One million more patients attended A&E in the past year amid strikes, record waits for routine care and difficulties accessing a GP, figures show.

Health leaders say people have turned to emergency departments because it is one part of the NHS where they know the ‘lights are on’ and they will be seen.

But the surge in demand meant more patients waited longer than the target of four hours to be treated, admitted or discharged.

There were 25.34 million attendances at A&E in England in 2022/23, up 4 per cent from 24.37 million in 2021/22, according to NHS Digital.

Some 29.2 per cent of patients spent more than four hours in A&E in 2022/23, up from 23.3 per cent the year before.

Meanwhile, a record 1,789,130 patients spent over 12 hours in A&E – up 80 per cent in a year and up 491 per cent since 2020/21.

Patients in the poorest areas of the country are almost twice as likely to attend A&E as those in the wealthiest areas, the figures also show.

The figures were released yesterday as junior doctors walked out of hospital for the second day in a row. They are also due to strike again today.

The junior doctors provided emergency care on Wednesday but did not spare A&Es yesterday or today.

Almost 1million routine appointment and operations have been cancelled as a result of NHS industrial action since December, with waiting lists now at a record 7.7 million.

It has resulted in patients turning up to A&E in agony after facing delays to their care.

Matthew Taylor, chief executive of the NHS Confederation, which represents healthcare organisations, said: ‘A&Es have been under enormous pressure for years, with people naturally gravitating towards “where the lights are on” and where they know they will be seen in a relatively short time frame.

‘But it’s not just A&Es that are under pressure and that is the problem.

‘With general practice and primary care also facing huge demand, we know that patients may turn towards urgent and emergency care should they struggle to get a GP appointment at a time suitable to them.

‘As well as this we have an aging population with increasingly complex needs, a neglected and under resourced social care sector, and an elective care waiting list currently standing at 7.7m, all of which has consequences for A&Es which provide a safety net for the entire system.

‘For instance, many of those on waiting lists might develop complications to their condition and so seek help from urgent care.’

He added: ‘The data for last year shows the scale of the effects ever growing demand is having on A&E and on patients, with over 410,000 people waiting over half a day for admission, up from 98,000 the previous year, and this isn’t even from time of arrival, so a patient could’ve been waiting much longer.

‘But with too few staff, beds, or capacity and availability in alternative services, health leaders can only do so much.

‘This level of demand is unsustainable, so we need to see a greater focus on prevention and resourcing for community care to help relieve some pressure, keep patients healthy and out of hospital, and enable them to get care closer to home.’

Louise Ansari, chief executive of Healthwatch England, the patient watchdog, said: ‘People continue to wait many hours for care, often in crowded waiting rooms, with little or no information on when they will be seen.

‘However, people who received care for a life threatening illness or injury were still confident in the quality of care.

‘Undoubtedly, urgent and emergency services have been under unprecedented pressure for the last few years amid the pandemic, industrial action, record waiting times for hospital treatment and struggles to access GP care.

‘People will go to A&E if there is nowhere else to go, leading to increased treatment and care because they couldn’t get help sooner.’

Miriam Deakin, director of policy and strategy at NHS Providers, which represents NHS trusts, said: ‘These figures show trusts are working incredibly hard to respond to rising demand by seeing more patients than ever before.

‘This is remarkable given the relentless pressure on urgent and emergency care services and the wider sector.

‘However, demand continues to outstrip capacity, which means too many patients are having to wait longer for care and treatment.

‘Shortages of staff, beds and equipment, as well as the need for proper investment in the NHS estate, social care, and more preventative support, are putting the health service under an alarming level of stress.

‘Strikes are also piling on the pressure. By the end of this week, more than a million patients will have had their appointments and procedures pushed back due to industrial action.

‘This is incredibly distressing for all involved as trust leaders and their staff are unable to give patients the timely, high-quality care they deserve.’

Biden asks Congress for $40 billion in extra funds

By Morgan Phillips, Politics Reporter For Dailymail.Com

Published: 11:40 EDT, 11 August 2023 | Updated: 11:40 EDT, 11 August 2023

Advertisement

Biden asks Congress for $40 BILLION in extra funds – including an extra $13 BILLION for Ukraine – teeing up potential showdown with Congress

• The total $40 billion request includes $13 billion in emergency defense aid and wildfire pay and an additional $8 billion for humanitarian support of Ukraine
• Also includes $12B for disaster relief after a season of heat and storms, as well as $4B for the border and to combat fentanyl to attract Republicans to the deal

By Morgan Phillips, U.S. Political Reporter For Dailymail.Com

Published: 18:17 EDT, 10 August 2023 | Updated: 18:22 EDT, 10 August 2023

Memoir 

A Fan for All Seasons

by Jon Harvey (Yellow Jersey £18.99, 288pp) 

Jon Harvey’s brother, Dan, was nine years older, meaning Jon saw him ‘almost like a second dad’.

The two shared a love of sport that survived their allegiances to different football clubs (Tottenham Hotspur for Jon, Crystal Palace for Dan).

