“Oh Jeremy, stop lying!”, is
the edited version of what I shouted at the television, on Monday evening, as
yet again they reported another ridiculous statement from Jeremy Hunt (1).
This time Hunt was hinting
that the government could redefine the 4 hour waiting time target in Accident
and Emergency. He said that the 4 hour target should only apply to patients
with “urgent needs” (1). Again, Hunt was faced with a crisis in the NHS and he
responded with weasel words. The NHS is in crisis, it needs strong leadership,
it needs help and understanding, it needs resources and funding, all it gets
from this Health Minister in an attempt to wriggle out of the crisis. Again
Jeremy Hunt fails in his job.
This January hospitals are
facing huge demands on their services and Accident and Emergency Departments
are breaking under the strains (2). A third of NHS trusts in England had issued
alerts that they needed urgent action to cope with demand (3). More than one in
ten patients faced long delays, well over four hours, waiting for a hospital bed
after being admitted via A&E (4). NHS hospitals are full, no spare beds,
patient beds are being placed in day rooms and staff rooms and even treatment
rooms, places that were never designed to house patient beds. New patients
cannot be admitted until other patients are discharged, the system is blocked.
Two patients died while
waiting in a corridor for treatment, at the Worcestershire Royal Hospital (5).
Their deaths are currently being investigated by I can’t help but ask, would
they have died if they had been sitting on a hospital trolley in an A&E
bay?
This whole terrible situation
has been called a “humanitarian crisis” by the British Red Cross (6). Mike
Adamson, the charity's chief executive, said that the British Red Cross is
currently providing support in twenty different A&E Departments (6). Their
assessment of the current situation is damning, but what is more damning is
that a charity is helping to prop up our A&E departments. What has gone
wrong?
Our press is full of claims
of mismanagement and over spending, but the truth is this crisis should be
firmly laid at the feet on this government.
Jeremy Hunt also said of
people attending A&E that “30% of whom do not need to be there” (1).
Figures from The Kings Fund show this isn’t true (9). from the Patients’ Survey
in 2015, they found that of the 11% of patients who couldn’t get GP
appointments when they wanted one, 4% of these people went to A&E. That is
4% of 11%. Not the 30% of all A&E attendees that Hunt was claiming. But the
number of patients using A&E because their GP is unavailable could be
increasing. Dr Helen Stokes-Lampard, chair of the Royal College of GPs Council,
has warned that many patients have to wait four weeks or more for a routine GP
appointment, because of the pressures on and short falls in GP Practices (10).
In that time a non-urgent problem could easily become an urgent one.
Local Authority budgets have
been cut 40% since 2010 (7). This has left social care at
NHS budgets are also
suffering too. 64% of trust finance directors and 88% of acute trusts are
forecasting a deficit at the end of the financial year (11). This is not due to
any mismanagement on behalf of these NHS organisations, this is due to the
financial cuts, in real terms, in NHS budgets. Demand on NHS services has increased
far higher than the current inflation rate, which is 1.2% (12), yet the NHS’s funding
is only increasing 0.9% a year (13), and
this doesn’t take into account the £22 billion of “efficiency” savings the
Department of Health is demanding from the NHS by 2021 (14). (The second half
of my blog posting Four Corners of the Same Room goes into this in much more
detail)
So what has our Government
done about the crisis overtaking the NHS? Simply put, not much.
In last year’s Autumn
Statement Philip Hammond, the Chancellor, announced no extra funding for the
NHS or social care (15). it was not as if he couldn’t see this year’s winter’s
crisis, the target for treating 95% of patients attending A&E within 4
hours was missed throughout all of last winter (16), and last winter we knew
that the cuts in social care was preventing hospital discharges. Even Andrew
Lansley, the Conservative architect of the 2011 reforms of the NHS, warned that
the NHS and social care needed more funding (17).
Jeremy Hunt told parliament
that the 4 hour A&E target might be revised and claimed 30% of people
visiting A&E were not appropriate (1) (In 2014, again in parliament, Hunt
admitted he took his children to A&E at a weekend because he couldn’t be
bothered to wait for an Out of Hours GP appointment (18)). That’s as far as his
leadership has gone.
Theresa May criticised the
British Red Cross for calling this a “humanitarian crisis” (19). Neither her of
Hunt have offered any political leadership or responded practically to this
crisis. We cannot expect any more from Hunt, he has show poor or non-existent
leadership in the face of previous NHS problems. Theresa May showed how low a
priority the NHS was to her when she became Prime Minister and left Jeremy Hunt
as Health Minister. Her priority is Brexit and she seems to have so little
interest in the NHS.
Again we are faced by a
winter crisis in the NHS, this is not a new crisis, it has been happening for
several years now, and still we are here again. Our government could have
prevented it, instead they react like they were caught off guard by this very
predictable crisis. What are these people being paid for?
Drew Payne
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