A Suffolk GP has called for more funding for the NHS, as winter pressures take hold of all parts of the health service.
Dr Matt Piccaver, who has been a GP for seven years and a doctor for 12 years, said the changing nature of the population was putting more pressure on the health service than ever before.
But a number of other factors played into the crisis seen in the last few days, where ambulances queued for hours at A&E departments and operations were cancelled.
Dr Piccaver, 39, said when the NHS started the population was smaller and it was used as a safety net.
'Now things are different,' he said. 'Now [the population] is bigger, and it's older.
'We've got under-funding in the NHS, it's understaffed, staff are working a capacity every day.
'Yesterday I worked from 8am to 10pm, that's a typical day. The door shuts at 6pm but there are still things to do. I was the only doctor in the building and some people are really quite ill.
'We try to offer gold standard but yesterday I thought 'man alive'.
'I asked some friends and colleagues [how things were] and the few that had time to reply said it's grim everywhere. Patients expect brilliance and we can't give it to them.
'The NHS has always been held together by the goodwill of staff. Because if you don't do it, who is going to?'
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Dr Piccaver said he did not usually have to admit patients to hospital, but yesterday (Tuesday) he did.
In a series of tweets he said: 'The hospital was full but my patients [were] accepted. There was an estimated 10-hour wait for the ambulance.'
He added: 'What is clear now is the wheels are falling off the bus. Without staff and appropriate funding we won't have an NHS much longer.'
On Christmas Eve, Dr Piccaver said he worked a shift in A&E and although there had been routine appointments available at his surgery during the day, there were patients at A&E who did not need to be there.
'But the other side of it is we have got a fragmented out of hours system,' he said. 'We've got NHS 111 who are risk-averse, we've had ambulances sent out by them when it wasn't needed.'
He said to run an effective service it was necessary to have clinically-experienced people speaking to patients.
'That is what you get with GP streaming,' he said.
'GPs know who needs to come in or not. But they are instead trained call handlers following an algorithm.'
He added: 'We've got a health and social care system which is underfunded, they want more care in the community but there's no funding for it.'
Dr Piccaver also pointed to problems with recruitment. He said when his partner joined his practice in Glemsford, Suffolk, there were 200 applicants for the job.
But since his partner retired last year, he had not been able to fill the position.
He said: 'I think morale in primary care has been quite poor for some years.'
Although he admitted a proportion of the problem in primary care was people made appointments when they did not need them, Dr Piccaver said: 'Blaming the patient is not useful.
'I think we need to look at health and social care from start to finish, we need to improve preventative measures. We need to improve the health of our younger people.
'We need government to work cross party, with experts in the health care to help run the NHS.'
His message to patients was: 'I'm sorry we can't do better for you.'
He added: 'We are all working flat out, I don't know anybody who is not tired, but I'm sorry we can't do more.'
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