Everything has changed, and yet nothing has changed. In the NHS, the one spring of hope for healthcare workers in this winter of despair is that finally the country has woken up to the daily struggle for staff and the frustration faced by patients. A struggle summed up perfectly by one man in the BBC documentary, Hospital, waiting to see if his cancer operation will go ahead, or whether the intensive care bed he needed would go to someone else:
'If they die, then the bed is available for me and we can do the operation'
You could be forgiven for thinking that the NHS woke up one morning last week to suddenly find itself in this situation. But the truth is that frontline staff have been warning healthcare leaders and politicians about this for years.
Each year, winter is worse, with hospitals full to bursting and community services compromised by cuts to social care and a shortage of general practitioners. The reality for our patients is cancelled operations, record waiting time and emergency departments resorting to pushing chairs together to make up a bed for a sick child.
The response from government has been borderline farce. Emergency departments report the worst four-hour time-to-treatment performance on record, Jeremy Hunt suggests we scrap the target. Record demand for hospital care, Jeremy Hunt blames patients and the Prime Minister blames GPs, both ignoring the fact that patients waiting 12-hours for an inpatient bed are unlikely to be candidates for community care.
How did we get here? The answer is poor planning by successive governments. The UK spends less on healthcare, as a percentage of GDP, than many of our European neighbours. We also have fewer doctors, nurses and hospital beds per head of population. Yet instead of trying to bridge this funding and resource gap, the last parliament saw through £20bn in cuts and now a further £22bn in 'efficiency savings' have been ordered. Sustainability and Transformation Plans, the mechanism by which the government intends to carry out these savings, will close emergency departments, wards and even entire hospitals. Things are going to get worse, not better.
What we have witnessed in recent weeks is not the fault of patients, lazy healthcare workers or immigrants abusing the system. Without migrant workers, the NHS would have failed decades ago. Without healthcare workers, including GPs, routinely working above and beyond their normal duties the NHS would have toppled under rising demand years ago.
Consistent cuts, the disastrous Health and Social Care Act and ruinous Private Finance Initiatives were political choices. This NHS Crisis is the result of political choice.
Politicians have chosen to underfund our health and social care system and ignore the warnings of healthcare professionals. Tragically, patients are now seeing the very real cost with clear examples of avoidable harm reported widely across the right and left-wing press.
If the government wants to solve the problems the NHS faces, it must first come clean about the scale and scope of the crisis.
If we want safe, high quality healthcare, free at the point of use, we must increase our investment in the NHS to a level that at least matches other leading countries. We must recognise the increased pressure that austerity and cuts to social care have created within the NHS.
The government must acknowledge that healthcare workers are uniquely placed to provide solutions to the problems we face. They must engage and work with unions, like the BMA, and listen to our ideas and concerns rather than impose draconian change like the junior doctors contract.
I have never been more proud of my colleagues in the NHS and the way they have handled the pressures we face every day, but we are at breaking point. It is up to everyone, public and healthcare workers together, to ensure that the Government doesn't just sweep this under the carpet. We must hold our leaders to account for the choices they have made. If the NHS is to continue, as I believe it must, we must work harder than ever to keep it. We must fight for it.