Twenty-four hours in A&E is now “no longer a documentary”, leading medics have warned, as figures show almost 400,000 patients spent a day or more in an emergency department in England last year.
The Royal College of Emergency Medicine (RCEM) said the very long waits are a “matter of national shame”.
Figures uncovered by the college and shared with the PA news agency show 399,908 people waited 24 hours or more in an emergency department in England in 2022-23.
The college warned there could be a similar situation this year, with Dr Adrian Boyle, its president, cautioning that patients are coming to avoidable harm as a result of long waits.
“We know that long stays in emergency departments are harmful,” Dr Boyle said.
“There is good scientific data that shows that once people spend more than about six hours, and they need to be admitted into hospital, actually their mortality starts to get worse.
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“I think it should be a matter of national shame that we have these very long waits for admitted patients.”
He said people caught up in the long waits are “often elderly and vulnerable”.
The RCEM has made a number of calls to political parties in its general manifesto, including:
• To end overcrowding in emergency departments, including by ensuring there are enough hospital beds to prevent people being stuck in emergency departments when they need a bed on a ward.
• More funding for social care to prevent a system where people who no longer need hospital care can be discharged when ready.
• More emergency medicine staff to deliver “safe and sustainable care” and for more work to retain current staff.
• More data to be published on hospital performance.
• A call to “resource the NHS to ensure the emergency system can provide equitable care to all”.
Record number attend A&E
A record number of patients attended A&E in England in 2022-33, 25.3 million, up 4% from the previous year, according to figures released last week.
The data also shows 71% of people spent four hours or less in A&E in 2022-23.
The NHS recovery plan sets a target of March 2024 for 76% of patients attending A&E to be admitted, transferred or discharged within four hours, with further improvements expected the following year.
An NHS England spokesperson said: “This data relates to last year and winter, when services were facing record demand, industrial action and a twindemic of COVID and flu, but since we published our urgent and emergency care recovery plan in January we have seen significant improvements.
“Thanks to the hard work of NHS staff Category 2 ambulance response times are now an hour faster than in December, A&E four-hour performance is up from 69% to 73%, and the proportion of patients waiting 12 hours in A&E is down a sixth.
“We know there is more to do, which is why we set out our winter plans earlier than ever before this year, expanding care ‘traffic control’ centres, delivering additional ambulance hours and extra beds to boost capacity and reduce long waits for patients, and other initiatives like same day emergency care units and virtual wards which can mean patients are able to get the care they need without an unnecessary trip to an emergency department – this is better for them, and means A&E staff can continue to prioritise those with the most urgent clinical need.”
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The culture secretary has claimed there is “a problem of leadership” at the BBC, as the controversy over Bob Vylan’s Glastonbury performance deepens.
Lisa Nandy criticised the corporation over its decision not to pull the livestream after the band’s frontman shouted “death, death to the IDF” – referring to the Israel Defence Forces – on Saturday.
A criminal investigation has been launched into the Glastonbury performances of both Bob Vylan and Kneecap after the police reviewed footage.
Ms Nandy condemned the “appalling and unacceptable scenes” at Glastonburyand said the government would not tolerate antisemitism.
She said she had called BBC director-general Tim Davie after the broadcast of Bob Vylan’s set to find out why it had aired, and why the feed had not been cut.
“I expect answers to these questions without delay,” she said.
Image: Culture Secretary Lisa Nandy. Pic: PA
Later, when asked in the Commons about the BBC’s editorial processes and who would be held accountable, Ms Nandy replied: “When you have one editorial failure, it’s something that must be gripped. When you have several, it becomes a problem of leadership.”
Ms Nandy said she had spoken to members of the Jewish community, including attendees at Glastonbury, who said they were concerned by imagery and slogans and ended up creating their own “safe space”.
Mr Davie has been facing calls for his resignation.
Yesterday, drummer Bobbie Vylan released a video statement on Instagram – saying politicians who have spent time criticising the band should be “utterly ashamed” for giving “room” to this over other issues.
He also addressed what was said on stage, saying: “Regardless of how it was said, calling for an end to the slaughter of innocents is never wrong. To civilians of Israel, understand this anger is not directed at you, and don’t let your government persuade you that a call against an army is a call against the people.”
Shortly after it was posted, the video was no longer available to view.
Israel denies targeting civilians in its war in Gaza.
