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It’s Narnia on the wards: the NHS is in permanent winter crisis now

<span>Photograph: Reuters</span>
Photograph: Reuters

Boris Johnson would be well advised to stay away from hospitals. His manicured photo-op visits cause extreme indignation to staff, who are kept well away, his presence unannounced to them for fear they would barge in and tell him a few truths. But his advisers still reckon the picture of the prime minister with a nurse or doctor with an ostentatious stethoscope is worth the mostly unheard aggro below stairs when it’s over.

Often these visits come with half-promises made to the local press of untold largesse, silencing managers for fear of the money evaporating. At one recently, a director, who wouldn’t let me breathe the hospital’s name publicly, told me that despite the large sums announced at the visit, all they were left with for certain when the PM had gone was a little extra for outdoor canopies under which patients could queue.

Queuing – the old NHS rationing mechanism – is back with a vengeance. With immense effort and spending, long waiting lists were finally abolished by the Labour government, proving to the many naysayers that it can be done. Today’s latest figures show A&E waiting times are the worst since a target of a four-hour maximum delay was introduced in 2004.

Will there be an NHS crisis during this winter election? There already is, everywhere. It’s Narnia on the wards: permanent winter, as the pressure never lets up in the summer now, with performance figures rapidly worsening year after year. The condition of the NHS is already critical, before the Australian flu epidemic predicted for this winter has even arrived.

Professor John Appleby of the Nuffield Trust warns “one of the bleakest winters in the NHS’s history” is upon us. People waiting on trolleys to be admitted to wards reached 80,000 last month, and he expects worse to come.

Labour is promising £5.5bn more a year than the Tories for the NHS by 2023-24. Is that enough? Though that 4.3% annual rise will be the second steepest by a government, after the last Labour government shot it up by 6% a year, no one really expects it to provide the instant magic of a “world-class health service we need”, which they suggest. How could it, after eight years of starvation at just more than 1% of funding increases a year, compared with the average annual rise in funding since 1948 of 3.7%?

A&E waiting times are the worst since a target of a four-hour maximum delay was first introduced in 2004.
A&E waiting times are the worst since a target of a four-hour maximum delay was first introduced in 2004. Photograph: UIG via Getty Images

Look at the ruination and depredations of this decade that need to be repaired, with 15,000 missing and desperately-needed beds and 100,000 missing clinicians and nurses. Nurse and doctor training places were cut sharply in George Osborne’s first budget.

Then nursing bursaries went, haemorrhaging applicants. Even with visas for foreign medics liberated from the iron grip of the last years, new staff can’t be summoned up miraculously overnight. GPs are in critical shortage, with waiting times sorely felt by voters. Under a less pig-headed treasury, more money could instantly solve the pensions crisis that has seen waiting lists soar to 4.6 million as a third of senior doctors abandon extra shifts.

The structural damage done by the 2012 Health and Social Care Act is still under repair by the NHS chief executive, Simon Stevens, who is trying to pull back together into a unified service the fragments blown apart in a reform intended by the former Tory health secretary Andrew Lansley to lead to greater competition. That commissioning model still leaves postcode lotteries in provision, and money sent from the top for mental health has not been ringfenced, so it often gets diverted to other emergencies, leaving children’s mental health services especially bereft.

Mind, the mental health charity, revealed this month that vulnerable children, many with suicidal and self-harming thoughts, had 175,094 appointments cancelled in the last year, a 25% rise on the previous year. As for the crisis in social care, which leaves older people lingering on wards for much longer than they should, no one expects the Tory manifesto to dare to solve the long-term financing question, just to apply a little more cash Elastoplast to get them through the election.

Voters naturally tend to credit Labour as the safest pair of hands for running the NHS. The health service is voters’ second greatest concern after Brexit – which, contrary to that bogus Boris-bus promise, will deplete the Treasury’s ability to fund it. Month after month, worse figures will keep tumbling out the about the service. It wouldn’t take much to thrust overflowing A&Es to the top of TV news bulletins every night, because the NHS is in crisis already, with a long month still to go.

• Polly Toynbee is a Guardian columnist