An average of 400 workers a week left the National Health Service (NHS) in 2021. Around 110,000 NHS posts in England are unfilled, with nearly 6 percent of doctor’s jobs and 10 percent of nursing positions empty, according to the most recent figures.

Among doctors, the worst hit region is the Midlands, with a 9 percent vacancy rate, but London, the North West, the North East and Yorkshire, the East of England and the South East all have vacancies of around 5 percent.

For nurses, London tops the region with the most nursing vacancies, at 13 percent, with all other English regions exceeding a vacancy rate of 8 percent. Most acute is the shortage in mental health nursing, where one in six, or 17.1 percent, of all posts are unfilled.

There are also well over 100,000 vacancies nationally in social care, and the sector is further handicapper by high staff turnover, with an estimated 34 percent of care workers leaving their roles in 2020-2021.

Among the main complaints cited by departing staff are burnout, heavy workloads, low pay, and post-traumatic stress disorder (PTSD). These were prevalent before the pandemic, but all of them have been compounded by the COVID-19 crisis. At the end of 2021, the NHS forecast there would be a further 230,000 cases of PTSD in England due to the pandemic, with healthcare workers being one of the primary groups to experience the debilitating disorder.

During the first wave of the pandemic, 709 intensive care staff across six NHS hospitals were polled by the Royal College of Psychiatrists, with two in five reporting symptoms of PTSD—double the rate of military veterans with recent combat experience.

In one of the most comprehensive studies carried out, the University of Oxford placed the figures even higher, finding that 44 percent of NHS staff working with COVID patients had PTSD, with depression affecting 39 percent.

Although the specific symptoms of PTSD can vary, many people experience vivid flashbacks and nightmares, involuntarily re-living traumatic events. As a result of the UK’s bipartisan herd immunity policy, leading to several massive surges of infections, health workers have repeatedly witnessed the distressing deaths of COVID sufferers, often in conditions where providing care, let alone compassion to loved ones, was extremely difficult.

The shortage of NHS staff is having a major impact on patients, with a study by charity Engage Britain raising significant concerns about the quality of their care. According to their surveys, over a quarter of adults (28 percent) believe they or a family member have received poor care due to workforce problems.

John Hall, a former strategy director at the Department of Health and Social Care, and now Strategy Consultant for Engage Britain, stated that “The UK has long had significantly lower numbers of doctors and nurses per capita than comparable systems… More recently, the impact of working conditions is showing an increasing impact on the ability of the NHS to retain staff. Around 50 in every 10,000 staff working in hospital and community health services in June 2021 left the service within the next three months, citing work-life balance as the reason. This was a new record.”

Julian McCrae, Director of Engage Britain, stated that “NHS workers across the country have spoken to us about feeling overstretched, undervalued and struggling to get support in a chaotic system.”

These shortages are crippling a health service facing record waiting lists. The Conservative government’s criminal handling of the pandemic, placing the profits of the corporations above the health and lives of millions, put unbearable pressure on the NHS, creating long delays for treatment. A new record of 6.1 million are now waiting for medical procedures, with nearly a quarter of a million having waited for at least two years.

Demand will only continue to grow. The Office for National Statistics predicts that there will be more than 17 million over 65s in the UK by 2040, with increasing health needs in old age. The UK has some of the lowest staffing and bed rates per capita across developed countries.

The desperate situation is highlighted by the now expanded call for the recruitment of “NHS reservists” to help clear backlogs. They will assist with administering the COVID vaccine, specifically with the fourth round for the vulnerable, as well as helping patients who have been recently discharged.

Piloted in 2021, across five sites, the number of reservists has so far reached 17,000, barely a scratch on what is needed. In any case, while the reservists may be able to assist in certain limited circumstances, most are vastly under qualified to cover the staffing gaps across the NHS.

Health Secretary Sajid Javid has repeatedly blamed the NHS backlog on the pandemic. This not only sidesteps the fact that it was the government’s herd immunity policies which were entirely responsible for the havoc wreaked by COVID in the health service, it covers over the decades of privatisation and austerity that have gutted the NHS.

The past 10 years have seen the NHS budget cut as a percentage of GDP even as greater levels of demand are placed on the system. Swathes of the NHS have been privatised, some sold off to global investors, while what remains has become increasingly reliant on private patients—which can contribute up to 50 percent of a hospital’s income—to stay afloat. The pandemic was used as enormous opportunity to grant lucrative NHS contracts to private sector profiteers, providing PPE and tracing systems that were not fit for purpose.

Some of the worst cuts have fallen on health workers, who have endured years of pay freezes culminating in the insulting 3 percent “pay rise” last year—a real-terms pay cut—allowed through by the trade unions.

Attacks on the health service will now proceed even more quickly to provide funds for Britain’s participation in the NATO confrontation with Russia. The Institute for Fiscal Studies (IFS) has published a paper pointedly explaining that to maintain Britain’s position as the largest European military power, ahead of Germany, defence spending would have to increase by about 20 percent, or £10 billion.

Calls for military spending to trump all else mean the NHS budget is fair game. The Telegraph, house organ of the Tory party, writes in criticism that the post-Cold War “peace dividend” has “been spent in areas such as the NHS, which has risen from accounting for less than 3 percent of GDP to more than 7 percent over the same period.” It directly counterposes military spending, reduced “as a share of GDP from more than 7pc in the 1950s to 2pc now.”

On Tuesday, addressing an audience at the Royal College of Physicians in London, Health Secretary Sajid Javid stressed his “small-state Conservative” beliefs and set out his plan for yet more NHS cuts. Claiming additional health spending necessarily meant making “some serious trade-offs on everything from education to infrastructure,” he demanded the health service “become much more efficient”.

He highlighted the government’s plan to use waiting lists as an excuse to more heavily involve the private sector and to dump ill patients on families.

“We can’t continue to have a system in which we need more and more money each year—more than double, on average, the rate of economic growth. It’s just not sustainable.”