Posted on 10th January by Max Pemberton for The Daily Mail
When will Jeremy Hunt admit what is glaringly obvious to everyone else:
the NHS is in crisis?
I never thought I’d say this as a doctor, but I’d be scared if a family member was taken ill and had to go into hospital.
Despite the best efforts of the hard-working staff, I’d worry that all the pressures mean that patients risk being discharged before sufficient preparations are made.
What’s more, some patients are forced to wait for days – that’s right, not an hour or so, but entire days – on trolleys in corridors. The situation has become so commonplace that hospital trusts are now allocating nurses and consultants specifically to corridor duties so as to care for the patients waiting there.
This is what you would expect in a Third World country, not a wealthy, developed nation like ours.
Not only has this resulted in reports of people dying on trolleys while they wait for care, but some doctors and nurses are worried about going to work because they feel powerless to make matters any better.
They face an awful dilemma. A friend who works in A&E put it to me: do I continue to work in a place I know is unsafe and endorse the system by doing so, or do I walk out because I feel I can’t guarantee my patient’s safety?
As for Mr Hunt’s comment yesterday, I’m afraid that problems with the four-hour target to treat A&E patients are a symptom of a much wider issue.
The fact is the rule, introduced by a Labour government, has been
exploited by people who see it as an incentive to go straight to A&E units
and bypass their GP because they think they will be guaranteed swift treatment.
Hospital staff have warned for some months that we have been nearing crisis-point – and now, with winter here, we have inevitably reached that moment.
So, how has this been allowed to happen? Certainly, Britain’s population of more elderly people has placed increased pressure on the NHS. Improved and costly treatments also drain budgets more quickly.
Hospitals trusts, too, are heavily in debt, often because they are forced to pay huge sums to repay the money that was borrowed to build their facilities.
In addition, there is poor workforce planning by managers which has led to a chronic recruitment crisis, especially in high-pressure services such as A&E. This said, the biggest problem facing hospitals is that they are suffering the knock-on effects of a crisis in the community and GPs surgeries which cannot cope.
Since 2010, there have been cuts to social care budgets – reduced by an estimated 40 per cent and leading to almost one million fewer people now in receipt of social care.
Therefore, hospitals have been forced to keep patients longer than necessary as there is inadequate provision for patients once they have been released.
Indeed, National Audit Office figures show that the number of days that beds have been occupied by patients due to delayed transfers of care have increased by 31 per cent in the period 2013-2015 alone. Then, of course, there is the GP crisis – with doctors’ surgeries facing a huge extra workload.
This has been exacerbated by a disturbing combination of factors: the effect of an increasing number of women GPs, many of whom work part-time; older GPs who have taken advantage of changes to their pensions which have encouraged them to take early retirement; the new contracts introduced in 2004 which allowed family doctors to opt out of evening and weekend work; and burnout suffered by some GPs which has led them to leave the profession or move abroad.
For their part, patients, who have become frustrated and angry over the decline in the standards of care, tend to blame their local GP.
Unforgivably, politicians and hospital managers have, in turn, allowed GPs to be scapegoats for their own failures.
Tragically, this becomes a vicious circle. With fewer GPs, the pressure on A&E units increases and the crisis deepens.
If you want proof of the degree of delusion of NHS bosses, look no further than an utterly idiotic comment last week by Professor Jane Cummings, England’s Chief Nursing Officer. Despite A&E units being overrun with patients and some people waiting for days on trolleys in corridors, she said: ‘The NHS must cut beds for better care.’
I wonder, for example, when was the last time she had to care for an elderly patient with a fractured hip in A&E when there wasn’t a bed available on the orthopaedic ward?
Or had to comfort a confused pensioner with a chest infection who’s been languishing on a trolley in a corridor for the past day and a half?
Scandalously, figures show that Britain has 2.8 beds per 1,000 people, ranking us as one of the lowest relative to population size in the developed world. Our hospitals are also among the fullest, with patient numbers frequently outstripping the number of beds.
These are the facts. As a doctor, I implore you to ignore the spin of people such as Jane Cummings and Jeremy Hunt.
When doctors and nurses are scared that their family members might
become sick and need to come into hospital, it is undeniable that there is a
monumental crisis.
