There was an interesting moment at the government's daily Covid-19 press briefing a couple of weeks ago. Angela McLean, the Deputy Chief Scientific Adviser, was reiterating the government's core message. 'What really matters', she said, 'is that people stay home, protect lives and save the NHS'. Then, a look of confusion, possibly even concern, took over her face. She raised a finger to her mouth and said: 'Or is it the other way around...?'
In short, she couldn't remember, for a moment, which message was most important: protecting lives or saving the NHS. She did have the message wrong. The government's latest public-health adverts make clear what the moral priorities are in Covid-hit Britain: 'Stay Home. Protect the NHS. Save Lives.'
Even when it’s in the right order, I find this messaging extraordinary, and worrying. It suggests our treatment of the NHS as a religion has reached such a dizzying level that the government thinks the best way to secure our obedience during this lockdown is by telling us we'll be helping to Save the NHS.
Of course, you could argue that these two goals are so closely linked that it doesn't matter which comes first. The justification for the lockdown is that we need to slow the spread of Covid-19 so the NHS doesn't become overwhelmed – ensuring doctors and nurses have the time and space to assist people with a bad case of the virus. So helping the NHS helps with the saving of lives.
Yet still, the importance of the NHS in the government's rallying cry is striking. Messaging is never accidental. And this messaging suggests officialdom sees our love for the NHS as possibly the last bit of social glue in our otherwise fragmented, Brexit-divided nation. Someone somewhere said: 'Tell them they'll be helping to save the NHS. That will do it.'
I think the government now needs to change its messaging, and with haste. Because it is becoming clear that the mantra of 'Save the NHS' isn't only a little weird – it is also possibly dangerous. More and more evidence is emerging that even gravely ill people are avoiding the NHS right now, and that lives may be being lost as a consequence.
This morning, the Daily Mail reports on Cancer Research UK's concerns about cancers going undetected during the Covid-19 lockdown. It says the number of people being referred by their doctors for urgent hospital appointments in relation to possible cancers has fallen by a staggering 75 per cent since the outbreak of the virus. This is disastrous because, as Cancer Research's Sarah Woolnough points out, operable cancers become inoperable if they are detected too late. Right now, as a consequence of our collective effort to Protect the NHS, people are developing cancers that will prove untreatable later on.
The Mail reports that some experts believe that the suspension of screening for cancer – again as part of the drive to Protect the NHS from being overburdened – could mean that 400 cancers a week are being missed. This is the collateral damage of the lockdown and the constantly pushed message that the public must do everything it can to avoid being a burden on the NHS right now.
It isn't only cancer. There also seems to have been a rise in cardiac-arrest fatalities at home. Minutes of a meeting held by London's Accident and Emergency chiefs, seen by the Guardian, report that more people than normal are dying from heart attacks at home. 'People don't want to go near a hospital', the minutes said. 'As a result, salvageable conditions are not being treated.'
Indeed, hospitals are incredibly quiet at the moment. They are 'eerily quiet', in the words of Scotland's interim Chief Medical Officer Gregor Smith. The Financial Times reports that health officials believe 'people may be failing to seek help for... life-threatening conditions during the coronavirus pandemic.’
Both anecdotal and statistical evidence suggests that this reluctance to impose on the health service is costing lives. As today's Mail points out, the latest Office for National Statistics figures confirm that the number of deaths in England and Wales are unusually high at the moment and most of the extra deaths are related to Covid-19. But not all of them necessarily are. Around 1,800 of the extra deaths could be from other causes. These could be from treatable conditions such as cardiac arrest or acute appendicitis or a result of the mental toll of life in lockdown. It all points, in the Mail's words, to a 'devastating wider impact' of the current crisis.
People are avoiding NHS services, either because they're afraid of contracting the virus or because they don't want to impose on an institution we have been tasked with protecting. Protecting from what? From us. That is the strange message of the government’s latest NHS slogan: the NHS is now depicted less as a service that protects us from ill-health, and more a kind of holy, untouchable institution that needs saving.
Has the cult of the NHS reached such a level that people are dying for it? Are people dying at home, or will die in the future, because they don't want to bother this unimpeachable institution? If so, ministers need to take action urgently. They should stop saying 'Protect the NHS'. If they aren't willing to do that, then they must, at the very least, make it clear every single day that very sick people can and must engage with the health service.
Protecting lives should be our overarching aim right now. And that means protecting lives from both Covid-19 and other diseases.