Why is the government limiting NHS hospital treatments when they are needed most?
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The government is limiting NHS hospital treatments in the midst of a flu epidemic, in a policy contradiction so severe it seems deliberate.
The BBC is telling us:
“Access to hospital treatments is being restricted in many areas of England as the NHS struggles to balance its books, the BBC has learnt.
“Regional health boards have ordered some hospitals to cut back on the number of patients they are seeing, meaning hundreds of thousands of patients could have to wait longer for treatment.
“The rationing measures are being applied mainly to private firms doing NHS work, but multiple NHS hospitals are understood to be affected too.”
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At the same time, this is happening:
“The number of patients in hospital with influenza has risen more than 50% in the past week, with officials warning there is still no sign of it peaking yet.
“In the week up to Sunday there were 2,660 flu cases a day on average in hospital, which NHS England said was the equivalent of having three hospitals full of flu patients.”
The BBC article does quote the Medical Director for the NHS in London, Chris Streather, who said the flu situation was “well within the boundaries” of what the NHS could cope with and that hospitals were better prepared for large disease outbreaks since the Covid pandemic.
But put the two BBC reports side-by-side and the contradiction is staggering.
On one hand, integrated care boards (ICBs) are ordering hospitals to cut activity, delay treatment, stop taking new referrals, and even cancel already-scheduled operations — because the NHS has run out of money and must “balance the books” before the end of the financial year.
This is not a marginal change. The reductions include:
- Activity cuts of up to 30 per cent
- Eight-week increases in waiting times
- NHS hospitals being pulled into the same slowdown
- An estimated 140,000 fewer patients starting treatment by March — almost certainly an undercount
- Surgeries cancelled at just a few days’ notice
- Private capacity going unused on purpose
This is rationing by budget line, not by clinical need.
On the other hand, the NHS is simultaneously dealing with:
- The worst early-winter flu surge since records began
- A possible doubling or tripling of admissions
- Children and older people especially hard hit
- A service already overwhelmed in A&E and acute medicine
- Ministers warning the NHS is in a “precarious situation”
- Strikes adding further strain
- NHS England’s own senior doctors calling it “unprecedented”
- Warnings that hospitals may soon face a “worst-case scenario”
So while emergency departments are being hammered and hospital beds are filling with flu and norovirus cases, the same system is being ordered to reduce elective work, delay patients, and use less capacity.
There is no way to reconcile these two positions with any coherent notion of public health planning.
It exposes three truths I think the government would rather not admit:
- The NHS’s crisis is driven primarily by underfunding and workforce shortages — not winter viruses.This is confirmed by acute physicians (e.g. Dr Vicky Price) who say winter illnesses are simply the spark landing on a decade-dry tinder pile.
- The financial framework forces ICBs into perverse incentives — cutting treatment even when demand is rising, because hitting the budget target takes legal precedence over meeting waiting-time standards.
- Ministers are using winter flu and a threatened resident doctors’ strike as political cover for a breakdown that was already happening.
The cuts to activity were in planning documents before the flu surge peaked and before these latest strike dates.
The result is an NHS that is being told to see fewer people at the very moment when more of us desperately need care.
A system in crisis is being told to shrink further, guaranteeing that backlogs grow, conditions worsen, and flu-related pressure becomes far harder to absorb.
And ministers can say: “Look! It’s the flu! It’s the strikes! It’s demand! It’s anything except our own policy decisions.”
But it is a government policy decision. And you need to know it.
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Labour’s planned ‘reforms’ are not – YET – an attack on human rights
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It would be easy to believe right-wing loons like Nigel Farage have a point when people start having hysterics at the notion of reinterpreting human rights laws.
They don’t.
But articles like this one, from The Guardian, don’t help:
“Keir Starmer and Europe’s hardline governments risk creating a “hierarchy of people” as they seek to address migration by curbing fundamental rights, Europe’s most senior human rights official has said.
“Michael O’Flaherty, the Council of Europe’s commissioner for human rights… pointed to the “lazy correlation” of migration and crime as an example. “This doesn’t correspond with reality,” he said.
““For every inch yielded, there’s going to be another inch demanded,” he said. “Where does it stop? For example, the focus right now is on migrants, in large part. But who is it going to be about next time around? ””
His view is supported, more or less by Lord Alf Dubs, Baroness Chakrabarti, Liberty director Akiko Hart and others.
The real question isn’t “Are reforms good or bad?” but “What exactly is being changed, and does it genuinely threaten anyone’s rights?”
To read the full analysis, head over to The Whip Line.
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Flu cases jump sharply – but will ‘super flu’ be deadly simply because the NHS can’t handle it?
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There’s a new flu epidemic in the UK.
I know, because I’m writing this while struggling to cope with it.
Here are some details, from the BBC:
“An average of 2,660 patients per day were in hospital with flu in England last week – the highest ever for this time of year and up 55% on the week before.
