Thursday, 9 April 2015

A&E Crisis 2015

The Accident and Emergency departments in hospitals across the whole country have descended into a cataclysm of endemic failure to "meet their targets". The system that has been in place for several decades now is that the performance of National Health Service organizations has been judged mathematically. A complicated network of statistics has been introduced and this has caused all kinds of problems, as Adam Curtis explains in his brilliant documentary, The Trap, see: Therefore the A and E departments of NHS hospitals are set quantitative limits on how they treat their patients. For example, every patient has to be seen by a doctor or nurse within four hours of their admission to the department. If the department fails to achieve this then it is listed as a black mark on the management's records. In the terminology of the hospital this is known as "breaching". I recall several times at weekends when the very stressed-out sister would complain that a senior hospital manager had phoned up asking: "How are things today? I hope we haven't had any breaches so far..." I can sympathize with that manager though because he was frightened that if the department suffered too many breaches then he would get into trouble and may even be relieved of his position. It's been revealed in the news that during last winter the entire system collapsed. 7.4% of patients breached, this is way below the redline limit of 5%. In Northern Ireland it was particularly bad; the breach level was almost 20%. This news page allows you to check the proficiency of your own local trust: My old hospital, the John Radcliffe in Oxford, is at 87.1%, this puts it in the lower half of the league table and certainly way outside the small Premiership of trusts who succeeded in achieving their targets, less than a quarter overall.

The Department of Health will deal with this crisis and all the negative publicity surrounding it in the usual way; they'll kick out the people they hold accountable, the senior managerial grades, and replace them with eager young newcomers. Then they can tell the general public that they've taken action to solve the problem... Only they haven't. Do they really think the staff at hospitals fall short in this way because they're incompetent or lazy? The truth is that successive governments, no matter what ruling party is elected, have squeezed the NHS to death between a huge increase in workload together with a reduction in staffing levels. I saw this myself. Many times on busy afternoons, ambulances were queued up in the entrance bay and I had to relay gas cylinders to them so that they wouldn't run out. I would regularly be tackled by nurses urgently saying: "Ben, could you move this patient right now please, he's about to breach!" Some hospitals called major incidents to try and avert the crisis; but of course this cannot be done on a routine basis. The thing is, the rules forbid hospitals calling in extra staff at any other time, which is insane. The nurses and doctors... not to leave out the porters as well naturally... are doing everything humanly possible, but they're serving in a system that is being deliberately degraded so that it is ripe for full spectrum privatization. This destruction is virtually complete, see: Unfortunately it is now too late to "save the NHS!" To bring back effective free public health care in Britain we will need to introduce a completely new system from brand new foundations. Of course this will not be possible until the vultures who destroyed the previous service are exposed and brought to justice. I'm well aware that the question over public healthcare is moot without taking into account more fundamental issues that conventional NHS campaigners will not address, such as Big Pharma and cancer cures etc, see:, however this doesn't mean that the future of the conventional medical system or its privatized replacement is a non-issue.

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