As Jon writes, ‘there are much worse things an older brother could be into. Just ask Prince Edward’.

Then, in 2015, aged 43, Dan died. Obesity had led to diabetes, and Jon lost ‘the keystone in my Jenga tower’. 

Inheriting his Palace season ticket, Jon went to the matches, including the FA Cup final, which the team reached the season after Dan’s death. They lost, which suited Jon: ‘The joy [of victory] would have brought pain’.

Maintaining the tribute, Jon decided to spend the next season attending as many sporting events as possible. 

We see him at The Boat Race, where he overhears a woman asking ‘how many boats are there?’; at the world handball championship in Paris (his brother’s memory is invoked by Denmark’s name appearing in their own language — ‘Danmark’), and at an England football match.

Because he’s been given premium tickets to this one, Jon discovers that the ‘prawn sandwich’ brigade (to quote Manchester United’s Roy Keane on corporate fans) enjoy their own private train service to Wembley from Central London.

This makes for a lovely contrast with the last-ever night at Wimbledon greyhound stadium before its demolition. 

Jon remembers previous visits and, in particular, the ‘elderly Irish waitress with hair as grey as the meat, who’d tend to have her thumb in the gravy as she brought the main course’.

A match at the world snooker championship finishes early, so the audience are treated to an exhibition performance by Dennis Taylor. 

Referring to the sport’s past drug scandals, Taylor mentions that it’s a good job the white-line graphics (used by commentators to illustrate possible shots) weren’t around in the 1980s, ‘or they’d have been gone in an instant’.

As you’d expect, there are plenty of sporting facts, the ‘kind of trivia that can be pub quiz heaven, or dating poison’. 

William ‘The Fridge’ Perry remains the heaviest American football player ever to score a touchdown in the Super Bowl — he was a pound shy of 24st. The note rung by the bell at the London Olympics was a B, although Bradley Wiggins only pretended to sound it — the bell was so huge it had to be chimed by a machine.

The first-ever winner of the Grand National (1839) was called Lottery. And the moves that allow you to solve a Rubik’s Cube are named after the shapes of the letters they make — T, J and Y are three of the main ones. 

Jon discovers this at the Cube’s world championship, where one member of the American team is called Patrick Ponce. The noise in the arena resembles ‘an army of angry rattlesnakes’.

The writing is vivid and funny, and it’s no surprise to learn that Jon is a comedy producer whose work includes Have I Got News For You, The Thick Of It and Yes, Minister.

The chandeliers at the Lakeside club in Essex (world darts championship) ‘floated like a bloom of blinged-up jellyfish’. At Selhurst Park football grounds ‘time stood still. So did the entire [Crystal] Palace defence’.

Approaching another football match, Jon notes that ‘at every street corner more and more clusters of fans in Spurs shirts were drawn in, like iron filings in range of a magnet’.

This is a wonderfully touching book about fandom and grief, and how the two can combine. 

When England have the Aussies 60 all out at Trent Bridge, Jon’s cricketing joy is tempered by his sadness at this being the first piece of sporting history that Dan’s not around to witness.

But gradually he accepts that life has to move on. Spurs certainly do — their stadium is demolished and rebuilt, and the first match at the new incarnation is (movingly for Jon) against Dan’s beloved Crystal Palace.

The club shop is selling commemorative ‘half-and-half’ scarves, each end bearing the name of one of the teams. 

This is a modern idea that ‘no self-respecting football fan can ever abide’. But on this occasion, Jon makes an exception.

The most uncomfortable journey of my life I spent squashed in economy class between two enormously fat passengers, on a jam-packed overnight flight from London Heathrow to New Delhi.

Veritable human elephants they were, with bottoms, thighs and tree-trunk upper-arms spreading far into my territory in the middle seat.

For nine hours I suffered there, hardly able to breathe, my shoulders hunched and my elbows tucked in front of my chest, finding it almost impossible to manoeuvre my food and drink into my mouth without spilling it down my shirt.

If you’ve ever sat down to a Christmas dinner for ten, round a kitchen table designed for six, you will understand my difficulty.

I thought of that flight this week, when I read that an American woman described as a ‘plus-size travel influencer’ is campaigning to make airlines offer free extra seats to passengers of her substantial proportions, who take up two or even three each. It’s a question of their human rights, apparently.

‘People with smaller bodies get to pay one fare to get to their destination,’ says Jaelynn Chaney, who keeps her weight private but admits that her frocks are an impressive size 6XL (that’s 24 UK, or European size 50). ‘But we have to pay two fares, even though we’re getting the same experience. If anything, our experiences are a little bit more challenging.’

Call me a brute, but I would have thought that if she wanted her experience of air travel to be a little less challenging, the remedy might lie in her own hands.

Isn’t it just possible that her discomfort in single seats may have something to do with the quantity and quality of her diet?

Dare I say it, wouldn’t it be within her power to slim down, if only she were to limit her intake of calories?

