Hospital wards are filling up again – with fakers

How do I know that Britain’s Covid crisis is over? The fakers are back. The hypochondriacs, the psychosomatics, the pseudo-fitters, the attention-seekers and the lonely. They’ve started to return to the acute medical ward where I work. They’ve been gone so long I actually almost missed them.

This collection of patients, who take up time and resources inversely proportional to the state of their physical health, simulate symptoms for gain (malingerers), simulate/induce their symptoms for the pleasure of the sick role (Munchausen’s syndrome) or genuinely experience symptoms such as pain, seizures or paralysis in atypical ways with no physically identifiable or treatable cause (now vaguely termed ‘functional disorders’).

Members of the first two categories often end up with the label of the third because it is easier than confronting them about their behaviour, though in my experience this only emboldens them to continue abusing services. Before the pandemic, they took up a huge amount of time and resources at the expense of others, and often with no satisfactory outcome for anyone involved. Even the patients who have serious psychiatric causes for their presentations almost never have them addressed by coming to hospital, because of the woeful provision of psychiatric services that might be able to help.

The cost to the NHS has been estimated at £3 billion a year. For comparison, the much debated 1 per cent pay rise for all nurses will cost about £200 million next year. The near total absence of these patients from our hospital wards over the past 12 months at least gives me hope that there has been one saving for the health service among all the excesses. It has certainly given frontline clinicians more time to deal with the truly unwell. So how did this minor miracle come about?

Most of the fakers, realising that hospital had become a dangerous place where they might actually get seriously sick from Covid, decided that they just happened to be feeling a lot better or could manage their previously debilitating conditions at home.