Reluctance to seek medical care risks storing up another public health crisis
Are people in Britain getting the healthcare they need?
The sad answer, after six months of intense pandemic response, is that far too many are not.
Some of that is down to the public’s own choice to avoid seeking medical advice. In May, a poll conducted by IPSOS for the Health Foundation showed almost half of us (47 per cent) were uncomfortable using our local hospital, largely from fears of being exposed to coronavirus and not wanting to bother NHS staff busy dealing with the pandemic.
The NHS itself, meanwhile, postponed routine treatment from April to focus on Covid-19 — routine treatment such as non-urgent surgery and diagnostic tests.
The result is that during the first wave of coronavirus, huge numbers of people who would normally have sought treatment — not only for minor ailments but even for urgent, potentially life-threatening conditions — did not do so.
This trend is already having serious effects. In the first half of 2020, nearly a quarter of a million fewer people were urgently referred for suspected cancer compared to the first half of 2019, while significantly fewer people have received treatment for heart attacks according to research published in The Lancet.
In April, a survey of people with long-term health conditions found 63 per cent had planned treatment cancelled by the NHS. In May, GP appointments were 33 per cent down, and visits to A&E down 42 per cent, while a survey showed that 24 per cent of people found it harder to access essential medications during lockdown.
There have already been 600,000 missed smear tests (screening for cervical cancer), and first treatments for cancer fell by 28 per cent in the last three months compared with the same period in 2019.
Early diagnosis for health conditions such as cancer is crucial to preventing serious complications and saving lives. The fall in people seeking advice about their symptoms due to fears about Covid-19 combined with the reduction in tests and early treatment is deeply disturbing and is likely to store up many more problems for the future — for individuals and for the NHS. Indeed, scientists are warning that delays to diagnosis and cancer treatment alone could lead to as many as 35,000 excess deaths.
Meanwhile, waiting times for non-urgent hospital treatment have grown — almost half of people on the waiting list have already waited longer than the 18-week target because of the pandemic.
As the number of people in hospital for Covid across England has significantly dropped (now only 545, from a peak of over 17,000), the NHS has started to reopen non-Covid services. But the NHS won’t be operating at anything like normal capacity for as long as the virus remains a threat, as the extra precautions needed to protect patients and staff from coronavirus constrain hospitals’ ability to treat the backlog.
On top of such pressure, the health service faces another imminent challenge: the winter flu season. Not only will we see the usual spike in respiratory infections from flu and other bugs as the weather turns colder, but worst case scenarios show that there could be about 120,000 more coronavirus deaths across the UK this winter. Both will result in more emergency hospitalisations that will inevitably hamper the health service’s efforts to clear the non-urgent waiting list.
The picture is worrying. But while the weather remains warm and the infection rate low, we have a crucial opportunity to rectify the situation.
The aim now should be to make as much progress as possible before winter sets in — and that means encouraging the public not to put off seeking advice from the GP about symptoms. Given that level of coronavirus now across the UK is extremely low, now is the time for a public information campaign explaining that the risks of waiting to seek help are currently greater than the risks of contracting Covid-19.
The government also needs to level with the public that the extraordinary circumstances of the pandemic inevitably mean longer waiting times for treatment for those of us with less serious conditions. Finally, it is more important than ever for people to go out and get a flu jab, to protect themselves and take pressure off the NHS.
Understandably, some of us are reluctant to use the NHS at the moment. We may be worried about our own health, or determined to do our bit not to overwhelm the health service. This is understandable. But there is an important opportunity for people to seek care now, rather than in the midst of flu season or a second Covid wave — and an opportunity for the NHS too, to ensure those who need urgent help get it.
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