Labour must convince the undecideds it can get the NHS back on track

Six days before Christmas, English A&Es reported their ‘worst week’ ever.

In the second week of December, 44,000 people waited in A&E for more than four hours before being seen; 10,000 patients waited on hospital trolleys for up to 12 hours before being admitted; and just six out of 140 emergency departments saw patients within the four hour target. All of these are landmark figures for an NHS preparing to enter its 66^th year.

Behind each of these statistics are personal stories; stories from staff, patients and their families of an NHS that appears to be reaching breaking point and struggling to cope even before the cold weather really kicks in.

What will be concerning officials, ministers and hospital directors most – and what is putting the greatest strain on frontline NHS services – is not necessarily the rise in people attending A&E, but the record number of people being admitted to hospital as an emergency.

These are not people attending A&E with minor ailments or unnecessarily, but seriously ill patients requiring urgent care. The result? Hospital staff struggling to perform routine operations and procedures because hospital beds are monopolised by patients admitted from emergency departments.

The NHS needs a quiet spring and summer period to be able to manage the busier winter season. However, in 2014 – unlike previous years – the quiet period never materialised. This comes at a financial cost for hospitals that have to pay for expensive, unplanned medical care and a cost to patients who see operations cancelled at the last minute as services try to manage the extra workload.

The reasons behind this deterioration in performance are complex, but there are some contributing factors.

People are living for longer. An older population means more people living with one or more long term conditions, such as dementia or diabetes, requiring more complex and expensive medical treatment.

Dramatic reductions in money to local government during the course of this Parliament have led councils to tighten their eligibility criteria for social care services. Greater numbers of older people at risk of frailty or illness are now living at home without adequate care or support to prevent avoidable admissions to hospital.

Finally, last year’s winter was unusually mild, leading to fewer than expected deaths due to cold weather and, consequently, less demand on hospital departments. It is too early to predict whether this winter will be same, but Coalition ministers will be keeping a watchful eye on the thermometer, fearful of any cold snap at a time when the NHS has already reached capacity.

The reality is that as the general election campaign officially starts the pressure on the NHS and its A&E departments is over and above what has been seen in recent years. We are entering new territory. Expect figures out tomorrow on NHS performance over the Christmas fortnight to compound this further and fuel the media narrative of a health system in ‘crisis’.

This would have been bad for any government of any party in any year, but an election year? Well, it certainly won’t have been on David Cameron’s New Year wish list. However, Labour cannot afford to be complacent. Although Labour is more trusted on the NHS than the Conservatives, David Cameron still leads Ed Miliband on the issue.

January is set to be Labour’s “health month”. The forthcoming publication of Labour’s ten year plan for health and social care cannot simply be a critic of the Conservative’s handling of the NHS since 2010. It must present a tangible alternative direction for the health system which can convince undecided voters that a Labour government led by Ed Miliband can put the NHS back on track and respond to the challenges of a 21^st century Britain.