election three years ago more than one in five cancer patients was already waiting more than two months to start treatment.

So it’s not striking staff or stroppy unions that have brought the crisis in today’s NHS. But vacancies across the NHS in England have risen to a new record high with more than 133,000 full-time equivalent posts unfilled in September – 29% higher than September 2021. 47,500 of the vacancies are for nurses, an average of almost one in eight posts. Meanwhile 165,000 new staff across the country are needed to plug gaps in social care.

With nurses leaving the nursing register at a faster rate than ever before, and ever-increasing problems securing safe staffing levels in wards and community services, it’s clear that unless the trade unions can force the government to shift from its insistence on imposing an endless decline in real terms pay, the quantity and quality of NHS services will inevitably continue to decline.

The nurses, paramedics and other health staff who take action over pay are literally fighting for the future of the NHS, while those politicians who oppose or refuse to support them are indifferent to its demise.


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