Image: Moglai Bap and Mo Chara of Kneecap perform at Glastonbury. Pic: Reuters
During Kneecap’s set, one member suggested on stage starting a “riot” outside his bandmate’s forthcoming court appearance, before clarifying he meant “support”.
In a statement, Avon and Somerset Police said that after reviewing footage of the performances of Kneecap and Bob Vylan, further enquiries are required and a criminal investigation is now being undertaken.
“A senior detective has been appointed to lead this investigation,” a spokesperson said. “This has been recorded as a public order incident at this time while our enquiries are at an early stage.”
The force said the investigation will be “evidence-led and will closely consider all appropriate legislation, including relating to hate crimes”.
“We have received a large amount of contact in relation to these events from people across the world and recognise the strength of public feeling,” it added. “There is absolutely no place in society for hate.”
Image: Bob Vylan performing on the West Holts Stage. Pic: PA
What happened?
During Bob Vylan’s set, the duo performed in front of a screen that showed several messages, including one that said Israel’s actions in Gaza amount to “genocide”.
Bobby Vylan also led chants of “death to the IDF”.
The set was live streamed by the BBC as part of its Glastonbury coverage, but has not been made available on demand.
Politicians including the prime minister have criticised the performance. Glastonbury organiser Emily Eavis said the chants “crossed a line” and that there was no place at the festival for “antisemitism, hate speech or incitement to violence”.
A BBC spokesperson said the broadcaster respected freedom of expression “but stands firmly against incitement to violence”.
They added: “The antisemitic sentiments expressed by Bob Vylan were utterly unacceptable and have no place on our airwaves…
“The team were dealing with a live situation, but with hindsight we should have pulled the stream during the performance. We regret this did not happen.”
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What’s the Glastonbury controversy?
Media watchdog Ofcom said it was in talks with the BBC and that the broadcaster “clearly has questions to answer” over the stream.
Irish-language rap trio Kneecap were on stage afterwards. Before their appearance at the festival, there had been calls for Glastonbury to remove them from the bill – as rapper Liam Og O hAnnaidh (who performs as Mo Chara) is facing a terror charge, accused of displaying a flag in support of the proscribed group Hezbollah at a gig in London last November.
Glastonbury organisers kept them on the line-up, but the BBC chose not to stream their set live. An edited version was later made available on demand.
On stage, the band led chants of “f*** Keir Starmer”.
O hAnnaidh’s bandmate Naoise O Caireallain (Moglai Bap) said they would “start a riot outside the courts” for O hAnnaidh’s next appearance, before clarifying: “No riots, just love and support, and support for Palestine.”
Hundreds of people turned out in protest for his first court appearance earlier this month.
Bob Vylan were set to perform in Chicago, Brooklyn and Philadelphia in the autumn. They are due to perform at Radar Festival in Manchester on Saturday and Boardmasters, a surfing and music festival in Newquay, Cornwall, in August.
Sharing a statement on Instagram after the Glastonbury set, Bobby Vylan said: “Teaching our children to speak up for the change they want and need is the only way that we make this world a better place.
“As we grow older and our fire starts to possibly dim under the suffocation of adult life and all its responsibilities, it is incredibly important that we encourage and inspire future generations to pick up the torch that was passed to us.”
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The war in Gaza started after Hamas militants launched attacks in Israel on 7 October 2023, killing 1,200 people and taking roughly 250 hostages.
More than 860 Israeli soldiers have been killed since the war began, more than 400 of them during the fighting in Gaza.
Israel’s offensive in Gaza has devastated the enclave and killed around 56,500 people, according to the Hamas-run health ministry, which does not differentiate between civilians and combatants, but says more than half of the dead are women and children.
The government has won a long-running legal challenge about its decision to continue allowing the sale of spare parts for F-35 fighter jets to Israel, while suspending other arms licences over concerns about international humanitarian law in Gaza.
But a key part of its case has highlighted mixed messaging about its position on the risk of genocide in Gaza – and intensified calls for ministers to publish their own assessment on the issue.
Lawyers acting for the government told judges “the evidence available does not support a finding of genocide” and “the government assessment was that…there was no serious risk of genocide occurring”.
Therefore, they argued, continuing to supply the F-35 components did not put the UK at risk of breaching the Genocide Convention.
This assessment has never been published or justified by ministers in parliament, despite numerous questions on the issue.
