Intended for healthcare professionals

Rapid response to:

Editorials

Is the NHS overwhelmed?

BMJ 2022; 376 doi: https://doi.org/10.1136/bmj.o51 (Published 11 January 2022) Cite this as: BMJ 2022;376:o51

Rapid Response:

You can't have cake and eat it

Dear Editor,

I have enjoyed reading Hugh Alderwick’s article exploring the current state of the NHS (1). The only thing to add to this most excellent of editorials is to say, drawing on a parallel from the mountaineering world, that the majority of accidents and tragedies occur on the way down after an arduous climb.

The pandemic was a steep and long climb and one that has been emotionally and physically challenging. During the descent one is tired and it is getting colder and darker. Indeed in healthcare the sympathy has evaporated and has on occasions been replaced by frank hostility. Dark are the times when fear, anxiety and exhaustion amongst those with patient facing roles are palpable. When the pandemic wanes the sense of victory and relief is likely to be overshadowed by the pressures of increased demand over backlog and ongoing mismatch between resources available (or perhaps not available) and the societal expectations.

You can’t have cake and eat it. Something’s is going to crack. And like in the mountains when the avalanche or crevasse fall often destroys dreams, the dream of what is the National Health Service may shatter in a way that could be irreversible.

(1) Alderwick H. Is the NHS overwhelmed? BMJ 2022; 376:o51.

Competing interests: No competing interests

21 January 2022
Piotr Szawarski
Consultant in Intensive Care Medicine
Wexham Park Hospital, Slough, UK