In April last year, British Prime Minister Boris Johnson thanked the doctors and nurses who saved his life after he spent days in hospital intensive care with COVID-19.
In an emotional address on television, he promised all the necessary funds for the state-run National Health Service (NHS), which is Europe's biggest employer.
But 12 months on, frontline health workers said that promise rings hollow and they feel "betrayed", as experts warn the system is imploding for lack of investment.
Even before the global health crisis hit, the NHS — a cherished national institution funded by taxation and providing free healthcare — was already under severe strain.
"The NHS had just finished the most difficult winter. We were behind on delays of treatment, on all metrics," said Stuart Tuckwood, nursing officer for the public sector union Unison.
Hospitals then had to cope with two devastating waves of Covid-19 that stretched staff to the limit and put capacity at breaking point.
Since Britain's outbreak began, more than 127,000 people have died after testing positive for the disease — one of the worst death tolls in the world.
Staff are physically and mentally exhausted, said Tuckwood.
"Then the government has indicated that all it's going to offer is a one-percent raise for NHS workers. It feels like a massive betrayal," he told AFP.
The proposed pay increase has caused anger far and wide, prompting calls from the main opposition Labour party — which set up the NHS in 1948 — for a much bigger award.
Even pop star Dua Lipa weighed in at this week's Brit Awards, saying frontline workers should be given a "fair pay rise".
Beyond COVID
A British Medical Association survey of 2,100 staff indicated that more than one in five plan to leave the NHS and change careers because of Covid-related stress and fatigue.
Nurses are widely viewed as underpaid, while auxiliaries and other staff earn even less, with many living below the poverty line.
The Royal College of Nursing wants a 12.5 percent pay rise, while Unison is calling for a one-off £2,000 ($2,809, 2,325 euros) per person bonus for the year.
Franco Sassi, professor of international health policy and economics at Imperial College, is concerned about the "lack of additional structural funding for the NHS, beyond the commitment of expenditure to face the pandemic emergency".
Health spending in Britain was already 43 percent lower than in Germany, and 15 percent less than in France before the crisis, he wrote in a note on the university's website.
The number of doctors — 2.8 per 1,000 people — is also "well below EU averages", while Britain has the second-lowest number of hospital beds in Europe.
If this backlog is not addressed, "the NHS will fail to meet patient needs and expectations in a post-pandemic world", he said.
"It will place additional demands on public finances, already under significant strain, but the risks involved in leaving the NHS underfunded are too great."
Waiting times
Johnson's Conservative government — regularly accused of wanting to privatise the NHS — has defended its proposed pay award.
The Department of Health pointed out that public sector pay increases have been suspended because of the economic situation caused by the pandemic.
More than one million NHS staff had been given new multi-year pay deals, leading to a rise of more than 12 percent for newly qualified nurses.
Junior doctors' pay scales will go up by 8.2 percent while an extra £63 billion has been made available for health services in the last year, and £29 billion in 2021.
"This includes £1 billion to support NHS recovery by incentivising providers to address backlogs and tackle long waiting lists which have built up because of the pandemic," the department said.
The backlog is causing concern. NHS figures this week showed nearly five million people were waiting for routine hospital treatment — and 436,000 for longer than a year.
George Stoye, associate director at the Institute for Fiscal Studies, said long waits were likely "for years to come", even as Covid-19 cases fall.
"The waiting times figures are only the tip of the iceberg… Catching up on this care will take years and billions of pounds of additional health spending," he said.
He welcomed a £160 million government package to tackle the backlog but said a "clear plan" was needed to boost staff numbers to cope.
"After more than a year of tackling the pandemic, a clear workforce strategy that rewards and retains staff is more vital than ever," he added.
