The NHS only survived the first wave of coronavirus because it was forced to withdraw care from millions

We may not have seen chaotic scenes of the sick filling corridors. But that shouldn’t be the benchmark we hold our health service to. We must aim higher, writes Harry Quilter-Pinner

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The NHS has coped with Covid-19 remarkably well – this is the emerging consensus among commentators and politicians as we pass the peak of the crisis.

Take the new NHS Nightingale hospitals as an example. Erected in just a few days in April and kitted out to support thousands of patients, they have ultimately been surplus to requirement in the fight against Covid-19. The London Nightingale has now been put on standby after treating only around 50 patients in its first three weeks.

As a result, it may appear to many that we overestimated the threat of Covid-19 to the NHS and that our existing services have managed the crisis perfectly well. But that is to miss the point of emergency capacity. It is there as an insurance policy: the aim is not to use it, but to have it to fall back on if the worst comes to pass.

We should be grateful that social distancing has radically reduced the number of people infected and the NHS has supported those who are within its existing capacity. But, as Brits, we must guard against complacency. As the Conservative MP Nigel Lawson once said: “the NHS is the closest thing the English people have to a religion”. As a result, we tend to look at it through rose-tinted glasses.

But, when the stakes are this high, we must confront the fact that the narrative that "the NHS has coped well" is sadly wrong. The truth is that the NHS was only able to manage the spike in Covid-19 patients by withdrawing care from millions of others with potentially devastating results.

Over two million "non-urgent" operations have been cancelled or delayed. Many patients have been unable to access vital treatment. There has been a huge drop-off in people presenting at A&E with symptoms of a heart attack and stroke. And, there has been a staggering 76 per cent drop in urgent cancer referrals from GPs. In time, it may come to pass that the death toll from this redeployment of NHS resources surpasses that of the pandemic itself.

These are not just statistics – they represent people’s lives.

“I have stage three colon cancer. I have been told by my oncologist that all cancer surgery has been cancelled so the resources can be used to fight Covid-19. With surgery I have a 70-80 percent chance of making a full recovery. Without it, I will die” – this is just one of many harrowing stories of those who are suffering indirectly as a result of our response to Covid-19.

The tragedy is that it was entirely preventable. The NHS was only forced to ration care for patients because when the pandemic hit, it was already under huge strain. Access times in A&E demonstrate the point: in 2013, the English NHS began missing its key performance targets and since then has faced a near "permanent winter crisis". Warning signs were flashing red on workforce shortages, hospital discharges referrals to treatment as well.

Historically, the received wisdom in the NHS was that hospital managers should aim for about 85 per cent resource utilisation. This left some capacity free to manage "health shocks" such as the winter flu. Yet, as we entered the Covid-19 crisis, many hospitals were running at 95 per cent utilisation. This wasn’t a mistake, but an active policy choice, made in order to increase NHS productivity during the era of "austerity".

Commentators may point to Italy and conclude the NHS has done well in comparison. Our hospitals haven’t been pushed to breaking point. We haven’t seen the chaotic scenes of the sick filling corridors. But that shouldn’t be the benchmark we hold our NHS to. We must aim higher.

Going forward, we need to change course: we must invest in properly resourcing our NHS to make sure it is more resilient in the future.

Harry Quilter-Pinner is a senior research fellow at IPPR, the UK’s leading progressive think-tank