BMA: Total Chaos of Government Thinking on NHS – Before and During Pandemic

Becky McCall

September 13, 2021

'Total chaos in government thinking' and chronic neglect of the NHS prior to the pandemic contributed to the excessive impact of COVID on the nation's health and on 130,000 deaths since the pandemic began, asserted the chair of the UK doctors' professional body, the British Medical Association (BMA).  

Dr Chaand Nagpaul

Speaking in his address to the BMA's Annual Representative Meeting (ARM), Dr Chaand Nagpaul, the BMA chair of council, asserted that prior to the pandemic, all parts of the NHS had been starved of facilities, and it was an NHS already in crisis with almost 90,000 staff vacancies.

"We have consistently called out the total chaos in government thinking, we gave leadership where the UK Government was lacking," he asserted. By way of example, he said the BMA was the first medical body to call for mandatory mask-wearing by the public and to financially support people to stay at home in order to protect the public's health.

Nor were the alleged failings of the test and trace system lost on Dr Nagpaul. "We challenged the scandalous waste of billions of taxpayers' money as privately run services reached only 60% of contacts, where local public health teams reached 97%."

Speaking to the virtual gathering of doctors' representatives, he said that the BMA "will not accept an NHS unprepared for a pandemic," nor, "a nation bereft of public health staff, facilities, and testing capacity, with ministers then paying billions to private companies who were unable to deliver".

GPs Vilified

In turning his focus to GPs, he applauded their work in reaching out to high-risk patients for vaccination, as well as more administrative information on taking bookings, giving information on eligibility, and supplies, but added that it was, "soul destroying for GPs to be unfairly and publicly vilified for not being able to operate normally".

"Our media rarely lends the hand of support when it can point the finger of blame," he remarked.

In a tweet, anaesthetist Dr Tom Dolphin, from Imperial College Healthcare NHS Trust referred to Dr Nagpaul's "slamming" of the Government for their total failure to defend GPs against the onslaught of unfair attacks in the media. 'GPs are following NHS COVID protocols for safety, and [are]still seeing huge numbers of patients. Why are the Govt not standing up for them?' he wrote.

Also, tweeting on the address, Dr Hannah Barham-Brown, GP trainee in Yorkshire, and council member of the British Medical Association, said: "We have been worked to the ground, sacrificing our own mental and physical health, despite the Govt letting us down time and again, and now they allow us to be vilified for following their orders."

Freedom Day or Epidemiological Stupidity?

As July 19 ('Freedom Day') approached, the Government lifted all legal restrictions on the basis of more than 34,000 new cases on 19 July, Dr Nagpaul pointed out. "[We are]… the only nation in the world to do so amidst spiralling infections - an approach the WHO called "epidemiological stupidity", yet the initial freedom date in June had been delayed by an arbitrary month due to over 8000 daily cases.”

Dr Nagpaul asserted that the so-called 'Freedom Day' was a "gamble" that had contributed to almost 40,000 hospitalisations and more than 4000 deaths since July 19 alone. "It sent completely the wrong message to the public as if the threat of the virus was behind us," he said.

"It would be like removing the requirement to wear seat belts at a time of increasing road traffic accidents. Ministers call this living with COVID but for too many they are suffering or dying with COVID," he said.  

Many of these infections could undoubtedly have been prevented through simple mandatory measures and would not affect reopening society, he added. "Wearing a mask does not stop you buying a pint of milk or getting on a train. Hairdressers wearing masks in ventilated salons would not stop them cutting customers hair."

Appreciation for the Whole Medical Workforce as Well as Pay and Staff Shortages

Congratulating the UK's medical workforce, he said the profession has stepped up magnificently, from hospital doctors doing vaccine shifts on top of a full working week, to retired doctors returning to work.

In support of the staff, he said: "We will not accept a return to the old pre-pandemic NHS, which was so patently under-staffed, under-resourced, that over 9 in 10 doctors say they are afraid of medical errors daily." He added that a BMA survey had shown that 51% of their members had suffered mental health difficulties, and that calls to the BMA mental health helpline were at an all-time high.

NHS doctors' pay was addressed, with Dr Nagpaul noting that, "after all that doctors have done for the nation, then we've been given a pay award lower than the projected rate of inflation". In terms of staffing, he also noted that the profession could not afford to lose a single doctor when they were already 50,000 doctors short compared to other European OECD countries. "Any further reduction in workforce will be catastrophic for the nation's health."

The Health and Care Bill 2021

With England's ongoing Health and Care Bill due to be debated again this autumn, Dr Nagpaul took the opportunity to comment on key aspects, notably saying that, "this is the wrong bill and the wrong time".  

"After the failure of the 2021 Health and Social Care Act, does the Government really want history to repeat itself with another rushed and disoriented reorganisation?"

First, turning to the Bill's promise to reduce privatisation by ending competitive tendering, he pointed out "yet [it] allows private providers to sit on clinical commissioning boards. It promises local and clinical leadership but gives the health secretary unprecedented powers to interfere in local matters."

He turned to the Bill's lack of consideration for staff shortages. "[It] does nothing to tangibly address staff shortages. It notably fails to mention the absolute need for a truly independent public health service. It doesn't give public health specialists a key seat on ICS [integrated care systems] boards."  

The BMA Annual Representatives Meeting is being held virtually and in-person at BMA House, London. September 13-14, 2021.

Lead Image: BMA
Image 1: BMA


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