The chief executive of a busy NHS Hospital Trust has described preparing for winter amid ongoing industrial action by consultants and junior doctors as “going into a really tough battle with one hand tied behind your back”.
He said: “I think we’ve cancelled more than 10,000 outpatient appointments here. We’ve cancelled more than a thousand non-urgent surgeries and a small number of urgent surgeries.
“What we’re increasingly seeing is actually we’re not cancelling things, because we’re not even booking stuff in any more for the strike days.
“It feels like we’re walking into a really tough battle with one hand tied behind our back.”
Mr Trainer, who has 12 hospitals under his care including the Queen’s Hospital in Essex and the King George Hospital in Ilford, said his patients and his staff were suffering because of the industrial action by NHS health workers. which is now in its 10th month.
He said: “It’s about the patients who are not getting access to the care that they need. And the second thing, it’s about the staff that we’re asking, at times, to work in some really tough circumstances.
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“I regularly meet our emergency department teams because they tend to bear the brunt of it. Emergency departments are the last unrationed part of health care, they’re the only place you can walk into and guarantee someone will see you. And as a result, we’re seeing real pressures piled on to them.”
Some 900,000 NHS appointments have been cancelled across England since December last year.
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Image: Matthew Trainer has 12 hospitals under his care
Hospitals now routinely do not book appointments for strike days, with the dates announced at least six weeks in advance. That means the true figure of disruption to elective care is likely to be much higher.
Mr Trainer added: “I think one thing that worries me is actually that we’re finding the strikes less difficult to cope with because we’re becoming so practised at them.
“The NHS is good at crisis management and responding to incidents. Actually, we now know how to stand up a strike rota. We know to take down all the planned care activity. This shouldn’t be something we’re used to doing.
“You know, this should remain a real outlier for us, to have cancelled 10,000 outpatient appointments since April is not normal. And we should not become accustomed to this as a way of doing business in healthcare.”
But this is likely to be the case for months to come, deep into another crippling winter.
The junior doctors and consultants have long mandates for strike action and show no sign of calling them off.
Their union, the BMA, will feel vindicated in its action after learning that the public is more than twice as likely to blame the government for the ongoing strikes than the doctors’ trade unions, by 45% compared to 21%, according to a YouGov poll commissioned by Sky News.
Prime Minister Rishi Sunak has made bringing down waiting lists one of his key pledges.
But that is not achievable unless there is a resolution to what is becoming an increasingly bitter and protracted dispute. It also means trusts are not able to prepare for the fast-approaching winter.
Mr Trainer continued: “We had a really tough winter, last year. January was as bad as I’ve ever seen it in terms of the pressures. Primary care is also seeing huge increases in demand.
“They’re seeing more people than ever before, but they can’t keep up with the demand, and mental health services are also dealing with enormous backlogs for care and emergency care.
“So we’re trying to get ourselves ready for that. But what we know at the minute is that unless there’s some kind of resolution to this, we’re going to have to deal with that regular disruption of strike action.
“And I think we’re getting to a position now where it’s making it very hard to plan for what’s going to be the toughest period of the year in the NHS.
“We’ve got clinical staff trying to deliver good quality health care in some really challenging environments at the minute. And this is just adding to the strain they’re feeling and adding to the pressures on the NHS.”
Sir Keir Starmer has announced the UK has officially recognised Palestine as a state.
“Today, to revive the hope of peace for the Palestinians and Israelis, and a two state solution, the United Kingdom formally recognises the State of Palestine,” the prime minister said on X, alongside a longer video statement.
“In the face of the growing horror in the Middle East, we are acting to keep alive the possibility of peace and a two-state solution.
“That means a safe and secure Israel alongside a viable Palestinian state. At the moment, we have neither.”
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Canada and Australia also officially recognised Palestinian statehood on Sunday, ahead of a conference of the UN General Assembly in New York this week.
It is a significant moment in the history of Britain’s involvement in the region, and comes as the death toll from the Israeli war on Gaza continues to rise and conditions for the people trapped become even more desperate.
