Is the NHS in more trouble than usual this winter?

As health service chiefs warn of a ‘tidal wave’ of viral infections, Sean O’Grady looks at the causes and implications of the crisis facing our hospitals

Rather like Santa, mince pies, Wham!’s “Last Christmas” and the (execrable) Mrs Brown’s Boys special, the NHS winter crisis has become something of an annual ritual. Indeed, only those now in their sixties can recall a time when the media wasn’t routinely full of stories about overcrowded wards and emergency departments at breaking point.

The peak of the Covid pandemic was obviously the worst of times, but the coronavirus, with its numerous variants, hasn’t disappeared. Indeed, this winter has brought what the NHS officially calls a “quad-demic” of viral illnesses, the seasonal peak has arrived early, and the health service is already in trouble. Flu cases are up fourfold on 2023.

What’s a ‘quad-demic’?

It is what we have now, because, unlike in past years, there are now four distinct, well-established, and prevalent viral illnesses that are potentially serious enough to inflict substantial damage to health, and in rarer cases can be fatal. Hence “quad-demic”. They are influenza, norovirus (“winter vomiting bug”), respiratory syncytial virus (RSV), and, of course, Covid-19.

All are unpleasant, and all are more dangerous than is commonly assumed. The numbers of cases have risen sharply compared with the same period last year. Stephen Powis, NHS medical director and a familiar figure from the Covid press conferences, calls it a “tidal wave” of infections, with a 70 per cent increase in flu cases in the last week alone. As we know from the emergence of long Covid, there can also be long-term implications for health – and, via the effects on people’s capacity to participate in the labour market, for economic activity.

Why now?

Winter is when people tend to huddle together inside, and Christmas and new year are obviously peak times for socialising. Without the old Covid restrictions, the various viruses are free to circulate. The difficulty many people still have is getting to see a GP – a problem that may also be pushing people towards the clinics and hospitals.

But there are also malign underlying trends at work. The nation’s health isn’t as good as it might be, meaning that people are less able to resist infection; long-term pressures on the NHS, demographic trends, and more obesity and diabetes, for example, are all unhelpful factors. Brexit made the recruitment of health and care workers more difficult and added to labour shortages.

The anti-science activities of the anti-vaxxers have also made their baleful presence felt, pushing vaccine rates down across the board, and adding to human suffering.

Could it get worse?

Quite easily, given that the bulk of the festivities lie ahead of us.

Is this a political issue?

Yes and no. The bugs don’t have a vote, and are indiscriminate (even egalitarian) in their habits – they’ll make anyone sick, from billionaires to the homeless, although some socio-economic and ethnic groups can be affected more than others, as we found during the most intense phase of the Covid pandemic (which of course hasn’t really gone away).

That said, any issue affecting the NHS is always a deeply political matter, and any further deterioration in its effectiveness would be a matter of grave concern. Powis is already cautioning that “as the incredibly busy winter continues, I would encourage everyone to remember to use NHS 111 in the first instance and only use A&E and 999 in life-threatening emergencies”. He also wants everyone to get a jab.

So who’s to blame?

Apart from the anti-vaxxers helping to wreck people’s lives, the political question is whether the public will tend to blame the present government for not doing enough, or the previous government for its awful legacy. Or both.

Wes Streeting, the health secretary, is almost six months into the job, and is beginning to feel the benefit of the tax hikes of the past few months. He’s also, perhaps, being a little too boastful about his record, given the atmosphere of crisis that seems to be gripping some hospitals. He says: “The NHS today is delivering a record number of treatments, and waiting lists have begun to fall. There’s a long way to go, but through our plan for change, we will get patients seen on time again.”

The shadow health secretary, Edward Agar, asked this of Streeting a few weeks ago: “Every year, irrespective of which party is in government, winter is challenging for the NHS. Possibly, it will be all the more so this year, with the potential impact on older people’s health of the loss of the winter fuel allowance by many. What winter preparedness steps has he taken, like previous governments, to increase A&E capacity and to increase the number of beds this winter, and can he say by how many?”

In any case, Keir Starmer would be well advised to make sure that Wes himself is up to date with his jabs. Labour has a lot riding on him.