Fraser Nelson
One of the most controversial slogans during the lockdowns was telling people to stay home to “protect the NHS”. This was deeply resented by actual NHS chiefs, who saw this as a hideous inversion of their duty. “The NHS is there to protect people, not the other way around,” one told me at the time.
He had another fear: that asking people to “protect” the NHS by not using it was the exact opposite of the message they should be giving. In pandemics, the risk is that people avoid everyday healthcare – and that kills people as surely as the virus. So it was to prove. We know, now, that there were 8 million fewer GP appointments in the years after the first lockdown. So what happened to these people? The trajectory of the NHS waiting list was always going to depend on the answer. If they all returned over the next two years, the waiting list would peak at about 12 million. If only half did, then 8.5 million. Now, it seems to have peaked at about 7.7 million – suggesting just a third of those missing patients came to seek help.
Rishi Sunak may now fulfil his promise to cut waiting lists, but only because the system never managed to find so many of those who need and deserve care. This may help explain why the weekly death figure is, even now, still far higher than the pre-pandemic trend. This year so far, an astonishing 32,000 more have died in the UK than would be expected from the five-year average. Yvonne Doyle, a former medical director of Public Health England, blames “an underlying pandemic of ill health”, driven by “highly-preventable conditions” like heart disease, diabetes and liver disease.
She didn’t mention the other problem: cancer diagnoses. There were always concerns that Covid would take priority over cancer care, but these were literally laughed off by Chris Whitty. “This is sometimes said by people who have no understanding of health at all,” he breezily informed a parliamentary committee. “Usually because they want to make a political point.” So even he, a professor of public health, had come to see basic questions as being politically motivated – rather than a genuine concern about what was going on. And what was going on? We now know. NHS cancer screening programmes were being postponed and diagnostic tests reduced. Diagnosis and starting treatment were hit by long delays. This, in turn, hit prognosis rates and mortality rates. The victims tend to be younger. Most Covid deaths were among the over-80s. But those hit by the cancer issue now are mainly women in their 60s and 70s (for breast and colon cancer) and men in their 40s and 50s (for prostate cancer).
In the summer, an Oxford University study estimated there have been 62,000 fewer cancer diagnoses than would be expected in the pre-pandemic trend. It called for urgent action, including targeted screening programmes to find the missing patients and reduce the backlog. The NHS says this is happening, but signs of progress are scant. In any ordinary situation, there would be an all-out campaign to try to identify them, given how many thousands of lives are still waiting to be saved. The NHS can still work very quickly: I had a cancer scare a while ago and was lying under a brand-new CT scanner within 10 days.
Three-quarters of patients are seen within two weeks of an urgent referral which, while far from the target, still shows a system that’s waiting to serve lost patients. While the NHS insists it is catching up, like the “ghost” school pupils, reaching many of them seems to be beyond the capabilities of government. There’s a similar story around the world. Australia and New Zealand had minimal Covid casualties but imposed strict lockdowns and they can now see the consequences. Their cumulative “excess death” figures are creeping up as high as Britain’s, from similar issues: more people dying of preventable causes. And lockdown-free Sweden? So far, it seems to have recorded fewer cumulative “excess deaths” than any other country in the developed world.
Sweden, too, had a significant cancer hit – which shows how pointless it is to blame lockdown for all such problems. When a pandemic strikes, people panic and stay at home anyway. They avoid A&E departments and GP clinics through fear of infection: this, of course, raises obvious health risks. This is why, rather than amplifying fear, Swedish health officials tried to counteract it by asking people to keep using the health service and keep going out. “Physical activity is good for public health,” ran the official message when the virus was at its peak. “Sports and exercise should, therefore, continue.”
This is what Britain’s message should have been, from the very start. Instead we amplified fears of NHS collapse which were, at first, bogey men conjured up by badly-wrong models and then used to enforce lockdown compliance. The full consequences of this fear messaging were never considered. I knew an official who worked on the campaign at the time who was appalled at how they only ever assessed the impact of reducing Covid contacts – and never tried to work out the side-effects, such as putting people off going to the doctor. The fact that the NHS coped so well during Covid is, even now, kept a secret. On peak Covid, April 12, 42 per cent of ventilator beds were lying unused. This figure should have been shouted out at the time to shore up confidence in the system. “Covid is on the way down,” Matt Hancock could have said, “And even at its peak, the NHS had four times as many empty beds as normal. Our health service is not in danger of collapse and doesn’t need protecting. It’s here to protect you and it’s vital that you keep using it.”
Dr Doyle is quite right to say that the Covid inquiry should look at “excess deaths” and consider it a pandemic in its own right. But we have all seen enough of the inquiry’s trivia-obsessed questioning to know this will never happen. Another public health agency should pick this up, though, for a simple reason. Far too many Brits are still dying, every single week, from preventable causes. The surest way to avoid repeating the old mistakes is for someone, somewhere to ask why.
The Telegraph