Some MPs argue its very existence contrasts with the position repeatedly expressed by ministers in parliament – that the UK is unable to give a view on allegations of genocide in Gaza, because the question is one for the international courts.
For example, just last week Deputy Prime Minister Angela Rayner told PMQs “it is a long-standing principle that genocide is determined by competent international courts and not by governments”.
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Situation in Gaza ‘utterly intolerable’
‘The UK cannot sit on our hands’
Green MP Ellie Chowns said: “The government insists only an international court can judge whether genocide is occurring in Gaza, yet have somehow also concluded there is ‘no serious risk of genocide’ in Gaza – and despite my urging, refuse to publish the risk assessments which lead to this decision.
“Full transparency on these risk assessments should not be optional; it is essential for holding the government to account and stopping further atrocity.
“While Labour tie themselves in knots contradicting each other, families are starving, hospitals lie in ruins, and children are dying.
“The UK cannot sit on our hands waiting for an international court verdict when our legal duty under the Genocide Convention compels us to prevent genocide from occurring, not merely seek justice after the fact.”
‘Why are these assessments being made?’
“This contradiction at the heart of the government’s position is stark,” said Zarah Sultana MP, an outspoken critic of Labour’s approach to the conflict in Gaza, who now sits as an independent after losing the party whip last summer.
“Ministers say it’s not for them to determine genocide, that only international courts can do so. Yet internal ‘genocide assessments’ have clearly been made and used to justify continuing arms exports to Israel.
“If they have no view, why are these assessments being made? And if they do, why refuse to share them with parliament? This Labour government, in opposition, demanded the Tories publish their assessments. Now in office, they’ve refused to do the same.”
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8:04
Routes for Palestinians ‘restricted’
Judges at the High Court ultimately ruled the case was over such a “sensitive and political issue” it should be a matter for the government, “which is democratically accountable to parliament and ultimately to the electorate, not the court”.
Dearbhla Minogue, a senior lawyer at the Global Legal Action Network, and a solicitor for Al-Haq, the Palestinian human rights group which brought the case, said: “This should not be interpreted as an endorsement of the government, but rather a restrained approach to the separation of powers.
“The government’s disgraceful assessment that there is no risk of genocide has therefore evaded scrutiny in the courts, and as far as we know it still stands.”
Image: Pics: Reuters
What is the government’s position?
Government lawyers argued the decision not to ban the export of F-35 parts was due to advice from Defence Secretary John Healey, who said a suspension would impact the whole F-35 programme and have a “profound impact on international peace and security”.
The UK supplies F-35 component parts as a member of an international defence programme which produces and maintains the fighter jets.
As a customer of that programme, Israel can order from the pool of spare parts.
‘This washing of hands will no longer work’
Labour MP Richard Burgon said the ruling puts the government under pressure to clarify its position.
“This court ruling is very clear: only the government and parliament can decide if F-35 fighter jet parts – that can end up in Israel – should be sold,” he said.
“So the government can no longer pass the buck: it can stop these exports, or it can be complicit in Israel’s genocide in Gaza.
“On many issues they say it’s not for the government to decide, but it’s one for the international courts. This washing of hands will no longer work.”
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Dozens dead in Gaza after Israeli strikes
Israel has consistently rejected any allegations of genocide.
Prime Minister Benjamin Netanyahu branded a recent UN report on the issue biased and antisemitic.
“Instead of focusing on the crimes against humanity and war crimes committed by the Hamas terrorist organisation… the United Nations once again chooses to attack the state of Israel with false accusations,” he said in a statement.
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‘Gaza disinformation campaign is deliberate’
The UK government has not responded to requests for comment over its contrasting messaging to parliament and the courts over allegations of genocide.
But in response to the judgement, a spokesperson said: “The court has upheld this government’s thorough and lawful decision-making on this matter.
“This shows that the UK operates one of the most robust export control regimes in the world. We will continue to keep our defence export licensing under careful and continual review.
“On day one of this Government, the foreign secretary ordered a review into Israel’s compliance with international humanitarian law (IHL).
“The review concluded that there was a clear risk that UK exports for the IDF (Israel Defence Forces) in the Gaza conflict might be used to commit or facilitate serious violations of IHL.
“In contrast to the last government, we took decisive action, stopping exports to the Israeli Defence Forces that might be used to commit or facilitate serious violations of international humanitarian law in Gaza.”