NHS ambulance staff, here outside the Royal London Hospital, are planning strike action. EPA
NHS ambulance staff, here outside the Royal London Hospital, are planning strike action. EPA
NHS ambulance staff, here outside the Royal London Hospital, are planning strike action. EPA
NHS ambulance staff, here outside the Royal London Hospital, are planning strike action. EPA

Health leaders warn Britain's NHS facing 'winter like no other'


Laura O'Callaghan
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Britain’s National Health Service (NHS) is facing “a winter like no other” as backlogs and patient waiting times reach historic levels, a former health minister has said.

Lord Ara Darzi, a member of Britain’s House of Lords, suggested the public health service could be reduced to a threadbare system, saying it “is in danger of being ossified”.

He blamed government inaction and Brexit for the "grim scenario" the NHS is in.

The independent peer, who is co-chair of the Institute for Public Policy Research’s commission on health and prosperity, suggested an urgent course of action is needed to save the NHS from further disarray.

At the IPPR’s health conference in London on Thursday, he emphasised that he oversees “a commission on health and prosperity” rather than “a commission on sickness and poverty”.

“Some might consider that more appropriate given the state of the country today,” he added. “A cost-of-living crisis, an energy crisis, an economy hobbled by Brexit, an NHS facing the longest-ever waiting lists, the biggest-ever backlog of care and a winter ahead like no other.

“It’s a grim scenario," he said. “But there's another way of looking at it. Much revered and long established institutions such as the NHS are in danger of being ossified.”

But he stressed that it was not all doom and gloom because “the best chance for achieving change comes in moments of crisis”, adding that there exists an opportunity for a new approach.

“With the right policies, and enough ambition, we could become a healthier, happier and more prosperous and more secure nation,” he said. He said the commission takes the view that health equality is vital to help the UK economy grow.

EMBARGOED TO 0001 WEDNESDAY NOVEMBER 30 File photo dated 27/01/21 of nurses working at the nurses station, as health and care employers have been urged to follow ethical recruitment guidelines after it emerged that more than 2,000 nurses have come to work in the UK from so-called red list recruitment countries.
EMBARGOED TO 0001 WEDNESDAY NOVEMBER 30 File photo dated 27/01/21 of nurses working at the nurses station, as health and care employers have been urged to follow ethical recruitment guidelines after it emerged that more than 2,000 nurses have come to work in the UK from so-called red list recruitment countries.

Since the launch of the IPPR project this year, research has shown that the labour market is down by more than a million workers compared with pre-pandemic levels. Cases of long Covid, the disruption to healthcare services during the pandemic and mental health were the reasons behind the missing workers, he said.

A report published by the commission on Wednesday suggested that about 2.5 million people were out of work due to long-term sickness. The figure is a rise of 250 per cent compared with estimates in April 2022 and the highest since records began.

Lord Darzi said rather than being struck down with one ailment, those unable to work are more likely to be suffering from several illnesses.

“Their health needs are increasingly complicated,” he said. “The vast majority have multiple conditions and a quarter have six or more conditions.”

His comments came after it emerged that ambulance services across much of the UK are in a state of disorder, according to new figures that said one in seven ambulances in England are delayed by more than an hour.

The average response time last month for ambulances in England — not including London — dealing with the most urgent incidents was nine minutes and 26 seconds, down from nine minutes and 56 seconds the previous month. The target is seven minutes.

Strikes among nurses and ambulance workers are set to add further fuel to the fire. The NHS will be hit by mass walkouts of nurses and ambulance workers over the Christmas period as part of what looks likely to be a winter of discontent among public sector workers.

Danielle Jefferies, from the King’s Fund think tank, described the service as “bursting at the seams”. Leading doctors in October warned the government that the NHS was at risk of "completely collapsing".

The figures from NHS England were released on Thursday as the government contends with widespread industrial action. The walkouts on December 21 will involve ambulance staff across most of England and Wales.

Non-life-threatening calls — not emergency requests — will be affected by the protest action co-ordinated by Unison, the GMB and Unite, the three main ambulance unions.

Soldiers are being trained to drive ambulances as the government prepares for the strikes. The strikes will affect NHS services around the same period as mass walkouts by nurses. The Royal College of Nursing said members would strike on December 15 and 20 in parts of England, Wales and Northern Ireland.

NHS ambulance services will be hit by mass walkouts this month. AFP
NHS ambulance services will be hit by mass walkouts this month. AFP

The government has been criticised for failing to resolve disputes with unions over pay and working conditions.

Ms Jeffries said the winter season looked likely to be particularly harsh for the NHS due to Covid-19 cases, cold and flu, and Strep A infections.

“All combined, this puts immense strain on staff in health and care services who are having to go above and beyond to support patients,” she said.