Image: An updated map of the region the Foreign, Commonwealth & Development Office website
In recognising Palestine as a state, the UK does so based on 1967 borders to be finalised as part of future negotiations. It would be led by a “reformed Palestinian Authority”.
The UK also acknowledges “all legal rights and obligations of statehood” for Palestine.
An updated map on the UK’s Foreign, Commonwealth & Development Office website now has the West Bank and Gaza labelled as ‘Palestine’ rather than the ‘Occupied Palestinian Territories’. This change has been rolled out across the website.
Image: Protesters in Tel Aviv calling for the release of hostages. Pic: AP
Sir Keir calls on Hamas to release the hostages
The prime minister repeated his calls for the the Israeli hostages – held in captivity since the brutal attacks on Israel on 7 October, 2023 – to be released by Hamas.
“I have met British families of the hostages. I see the torture that they endure each and every day. Pain that strikes deep in people’s hearts across Israel and here in the United Kingdom.
“The hostages must be released immediately and we will keep fighting to bring them home.”
Sir Keir was also clear to emphasise that recognition of Palestine was “not a reward for Hamas”, saying that the terror group “can have no future, no role in government, no role in security” in a future state.
“I have directed work to sanction other Hamas figures in the coming weeks,” he added.
Image: Huge amounts of Gaza have been razed to the ground. Pic: Reuters
Starmer calls on Israel to end Gaza offensives
Sir Keir also repeated his criticism of Israel, which for nearly two years has waged a brutal war on the densely-populated Gaza Strip.
“The Israeli government’s relentless and increasing bombardment of Gaza, the offensive of recent weeks, the starvation and devastation are utterly intolerable.”
The death toll in Gaza since the IDF launched its offensive following the 7 October attacks has now risen above 65,000 people, according to Hamas-run health authorities.
“This death and destruction horrifies all of us. It must end,” he said.
Image: A pro-Palestinian march in London earlier this year. Pic: PA
British people ‘desperately want to see’ peace
Sir Keir also said: “Ordinary people, Israeli and Palestinian, deserve to live in peace. To try to rebuild their lives free from violence and suffering.
“That’s what the British people desperately want to see.”
But he warned that the possibility of a Palestinian state was in danger of vanishing forever.
“With the actions of Hamas, the Israeli government escalating the conflict, and settlement building being accelerated in the West Bank, the hope of a two-state solution is fading, but we cannot let that light go out.
“That is why we are building consensus with leaders in the region and beyond, around our framework for peace.”
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15:16
What changed in UK’s Gaza policy?
Sir Keir said this is a “practical plan” to bring people together behind a “common vision” that moves from a ceasefire in Gaza to negotiations on a two-state solution.
Today, Sir Keir Starmer will deliver on his pledge to recognise a Palestinian state – after setting out a series of conditions in July which there was little prospect Israel could meet, including agreeing a ceasefire with Hamas.
The prime minister will say it recognises the “inalienable right” of the Palestinian people and what he feels is a moral responsibility to keep a two-state solution alive, amid the devastation of the war and concern about settlement expansion in the West Bank.
This will be formally put forward by the British government at a conference of the UN General Assembly in New York this week, after a diplomatic push led by Emmanuel Macron. Canada and Australia are also expected to recognise it, although may call for Hamas to disarm.
But Labour has always said it’s a move they would make as part of a peace process, which looks further away than ever.
What does it mean?
The move has been heavily criticised and leaves a number of questions not only about what it will achieve – but about whether it will have the opposite effect on the conflict.
David Lammy as foreign secretary conceded when the pledge was announced that “it will not change the position on the ground” which can only come through negotiations.
After all, 147 of the 193 member states of the United Nations recognise it already. Palestine has permanent observer status at the UN – speaking rights, but not voting rights – where it’s represented by the Palestinian Authority. Any move to full status would have to be agreed by the Security Council where the US has a veto.
