Leading medics are warning that heart patients are bearing the brunt of a collapse in health services triggered by Covid-19 disruption and strikes, with thousands of lives in the UK being put at risk by delays in diagnosis and treatment.
The warning comes as health workers staged Britain's largest ever strike on Monday over pay. It is estimated at least 55,000 appointments could be delayed as a result of this week’s strikes.
The combined walkouts “could see the worst disruption yet”, said Saffron Cordery, deputy chief executive of NHS Providers, which represents hospital trusts across the UK. “We can’t go on like this.”
About 90,000 appointments, including elective procedures, have already been rescheduled due to the strikes that have already taken place, according to NHS data.
Nearly 25,000 appointments needed to be rescheduled on each of the days that nurses walked out in January, when 55 trusts were affected. This week’s action affects 73 trusts.
The delays have been compounded by the Covid-19 pandemic, which resulted in thousands of appointments being cancelled.
The British Medical Association estimates a record 7.2 million patients are waiting for treatment.
Although the issues are affecting all areas of the UK's health system, cardiology is facing one of the largest crises.
British consultant cardiologist Dr Rohin Francis said the delays were so bad that some patients were not surviving long enough to attend their appointments.
“I’ve never known it to be like this before,” he told the i newspaper. “There’s no two ways about it: this is putting patients at risk.
“We know patients are dying waiting for angioplasty and we know patients are dying waiting for bypass [surgery].”
Average waiting time of more than 20 weeks
Some hospitals have an average waiting time of more than 20 weeks for a first outpatient appointment in cardiology while the number of people waiting for an echocardiogram has nearly doubled, research by the paper revealed.
The British Heart Foundation said that without further funding, the total number of people waiting for care and diagnosis could almost double to more than half a million by January 2024.
Latest BHF data shows that 275,000 people were waiting for heart tests, treatment and surgery at the end of September 2021 in England — a rise of 42,500 from the year before the pandemic.
It said the number of people waiting for more than a year (3,575) was 128 times higher than before the pandemic and estimated that 23,000 people in England missed out on being diagnosed during the pandemic and are still missing out on vital treatment.
Cardio backlog could stretch five years
A report by the BHF warns it could take up to five years for the heart care backlog to return to pre-pandemic levels.
“Vital heart tests and surgery can’t be put off — long delays cause anxiety and put people’s lives at risk,” BHF chief executive Dr Charmaine Griffiths said.
“The voices of people with heart and circulatory diseases must be heard as the government considers the action needed to tackle the backlog.”
This week's strikes by nurses and ambulance workers are expected to put further strain on the state-run National Health Service.
Nurses and ambulance workers have been striking separately on and off since late last year but Monday's walkout involving both, largely in England, is the biggest in the 75-year history of the NHS.
Nurses will also strike on Tuesday while ambulance staff will walk out on Friday and physiotherapists on Thursday, making the week probably the most disruptive in NHS history, its medical director Stephen Powis said.
They are demanding a pay rise that reflects the worst inflation in Britain in four decades, while the government says that would be unaffordable and cause more price rises, in turn, making interest rates and mortgage payments rise.
Strikes highlight deadlocked pay talks
About 500,000 workers, many from the public sector, have been staging strikes since last summer.
Prime Minister Rishi Sunak, who has made reducing NHS waiting lists and halving inflation two of his government’s five key priorities, is facing mounting pressure to resolve the disputes and limit disruption to public services such as railways and schools.
At the weekend, the Royal College of Nursing trade union wrote to Mr Sunak asking him to bring the nursing strike “to a swift close” by making “meaningful” pay offers.
“We've got one of the busiest winters we have ever had, with record levels of funding going into the NHS to try to manage services,” Maria Caulfield, Minister of Mental Health and Women's Health Strategy, told Sky News on Monday.
“So, every per cent of a pay increase takes money away.”
The RCN says a decade of poor pay had contributed to tens of thousands of nurses leaving the profession — 25,000 over the past year — with the severe staffing shortages affecting patient care.
Last week, Mr Sunak said he would “love to give the nurses a massive pay rise” but said the government faced tough choices, and that it was funding the NHS in other areas such as by providing medical equipment and ambulances.
Chris Hopson, chief strategy officer at NHS England, said the timing of Monday's action means it had made it “difficult to deploy the discharge of patients”.
“We are now entering a new and more difficult phase in the dispute,” he said.