“Sadly, there are no immediate solutions or quick fixes. These are widespread issues that will require actions across the whole health and care system and it will take time for any improvements to be felt by patients.”

Chris Hopson, chief strategy officer of NHS England, highlighted "so many instances that we have at the moment where, despite best efforts at the front line, NHS staff aren’t able to provide the quality of care they would want to see, but there is a clear plan to address that”.

"We know we need to transform the NHS for the future. So there is a clear plan but, yes, we are under very significant pressure.”

Strikes across the UK in pictures

  • National Health Service cleaning staff hold placards during a strike outside a hospital, in London. EPA
    National Health Service cleaning staff hold placards during a strike outside a hospital, in London. EPA
  • A traveller walks under the departures board of an empty Euston Station in London, as rail workers strike. Getty Images
    A traveller walks under the departures board of an empty Euston Station in London, as rail workers strike. Getty Images
  • General secretary of the National Union of Rail, Maritime and Transport Mick Lynch speaks outside the Department of Transport in London, after talks with the government. Getty Images
    General secretary of the National Union of Rail, Maritime and Transport Mick Lynch speaks outside the Department of Transport in London, after talks with the government. Getty Images
  • Employees of bus operator Abellio strike outside a depot in London. EPA
    Employees of bus operator Abellio strike outside a depot in London. EPA
  • University and College Union members take part in a 'March for higher education', in Leeds. EPA
    University and College Union members take part in a 'March for higher education', in Leeds. EPA
  • Postal delivery vans are parked as Royal Mail workers strike, in Leeds. EPA
    Postal delivery vans are parked as Royal Mail workers strike, in Leeds. EPA
  • Employees demonstrate during a rally held by University and College Union members, in central London. EPA
    Employees demonstrate during a rally held by University and College Union members, in central London. EPA
  • Royal Mail workers strike in Leeds. EPA
    Royal Mail workers strike in Leeds. EPA
  • Members of the Educational Institute of Scotland join teachers at a rally outside the Scottish Parliament, in Edinburgh. AP
    Members of the Educational Institute of Scotland join teachers at a rally outside the Scottish Parliament, in Edinburgh. AP
Ten tax points to be aware of in 2026

1. Domestic VAT refund amendments: request your refund within five years

If a business does not apply for the refund on time, they lose their credit.

2. E-invoicing in the UAE

Businesses should continue preparing for the implementation of e-invoicing in the UAE, with 2026 a preparation and transition period ahead of phased mandatory adoption. 

3. More tax audits

Tax authorities are increasingly using data already available across multiple filings to identify audit risks. 

4. More beneficial VAT and excise tax penalty regime

Tax disputes are expected to become more frequent and more structured, with clearer administrative objection and appeal processes. The UAE has adopted a new penalty regime for VAT and excise disputes, which now mirrors the penalty regime for corporate tax.

5. Greater emphasis on statutory audit

There is a greater need for the accuracy of financial statements. The International Financial Reporting Standards standards need to be strictly adhered to and, as a result, the quality of the audits will need to increase.

6. Further transfer pricing enforcement

Transfer pricing enforcement, which refers to the practice of establishing prices for internal transactions between related entities, is expected to broaden in scope. The UAE will shortly open the possibility to negotiate advance pricing agreements, or essentially rulings for transfer pricing purposes. 

7. Limited time periods for audits

Recent amendments also introduce a default five-year limitation period for tax audits and assessments, subject to specific statutory exceptions. While the standard audit and assessment period is five years, this may be extended to up to 15 years in cases involving fraud or tax evasion. 

8. Pillar 2 implementation 

Many multinational groups will begin to feel the practical effect of the Domestic Minimum Top-Up Tax (DMTT), the UAE's implementation of the OECD’s global minimum tax under Pillar 2. While the rules apply for financial years starting on or after January 1, 2025, it is 2026 that marks the transition to an operational phase.

9. Reduced compliance obligations for imported goods and services

Businesses that apply the reverse-charge mechanism for VAT purposes in the UAE may benefit from reduced compliance obligations. 

10. Substance and CbC reporting focus

Tax authorities are expected to continue strengthening the enforcement of economic substance and Country-by-Country (CbC) reporting frameworks. In the UAE, these regimes are increasingly being used as risk-assessment tools, providing tax authorities with a comprehensive view of multinational groups’ global footprints and enabling them to assess whether profits are aligned with real economic activity. 

Contributed by Thomas Vanhee and Hend Rashwan, Aurifer

Banned items
Dubai Police has also issued a list of banned items at the ground on Sunday. These include:
  • Drones
  • Animals
  • Fireworks/ flares
  • Radios or power banks
  • Laser pointers
  • Glass
  • Selfie sticks/ umbrellas
  • Sharp objects
  • Political flags or banners
  • Bikes, skateboards or scooters
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Updated: December 08, 2022, 3:50 PM