Sir Keir has made clear he doesn’t accept Hamas – which he calls a “brutal terrorist organisation” – as a government in Gaza. The borders of such a state, wrangled over for decades during multiple rounds of negotiations between Israel and the Palestinians, are also not agreed.
Recognition is opposed by the Trump administration, as the US president made clear in London last week. US secretary of state Marco Rubio has said it would “embolden Hamas” and be symbolic only.
In Britain there is cynicism too. Kemi Badenoch, the Conservative leader, has accused the prime minister of a “desperate and insincere attempt to placate his backbenchers”. He heads to the party’s conference in Liverpool next week with a further slump in his approval ratings to -42%, around where Rishi Sunak’s was after his D-Day blunder.
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1:28
Could recognition of Palestine change the West Bank?
Other Labour MPs oppose the recognition move. The Labour Friends of Israel group has said: “It is important to recognise that Israel is not the only party to this conflict… Hamas could end this conflict tomorrow by releasing the hostages and laying down its arms.”
The move is also opposed by the families of the hostages in Gaza, of which 20 are believed to be alive – for not imposing their release as a condition on Hamas.
Ilay David, the brother of Evyatar David, who recently appeared emaciated in a Hamas video, said: “We want to meet with Starmer but he refuses to meet with us… Giving this recognition is like saying to Hamas: ‘It is OK you can keep starving the hostages, you can keep using them as human shields’. This kind of recognition gives Hamas power to be stubborn in negotiations. That is the last thing we need right now.”
Sir Ephraim Mirvis, the UK’s Chief Rabbi has said the “unconditional” recognition of the state “is not contingent upon a functioning or democratic Palestinian government, nor even upon the most basic commitment to a peaceful future”.
Image: Sir Keir Starmer welcomed Mahmoud Abbas, president of the Palestinian Authority, to 10 Downing Street earlier this month
What happens next?
Sir Keir met 89-year-old Mahmoud Abbas, the president of the Palestinian Authority, in London this month and they agreed Hamas should not be involved in the governance of Gaza.
Efforts to set up a transitional government have been discussed between the US and Gulf states. But Mike Huckabee, the US ambassador to Israel, said last week there was nothing “ready for signature”.
The UK government is expected to announce further sanctions on Hamas figures this week. But the Israeli government has already responded with fury to the prospect of recognition and it’s reported that retaliation could include further annexations in the West Bank.
The UK government sees this as an important diplomatic move with allies, when nothing else is moving the dial. But it can only be made once, and even supporters in government acknowledge that on the ground in Gaza it won’t immediately change very much.
Image: One of three Russian MiG-31 fighter jets in images shared by Sweden’s armed forces. Pic: Swedish Armed Forces
The three incursions into NATO airspace fuelled concerns about the potential expansion of Russia‘s three-year war in Ukraine and have been seen as an attempt by Moscow to test the military alliance’s response.
The incident over Poland prompted its prime minister, Donald Tusk, to warn that his country was the closest to “open conflict” it had been since the Second World War, while the UK announced it would provide Warsaw with extra air cover.
Two RAF Typhoons, supported by an RAF Voyager air-to-air refuelling plane, took off from RAF Coningsby, in Lincolnshire, on Friday night to defend Poland’s skies before returning safely early on Saturday morning.
Image: A Gerbera drone landed in a field in the Olesno region of Poland
Defence Secretary John Healey said the mission sends a clear signal that “NATO airspace will be defended”.
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“I’m proud of the outstanding British pilots and air crew who took part in this successful operation to defend our allies from reckless Russian aggression.”
He said the mission was “especially poignant” coming as the UK marks the 85th anniversary of the Battle of Britain – when Polish pilots came to the aid of the UK – this weekend.
The head of the RAF, Air Chief Marshal Harv Smyth, said: “This sortie marks the RAF’s first operational mission on Eastern Sentry, reinforcing the UK’s steadfast commitment to NATO and its allies.
“We remain agile, integrated, and ready to project airpower at range.”