Our ambulance service is in freefall but nobody dares call it an emergency

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Natasha Pszenicki
Martha Gill15 March 2023
WEST END FINAL

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I’ve been swimming in Hampstead ladies pond through the winter for years now, but in the last couple of seasons I’ve been concerned that things are getting a bit soft over there. “Be aware of the low temperatures!” a new noticeboard reads, while concerned lifeguards flutter about, checking that you’ve done this before. “Get in slowly!” “Every added degree is a minute you should take off your swim!”. At this time of year most of us there are regulars, and you can see people feeling huffy.

It was a beautiful sunny day last week, the first for ages, and I decided to swim a bit further than usual. The initial bite wore off — I’m usually prompted to get out after about four minutes — and it became almost warm: it’s funny how I could stand the cold so much better than usual. Dimly, I realised that I was quite a way from the ladder, and wasn’t sure if I could make it. Of course I was becoming hypothermic, and hadn’t realised. It can happen to anyone.

The strangest thing about crises is how quickly we get used to them. A situation that might be cause for pandemonium when it first arises becomes, after a while, quite unremarkable. Take Liz Truss’s mini-Budget, which had immediate effects, and therefore provoked immediate action. The effects of Brexit, on the other hand, have been slow burn — it’s an economic catastrophe but never quite a crisis. We have simply learned to accept it.

Or take ambulance waiting times. Imagine if, owing to some monumental screw-up, that there was a single week in which people suddenly had to wait almost five times as long as usual after a 999 call, meaning stroke victims died in their kitchens or in hospital car parks, totally unnecessarily.

You might expect uproar, recriminations, a demand for culprits, sackings, inquiries. This “death week” would become notorious — a warning not to make the same mistakes again.

But it’s different when the death week creeps up slowly, and then stretches to several years. It becomes routine. We’re in the death week now, and have been getting here for quite some time. It used to take 20 minutes for an ambulance to reach stroke victims, and now it takes around an hour and a half. And sometimes up to 15 hours.

These days, if you have a heart attack or fall down the stairs, you can’t expect a rescue system to click into place like it used to. You might get lucky, but you might not.

Over 500 deaths last year are attributed to ambulance delays. But there has been surprisingly little noise about this from the public, so far — and correspondingly surprisingly little crisis action from the government. Do they even think of it as a crisis? Rishi Sunak says he is working to improve response and waiting times, but no emergency measures have been announced.

This comes against a background of gentle NHS collapse. There are not enough doctors, not enough nurses, not enough equipment. We’re in deep cold water but have stopped struggling to get out. We’re floating listlessly, and are starting to feel warm and sleepy. More than half of paramedics have seen a patient die due to expanded wait times in the emergency system. Yet this has fallen off the political agenda. We’ve drifted into this situation, and no one seems to be coming to help us.

What will happen next? Without a big intervention, things are likely to get worse. A giant backlog of patients blocks the NHS: some seven million are now waiting for treatment. The longer this goes on, the more likely these patients are to end up having to phone an ambulance, or turn up at A and E.

But a political reckoning might just be coming too — there are signs that we are at last starting to awake from our daze. When you fall ill in a rich nation and can’t get help, you eventually start to think your country is malfunctioning. Recent polling from Ipsos shows only 8 per cent in England think the government has the right policies for the NHS and 82 per cent think it needs more funding. In January the NHS topped public concerns for the first time since the pandemic.

This is the sort of thing that costs governments at elections, especially Conservative ones. Tory nightmares in both 1997 and 2017 coincided with the NHS ticking up the list of voter concerns. It is an old cliche in politics to say the British are attached to their health system — so Rishi Sunak should not need reminding that keeping it up and running is one of the biggest motivators in politics. Fix ambulance wait times, or feel the consequences.

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