Not possible, says her champion Gabor Lukacs, the founder of an organisation called Air Passenger Rights. ‘Being a large-size person is not a choice,’ he says, ‘as many people mistakenly believe.’

Thus, in a single sentence, he dismisses the age-old notion that human beings are endowed with free will.

I’m reminded of that brilliant comedian Peter Cook’s waspish rejoinder when someone said that it wasn’t Elizabeth Taylor’s fault she was putting on weight. It was all down to her glands.

‘I know, poor woman,’ he said. ‘There she is, in her suite in the Dorchester, harmlessly watching television. Suddenly her glands pick up the phone and order two dozen eclairs and a bottle of brandy.

‘No,’ she screams, ‘please, I beg you!’ but her glands take no notice. Determined glands they are, her glands.

‘You’ve never known glands like them. The trolley arrives and Elizabeth Taylor hides in the bathroom, but her glands, her glands take the eclairs, smash down the door and stuff them down her throat.

‘I’m glad I haven’t got glands like that. Terrible glands.’

All I will say, cruel though this may sound, is that you don’t see many morbidly obese people among the wretched souls fleeing from famine in refugee camps.

Now, as regular readers will be quick to point out, I am the last person on Earth qualified to get on my high horse and preach against people in the grip of addictions. After all, I have a revolting 50-a-day cigarette habit, and I know how terribly hard it is to quit. I imagine the same must be true of people who are addicted to doughnuts and sweets, Big Macs and chips.

Indeed, I’m sure that it’s only my half century of addiction to nicotine that has kept my own weight down to between 10½ and 11 st since I was 18 — or rather less, over recent months, since my rotting teeth began to make eating a bit of an ordeal.

It’s almost certain that if I were to give up smoking now, and get my teeth fixed, I would exchange the hit I get from my Marlboro Reds for the comfort of over-eating. No doubt my figure would balloon, as has happened to so many of my friends, with stronger wills than mine, who have managed to wean themselves off the evil weed.

(I hasten to say that I can’t recommend chain-smoking or avoiding the dentist as wholly satisfactory ways of losing weight. The former is cripplingly expensive, at well over £14 a packet these days. As for the latter, I find that children tend to shriek and run away, terrified, when I smile.)

All I will say in my defence is that I fully acknowledge my weakness, I don’t blame anyone else for it and I try, as far as possible, to avoid letting my self-indulgence cause discomfort to others, never lighting up in the presence of people who object.

Oh, and unlike Jaelynn Chaney, who appears to believe all passengers on a flight should share the cost of awarding her an extra seat, I don’t expect anyone else to suffer financially because I won’t make the effort to kick my anti-social habit. Yes, I know. Anti-smoking fanatics will tell me that my vice costs the health service a fortune, estimated by NHS England at £2.6 billion a year.

To them, I can only point out the Office for Budget Responsibility’s estimate that tobacco duty alone will raise £10.4 billion in the current financial year.

What’s more, the obesity epidemic is claimed to cost a whopping £14 billion a year, which is the amount the NHS would save if everyone were of a healthy weight.

That’s according to an authoritative study last month, led by Dr Jonathan Pearson-Stuttard, a public lecturer at Imperial College London and head of health analytics at a consultancy firm, Lane Clark & Peacock.

But, no, I’m not for one moment disputing Jaelynn Chaney’s right to be fat. Nor do I begrudge overweight people the subsidy from other passengers which they already enjoy if they occupy single seats, since every extra pound of flab aboard increases the amount of fuel a plane needs and so pushes up fares for all.

Still less would I suggest that in the UK, the NHS should refuse to treat patients who have brought their suffering on themselves — whether smokers, fatties, speeding motorists or enthusiasts for dangerous sports.

All I am saying is that Jaelynn should acknowledge her personal responsibility for her enormous size, and accept that she could do something about it, if only she put her mind to it. As with me and my smoking (all right, Mrs U, and my drinking too), she has a choice.

No doubt I’ll be roundly condemned for ‘fat-shaming’. But then we nicotine addicts are constantly shamed for our habit, banished like lepers from enclosed public spaces, and scolded by warnings on our cigarette packets that our selfishness harms others around us, and stunts our unborn babies’ growth.

But you won’t hear many of us whimpering that this is an abuse of our human rights.

I would even argue that the shaming of smokers, whether by governments of every hue or by hosts at private parties who tell us to light up in the garden or the street, ‘if you really must’, has improved the health of the nation’s lungs.

Of course, the annual increases in tobacco duty have been by far the most influential factor in bringing the number of UK smokers down from roughly 40 per cent of the adult population in the 1970s, to the mere 13.3 per cent recorded in the 2021 census. But the campaign to shame us must surely have helped.

By the same token, mightn’t a spot of concerted fat-shaming help slim down the Great British buttocks, and save our own growing army of Jaelynns from themselves?

But let me end with a plea to airline check-in staff the world over. As a nicotine addict, I have a great deal of sympathy with people who can’t bring themselves to say no to that extra slice of cake. But the next time a pair of human elephants waddle up to your desk, please don’t seat me between them.