The Health Secretary won't admit to an A&E crisis. Photo: Getty
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NHS pressures hitting A&E causes a political crisis for the Tories

A number of hospitals in recent days have declared "major incidents" because of A&E pressures.

Emergency departments in our hospitals have reached a "tipping point", according to Dr Clifford Mann, the president of the College of Emergency Medicine. He is referring to the release of figures today expected to show the worst performance of A&E units in a decade, with the government's four-hour target waiting time almost certainly missed.

NHS England is set to publish some damning data on the last quarter of last year today, revealing the pressure on our hospitals that the increase in patients attending A&E, up 20,000 since 2013, has had. A number of hospitals have filed "major incident" warnings in recent days, because their emergency departments have been overstretched.

In spite of a number of senior figures in the medical world – including those working in some of the hospitals issuing major incident warnings – regarding the situation as an unprecedented situation, government figures have so far refused to call this a "crisis". Dr Ian Proctor of one of the affected teaching hospitals used the word in an interview on the BBC's Today programme this morning, but the Health Secretary, Jeremy Hunt, who was interviewed afterwards, refused to use such terms.

It's clear there is a capacity and, to some extent, a resource issue affecting our hospitals, but government ministers – specifically Conservative ones – would fall into a political crisis if it treated the situation with the gravity it calls for. This is because Labour's narrative for over a year has been about an "A&E crisis" in our hospitals. As Labour ramps up its rhetoric on the NHS, and the rhetoric manifests itself as a reality in our beleagured health service, it will become increasingly difficult for Tory figures like Hunt to close the credibility gap in its approach to the public service that could well become the general election's central battleground.

Anoosh Chakelian is deputy web editor at the New Statesman.

Photo: Getty
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The big problem for the NHS? Local government cuts

Even a U-Turn on planned cuts to the service itself will still leave the NHS under heavy pressure. 

38Degrees has uncovered a series of grisly plans for the NHS over the coming years. Among the highlights: severe cuts to frontline services at the Midland Metropolitan Hospital, including but limited to the closure of its Accident and Emergency department. Elsewhere, one of three hospitals in Leicester, Leicestershire and Rutland are to be shuttered, while there will be cuts to acute services in Suffolk and North East Essex.

These cuts come despite an additional £8bn annual cash injection into the NHS, characterised as the bare minimum needed by Simon Stevens, the head of NHS England.

The cuts are outlined in draft sustainability and transformation plans (STP) that will be approved in October before kicking off a period of wider consultation.

The problem for the NHS is twofold: although its funding remains ringfenced, healthcare inflation means that in reality, the health service requires above-inflation increases to stand still. But the second, bigger problem aren’t cuts to the NHS but to the rest of government spending, particularly local government cuts.

That has seen more pressure on hospital beds as outpatients who require further non-emergency care have nowhere to go, increasing lifestyle problems as cash-strapped councils either close or increase prices at subsidised local authority gyms, build on green space to make the best out of Britain’s booming property market, and cut other corners to manage the growing backlog of devolved cuts.

All of which means even a bigger supply of cash for the NHS than the £8bn promised at the last election – even the bonanza pledged by Vote Leave in the referendum, in fact – will still find itself disappearing down the cracks left by cuts elsewhere. 

Stephen Bush is special correspondent at the New Statesman. He usually writes about politics.