On 19 July, most COVID-19 restrictions were lifted in England. However, scientists and academics warn that the NHS may not be able to cope with the tide of infections and that the government's new healthcare reforms are unlikely to fix this problem.
Prior to the removal of the restrictions, healthcare experts and scientists voiced concerns over the growing pressure on the country's National Health Service (NHS). A survey by the Academy of Medical Sciences suggested that flu and RSV (respiratory syncytial virus) hospital admissions and the death toll could be twice as high in 2021 as compared to a "normal" year. In addition, Public Health England has warned that COVID-19 cases in all regions of England are at their highest level in almost six months.
NHS 'watching rising curve of daily cases with horror'
On Monday, an unnamed NHS COVID ward employee published an op-ed expressing frustration over the rapid increase in cases of RSV in children and other respiratory viruses starting to rise again in adults. Coupled with the hike in COVID cases, this puts further pressure on NHS workers, the author of the article highlighted.
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"It is hard not to watch the steeply rising curve of daily cases with horror", the unnamed employee wrote. "Two cohorts were hard enough – Covid and non-Covid – but now that we have different Covid variants and patients with other respiratory viruses to isolate from one another, we are rapidly running out of side rooms and space in the hospital to do so".
UK Prime Minister Boris Johnson urged caution in a tweet on Monday: "This pandemic is far from over and that is why it is essential to keep up the system of Test, Trace & Isolate", he wrote. "We will protect crucial services by making sure that a very small number of fully vaccinated, critical workers can leave isolation solely for work."
However, it appears that adhering to the test-and-trace system might not be enough. Members of the Scientific Advisory Group for Emergencies (Sage) have reportedly told the prime minister that he should be ready to reintroduce COVID restrictions in August to avoid the NHS becoming overwhelmed, accordingto The Guardian. A total of 46,558 new cases were reported across the country a day after COVID rules were lifted.
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Still, it's not only the steep rise in infections which makes the NHS overwhelmed, according to Dr Sabrina Germain, a senior lecturer at the City Law School and member of City University's Centre for Healthcare Innovation Research (CHIR).
"I would say at this point, we're under great pressure at the moment for multiple reasons", she says. "Of course, we had a pandemic which is creating a backlog in the NHS, and we had a history of underfunding in successive healthcare reforms prior to this. But we have to take a step back and look at not only the amount of healthcare reforms we've had in the NHS, but also the reasons why".
According to Germain, the NHS was founded in 1948 on the idea that universal access to healthcare would be the solution to health problems. However, 30 years on, the NHS, the UK "started seeing reorganisations and reforms because of the pressure that it puts on the system when [one] offers free healthcare to all".
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Despite all the aforementioned efforts, Britons still do not have equal access to healthcare services for multiple reasons, the academic says. On the one hand, new technologies remain quite expensive and on the other hand the UK population is very diverse in terms of income, living environment, ethnicity, age etc. In particular, ethnic minority and migrant women "have a very different experience with the NHS than other population groups", she says, citing her research with Dr Adrian Young.
To complicate matters further, the UK population is ageing at a significant rate: in 2018, 18 percent of the country's total population was aged 65 years and over, compared with 10.8 percent in 1950. According to some estimates, between 2017 and 2040 the population of people aged over 65 will increase by 49 percent. Meanwhile, the numbers of those above 85 – the group most in need of health and care services – may double over the same period.
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Additional funding and targeted aid could at least partially help solve the British healthcare dilemma, according to Germain.
"More money is needed", the academic points out. "It was needed even prior to the pandemic, the coalition government and the present conservative government injected an insufficient amount of cash into the system, that's for sure… We need a greater number of workforce and we need more funds for that, obviously. We also need an injection of cash in public health to sum down those health inequalities".
The pandemic has become a litmus test for the country's healthcare system, exposing its vulnerabilities with the historically underserved population having a harder time with the COVID outbreak. This situation has also shown that it's important to have long-term planning, according to the lecturer.
The newly proposed healthcare reform in the UK, which envisages more government control over the NHS, still lacks a long-term vision, especially with issues around staffing in the country's healthcare system which remains a hot button issue, Germain believes.
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The Health and Social Care Bill is designed to facilitate the integration of services between existing standalone providers — such as hospitals, community care centres, and care services — and to get rid of burdensome tendering requirements for all services, according to Politico. However, NHS leaders have expressed concerns over handing the government more power over the system's functioning.
"I would say that centralisation, which is something that is actually offered by the new healthcare reform that's been introduced in parliament on 16 July is not necessarily something that will lead to better patient care", the academic presumes. "Here in the healthcare reform that's proposed it's much more of a power grab on the hands of the Health Secretary that could get involved in the workings of the NHS".