““This unprecedented wave of super flu is leaving the NHS facing a worst-case scenario for this time of year,” NHS national medical director Prof Meghana says.
“With no peak in sight, NHS England says there are now enough flu patients to fill more than three whole hospital trusts.
“Meanwhile, flu cases are also rising in Scotland – but at a slower rate
“Experts have been predicting this season could be a particularly nasty one for flu because of a new mutated version of the virus.”
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This is not a reflection on the readership; it is a structural shift affecting small publishers everywhere.
Rather than quietly winding down, I’m giving you clear notice: Vox Political will close at the end of the year unless something dramatically changes. The good news is that The Whip Line already exists, is reader-funded, and is growing. That is where I can continue producing the journalism you value, free from the chaos of advertiser algorithms.
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The question isn’t why we’re dealing with an epidemic, of course – we have one every year and there are regular vaccinations of vulnerable people to try to control it. Vaccines should still work well in this case, by the way.
No, the question is whether the NHS is able to cope with it. My impression is that, despite anything Labour might have done since taking office in 2024, it isn’t.
Me writing this while I’m bunged up with a cold is essentially the experience of Britain in microcosm: we just keep going because there’s no alternative, even when the system should be supporting us and isn’t.
This absolutely fits the pattern we’ve seen developing for years: a system permanently operating beyond capacity, so that even a predictable seasonal surge – even a moderate one – forces everyone to pretend it’s some kind of unforeseeable meteor strike.
The BBC piece is doing that familiar thing of labelling it “unprecedented”, when the reality is simply that the data series being used is too short, and the NHS has already lived through far worse flu seasons within very recent memory.
The winters of 2014–15 and 2017–18 were brutally heavy for influenza, with more than 20,000 deaths in each.
The difference is that, back then, the system was strained but still had some slack left to absorb pressure. That slack has been stripped out year after year since.
So the real story isn’t that this is a “super flu” – the experts are making it clear that the virus isn’t more severe, just more widespread because immunity is lower.
The real story is that:
- Hospitals are already full before winter properly bites.
- A&E is at record attendance.
- Ambulance call-outs are up nearly 50,000 in a year.
- And workforce relations are so degraded that strikes can be triggered at a moment’s notice.
Into that environment, even an ordinary flu wave becomes a system shock.
The evidence says the NHS is barely coping already and winter has only just started.
If this new wave – a mutated version of a flu we’ve already seen – H3N2 (subclade K) – follows the pattern of the mid-2010s, it could easily run for several weeks yet.
Of course there is a political angle: Labour came in promising stabilisation, but stabilisation requires two things the government hasn’t delivered – money and manpower.
Rachel Reeves’s “iron discipline” and Wes Streeting’s “reform” lines don’t add ICU beds, don’t train doctors, and don’t shorten waiting lists. They just rebadge the crisis.
So the question isn’t whether the NHS can cope with the flu. It’s whether the NHS can cope with winter at all anymore.
The answer, judging by the numbers, is: only just, and only because staff keep performing miracles in a system that no longer gives them the tools to succeed.
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Government adopts Vox Political writer’s call to reform European human rights rules from within
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Keir Starmer has urged European leaders to reform human rights laws to make it easier to deport illegal migrants – directly in line with what The Whip Line has been demanding for months.
Some of what he’s saying tracks with what I’ve written here – word for word.
You can read the BBC’s report on it here.
What Starmer’s saying is almost a point-for-point adoption of a strategy laid out here on The Whip Line on November 4.
An honest future-direction message
“Vox Political is nearing the end of its fourteenth year, and I want to be honest with you: the online advertising model that kept the site free to read has deteriorated so sharply that it can no longer sustain the work.
This is not a reflection on the readership; it is a structural shift affecting small publishers everywhere.
Rather than quietly winding down, I’m giving you clear notice: Vox Political will close at the end of the year unless something dramatically changes. The good news is that The Whip Line already exists, is reader-funded, and is growing. That is where I can continue producing the journalism you value, free from the chaos of advertiser algorithms.
If you want the work to continue, please join me there. Free and paid subscriptions are available, but please remember it is the paid subscriptions – monthly and annual – that directly fund the reporting.”
Let me explain:
What’s happening now is almost exactly the direction for which I’ve been arguing since that earlier article.
I have stated repeatedly that the sensible path was not to pull the United Kingdom out of the European Convention on Human Rights, but to negotiate reforms within it so that migration cases could be handled more efficiently without sacrificing core liberties.
That is precisely what Starmer is now doing.
To read the full analysis, head over to The Whip Line.
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Asylum report confirms Vox Political’s view on government policy failures
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A new report may have confirmed Vox Political’s opinion of government policy on asylum-seekers: that we have seen a series of headline-grabbing stunts rather than any coherent strategy.
