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Our correspondent looks behind the recent stories about accident and emergency departments being swamped and points the finger of blame

Every winter for the past four or five years we have witnessed the unedifying spectacle of accident and emergency departments finding it increasingly difficult to cope with the demands that are made of them. To some extent, the increased demand in winter is predictable €“ the cold weather brings with it chest infections, hypothermia, elderly people falling on slippery pavements and so on. But this year, the crisis we have witnessed is not due to the expected seasonal increase: we have yet to bear the brunt of any winter epidemic, and the weather has largely been unseasonably warm.

So why have so many hospitals had to declare 'major incidents' over the past months? These are not isolated cases. Many hospitals across the UK, including my own local hospital, have had ambulances queuing outside A&E departments, patients on trolleys in corridors and every bed in the hospital full. Patients are urged to attend only for genuine emergencies, while, according to the Daily Mail, €off-duty nurses are begged on Twitter to work longer€, and casualty wards are likened to a €packed nightclub€. In addition, surgical procedures have been postponed and clinics cancelled.

Attendance statistics for A&E departments in England are available on the NHS England website. They make troubling reading, but not for the reasons you might think.

If demand hasn't risen, as we have been led to believe, where have all the problems come from?

 It seems that reports of unprecedented demand on A&E departments this winter are not entirely accurate; in fact, they're not accurate at all. I've obtained the statistics on the total number of A&E attendances for January for the past five years. For the second week of January, in 2011, the number of attendances was 253,937; in 2015 it was 249,648. Over the five-year period, the number of attendances has remained static at about a quarter of a million a week, with the highest number of attendances being in 2013.

So, if demand hasn't risen, as we have been led to believe, where have all the problems come from? It's difficult to point to one single issue and say that it is the root cause. The causes are complex. There are problems with commissioning as clinical commissioning groups attempt to divert resources from hospital-based services. There are also problems caused by the inability of hospitals to discharge patients because of delays in providing community- based care, especially for the elderly. And, of course, there are all the 'efficiency savings' that hospitals have had to make over the past five years €“ closing wards and reducing staff numbers. But these disparate causes all arise from the same source: the health policy of the coalition, with its toxic combination of 'reforms' and austerity is what has led us to this current crisis, which is itself only a symptom of the deeper malaise that lies beneath. Under this government's stewardship, the NHS has been allowed to decline to the point that everyone can see on their TV screens: the chickens are finally coming home to roost.

Pen name of a practising independent community pharmacist. Withering's views are not necessarily those of ICP