Junior doctors are also calling for a strike and senior medics are in discussions over potential action.
“The real risk was always that rather than being a one-off, the strikes would drag on, cause regular disruptions, and derail efforts to increase overall treatment volumes and tackle waiting lists,” said Ben Zaranko, senior research economist at the Institute for Fiscal Studies.
“There is also a wider risk that an ongoing ill-tempered industrial dispute hits staff morale.”
The Kites
Romain Gary
Penguin Modern Classics
Company%20profile
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Cryopreservation: A timeline
- Keyhole surgery under general anaesthetic
- Ovarian tissue surgically removed
- Tissue processed in a high-tech facility
- Tissue re-implanted at a time of the patient’s choosing
- Full hormone production regained within 4-6 months
Company Profile
Name: Thndr
Started: 2019
Co-founders: Ahmad Hammouda and Seif Amr
Sector: FinTech
Headquarters: Egypt
UAE base: Hub71, Abu Dhabi
Current number of staff: More than 150
Funds raised: $22 million
Avatar: Fire and Ash
Director: James Cameron
Starring: Sam Worthington, Sigourney Weaver, Zoe Saldana
Rating: 4.5/5
WHAT IS A BLACK HOLE?
1. Black holes are objects whose gravity is so strong not even light can escape their pull
2. They can be created when massive stars collapse under their own weight
3. Large black holes can also be formed when smaller ones collide and merge
4. The biggest black holes lurk at the centre of many galaxies, including our own
5. Astronomers believe that when the universe was very young, black holes affected how galaxies formed
Emirates Cricket Board Women’s T10
ECB Hawks v ECB Falcons
Monday, April 6, 7.30pm, Sharjah Cricket Stadium
The match will be broadcast live on the My Sports Eye Facebook page
Hawks
Coach: Chaitrali Kalgutkar
Squad: Chaya Mughal (captain), Archara Supriya, Chamani Senevirathne, Chathurika Anand, Geethika Jyothis, Indhuja Nandakumar, Kashish Loungani, Khushi Sharma, Khushi Tanwar, Rinitha Rajith, Siddhi Pagarani, Siya Gokhale, Subha Srinivasan, Suraksha Kotte, Theertha Satish
Falcons
Coach: Najeeb Amar
Squad: Kavisha Kumari (captain), Almaseera Jahangir, Annika Shivpuri, Archisha Mukherjee, Judit Cleetus, Ishani Senavirathne, Lavanya Keny, Mahika Gaur, Malavika Unnithan, Rishitha Rajith, Rithika Rajith, Samaira Dharnidharka, Shashini Kaluarachchi, Udeni Kuruppuarachchi, Vaishnave Mahesh
RESULTS
6pm: Al Maktoum Challenge Round-2 – Group 1 (PA) $55,000 (Dirt) 1,900m
Winner: Rajeh, Antonio Fresu (jockey), Musabah Al Muhairi (trainer)
6.35pm: Oud Metha Stakes – Rated Conditions (TB) $60,000 (D) 1,200m
Winner: Get Back Goldie, William Buick, Doug O’Neill
7.10pm: Jumeirah Classic – Listed (TB) $150,000 (Turf) 1,600m
Winner: Sovereign Prince, James Doyle, Charlie Appleby
7.45pm: Firebreak Stakes – Group 3 (TB) $150,000 (D) 1,600m
Winner: Hypothetical, Mickael Barzalona, Salem bin Ghadayer
8.20pm: Al Maktoum Challenge Round-2 – Group 2 (TB) $350,000 (D) 1,900m
Winner: Hot Rod Charlie, William Buick, Doug O’Neill
8.55pm: Al Bastakiya Trial – Conditions (TB) $60,000 (D) 1,900m
Winner: Withering, Adrie de Vries, Fawzi Nass
9.30pm: Balanchine – Group 2 (TB) $180,000 (T) 1,800m
Winner: Creative Flair, William Buick, Charlie Appleby
Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”
Classification of skills
A worker is categorised as skilled by the MOHRE based on nine levels given in the International Standard Classification of Occupations (ISCO) issued by the International Labour Organisation.
A skilled worker would be someone at a professional level (levels 1 – 5) which includes managers, professionals, technicians and associate professionals, clerical support workers, and service and sales workers.
The worker must also have an attested educational certificate higher than secondary or an equivalent certification, and earn a monthly salary of at least Dh4,000.