With record waiting times, staff shortages, financial black holes and now a nurses strike over pay, the UK's state-run National Health Service is facing an unprecedented crisis.
The walk-out by nurses planned for next month heaps fresh misery on the much-loved but creaking institution, just as winter illnesses bite and as the country faces a prolonged recession.
Matthew Taylor, head of the NHS Confederation, which represents the service in England and Wales, said demand for frontline care is "sky-rocketing".
"Waiting time standards are deteriorating despite the sterling efforts of NHS staff – and the winter months look to be very bleak and the busiest on record," he said recently.
A record 7.1 million people are waiting for treatment, with long delays for tests as well as routine and emergency care.
Richard Sullivan, a cancer care specialist, said some 14,000 prostate cancer cases were "missing" due to a lack of diagnosis, with around one in 18 waiting more than a year.
"You shut down your health system... you are going to lead to a massive number of people with stage shifts, where their cancers become more advanced," he added.
Difficulty in replacing departing staff has deepened the crisis.
Record inflation has led to gloomy forecasts of a prolonged recession and cuts to public spending, potentially extending the crisis.
Sullivan, professor of cancer policy and global health at King's College London, said the NHS was "burning hot for years" even before Covid placed extra burdens.
"Once you start overheating the motor and constantly burning it...you're wearing it out," he added.
"I think we're in for a really rough ride over the next few years." (AFP)