The report by the National Audit Office states that the UK’s asylum system is affected by inefficiencies, “wasted public funds” and a succession of “short-term, reactive” government policies that have moved problems elsewhere.
According to the BBC, “The spending watchdog looked at a sample of 5,000 asylum claims lodged almost three years ago, in January 2023.
“Since then, 35% (1,619) of those asylum seekers had been given some sort of protection such as refugee status, and 9% (452) had been removed from the country. But 56% (2,812) still did not have a final outcome in their case.
“Most of the cases in the remaining group (2,021 out of the 2,812) remained in a sort of “limbo”, with no appeal lodged.
An honest future-direction message
“Vox Political is nearing the end of its fourteenth year, and I want to be honest with you: the online advertising model that kept the site free to read has deteriorated so sharply that it can no longer sustain the work.
This is not a reflection on the readership; it is a structural shift affecting small publishers everywhere.
Rather than quietly winding down, I’m giving you clear notice: Vox Political will close at the end of the year unless something dramatically changes. The good news is that The Whip Line already exists, is reader-funded, and is growing. That is where I can continue producing the journalism you value, free from the chaos of advertiser algorithms.
If you want the work to continue, please join me there. Free and paid subscriptions are available, but please remember it is the paid subscriptions – monthly and annual – that directly fund the reporting.”
“A shortage of other types of accommodation means that large numbers of asylum seekers whose cases are not closed are being housed in hotels. The cost of accommodation in 2024-25 was £2.7bn.
“The NAO’s report criticises how successive governments have dealt with the current surge in small boats crossings that began in 2018.
““Interventions have tended to be reactive and focused on fixing an urgent problem in one part of the system only, such as intake or initial decisions, without a clear view of the effects on other parts,” the report says.
““Increases in speed of processing have sometimes come at the expense of the quality of decisions, and improvements in one area have shunted problems elsewhere.”
“The NAO said it would be looking for evidence that the government was now moving away from “short-term, reactive fixes” towards a “sustainable whole-system approach”.
“The NAO also found that it was impossible to track individual cases through the whole asylum process because there is no “unique asylum case identifier” shared by Home Office, court service and local authority computer systems.
“The report says that because the asylum applications are subject to fluctuating demand with significant peaks, it was important to build a flexible and resilient system that can respond to increases and decreases in demand.
“Ruth Kelly, the NAO analyst, said the government needed to avoid reverting to “that pattern of counter-productive quick fixes that we have seen in the past”.”
A Home Office spokesperson has responded as follows: “The home secretary recently announced the most sweeping changes to the asylum system in a generation to deal with the problems outlined in this report.
“We are already making progress – with nearly 50,000 people with no right to be here removed, a 63% rise in illegal working arrests and over 21,000 small boat crossing attempts prevented so far this year.
“Our new reforms will restore order and control, remove the incentives which draw people to come to the UK illegally and increase removals of those with no right to be here.”
The NAO report is basically a forensic confirmation of something This Writer has highlighted for years, both here and in Vox Political: the asylum system keeps breaking because every government since 2018 has opted for flashy, vote-baiting “toughness” instead of building a system that can actually function.
The NAO report lays out these key points:
First, the inefficiency is structural, not situational. More than half of claims from nearly three years ago still have no final outcome. That alone demonstrates that the “backlog-clearing” narrative was a political performance, not a reform.
Second, the NAO stresses what happens when policy is driven by headlines. Fixing “one part” of the system only to break another demonstrates the consequences of such reactive policymaking.
Rishi Sunak’s attempt to clear the legacy backlog simply pushed the load onto the appeals process — where, as the report points out, there aren’t enough judges and incentives to handle the cases and the system stalled.
Third, the government cannot even track an individual through the system because agencies don’t share a unique case identifier. That is not an ideological failure; it is an organisational one. It gives the impression that nobody in power has ever seriously tried to run this system competently.
All of this supports my long-standing argument, that ministers have created the problems they now blame on refugees.
The interesting part is what the government says in response. You’d expect the NAO’s emphasis on root-and-branch structural issues to prompt a sober, detail-driven reply.
Instead, the spokesperson lists numbers designed for newspaper headlines – people “removed”, “illegal working arrests up”, small-boat attempts “prevented”.
None of that addresses any of the core failures the NAO identifies. It is, again, the language of spectacle, not system-building.
So the real question is whether the government is genuinely preparing meaningful reform – or doubling down on precisely the sort of stunts against which the NAO warns.
The tone of the official response — emphasising enforcement stats rather than structural fixes — strongly implies the latter.
The NAO is describing a system broken by governments addicted to headlines, and the government’s response is a symptom of that addiction.
That should tell us all we need to know about whether the asylum mess is going to be solved – or just repackaged for another round of headlines.
To read the full analysis, head over to The Whip Line.
A subscription unlocks all my analysis and helps keep independent UK political journalism going.
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