I’m embarrassed every Thursday. I don’t mean to sound ungrateful. The outpouring of love for NHS workers at 8 p.m. each week has been touching. Who wouldn’t want to be clapped and cheered? But quietly among ourselves, many of us in the health service have increasingly felt it’s misplaced. I’ve come to dread it. It makes me wince. The fact is that the NHS is currently letting down thousands upon thousands of patients. When the dust has settled, I fear that we will be responsible for the death or morbidity of countless people.
Since the pandemic hit, entire NHS services have completely stopped. I fear that this will have catastrophic consequences for the health of the nation. What’s more, as ill health is inexorably linked to poverty, it will affect the poorest the most. Many of us in the health service, as we look around at our near-empty hospitals and blocked-out diaries, are asking if we have gone too far. Has the fear of the pandemic meant that we have overreacted? Could we have caused more harm than good with our attempts to prepare for the influx of Covid patients?
I work in mental health and it is well known that many community mental health teams have effectively shut up shop, which condemns patients with severe enduring mental illnesses to spiral into psychosis, mania or suicidal depression. Surgical operations have been cancelled. A friend with a tumour growing in his jaw has sat at home for the entire lockdown waiting until this madness ends with no idea when he can have the operation he was supposed to have two months ago. The departments that are still running offer a skeleton service which struggles to provide any real, meaningful care.
It’s not something that people feel able to talk about publicly, but many of us are quietly panicking about the inertia that has struck the NHS. There is no real incentive to start services up again and there’s the convenient cover of wanting to avoid a second wave. There’s no doubt that many doctors and nurses are working flat-out, but this is by no means uniform across the health service. There’s a risk that we have become so wedded to the apocalyptic Covid predictions that we refuse to accept that it’s time to enter a new phase: to open up the economy for the health of the nation, to restart NHS services and to get the country back up and running.
It needs to be remembered that what the NHS achieved in the early days of the pandemic was nothing short of miraculous. Within days of a critical incident being declared, entire services were restructured in preparation for the onslaught of Covid patients. It was an astonishing thing to witness and I feel proud of the speed and focus with which our health service — often criticised for being slow and unwieldy — responded to the challenge.
But many things didn’t turn out the way we had thought they would. In hindsight, mistakes were made in the rush to prepare. Ventilators which everyone had demanded were not as useful as first thought. Many of those badly affected — the very elderly or those with severe or terminal illnesses — would never have been suitable for intensive care anyway. Dedicated Covid wards, which had been created by hastily discharging sick patients, stood empty. The much-lauded Nightingale Hospital in east London — which took resources, attention and staff — treated just 19 patients over Easter weekend and has since been mothballed. But we’ve been unable — or unwilling — to accept that the strain on resources wasn’t as extreme as we expected and the NHS didn’t need to grind to a halt. It seems we now don’t know how to start the health service up again, despite the consequences its shutdown will cause.
Perhaps worse, many medical professionals have parroted the line that continuing lockdown is necessary to save lives, without appearing to consider the effect it is having on the poorest and most vulnerable. So many seem to have lost all critical abilities when it’s come to our response to this pandemic. There are estimates that the lockdown will cost 150,000 lives. That’s not just things like missed cancer diagnoses, which have been estimated at 60,000 — but increased domestic violence, alcoholism and suicide, untreated heart attacks, strokes and meningitis. Figures suggest two million patients who need treatment for non-Covid illnesses will be collateral damage.
And that’s not even accounting for how the economic destruction will affect health. The chattering, clapping middle classes who champion the lockdown have no idea of the grinding poverty or bleak reality of people’s lives and the way the lockdown has compounded and crystallised the misery they experience. It’s not all banana bread and Zoom yoga. The lockdown might still be shown to have been the sensible option — although the Nobel prize-winner Professor Michael Levitt said this week that he thinks it has saved no lives — but we need to accept that in trying to save lives with this strategy we have condemned others, the majority of whom are powerless and voiceless, to lose theirs.
I work around the corner from where Baby P was murdered and many psychologists, therapists and social workers now dread what will be discovered when services start to go back into the estates that we have abandoned for months. The lockdown was based on research that was not peer-reviewed from someone with no clinical experience and a history of making errors in his predictions. Yet where was the caution in acting on this modelling? Where was the usual critique that doctors would employ before adopting something that had the potential to be so damaging? When all this is over will we look back with horror at a trail of misery and death caused not by the virus, but by our attempts to prepare for it?
In the early days of lockdown, the adulation of the NHS served an important role in the collective consciousness. It was a salve to calm the fear and worry that spread through the public as the pandemic took hold. We needed to focus our attention on something positive. We needed heroes. But I do not think that we have behaved heroically. We have abandoned some of the weakest in society.
Dr Max Pemberton is a columnist for the Daily Mail and a medical doctor specialising in mental health and eating disorders.