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Wednesday, 7 January 2015

This is not a "New Crisis"

Why are we experiencing an A&E crisis now?

A very busy HNS

Since the 1980's, when it became the policy to close hundreds of the smaller hospitals and create super size “centres of excellence” at a few locations around the country with the rather naive assumption that “Bigger is better”, we have had an “A&E crisis”, which has not been limited to the A&E departments but has percolated throughout the hospital system. This A&E crisis, was exacerbated throughout the 1990's with the fallacious proposition, that in order to solve the problem it was essential to introduce more and more layers of management, introduce “targets” to monitor performance of departments and individuals, and to pour money into the system. A fiscal policy which mainly went into financing the expanding bureaucracy rather than improving the standards of care.
Over the past 15 years, the situation has deteriorated significantly with the drive towards making the NHS more efficient and cost effective, by cutting non essential services (what ever that means), closing wards, reducing bed numbers and provision of hospital services such as cleaning facilities and providing meals to patients. It is crass and unacceptable to load onto nurses and other medical staff the added responsibility for meal provision, cleaning wards and rest rooms, public spaces such as visitor rooms on top of their already more than full duty hours of providing care for patients and the endless demands of “management” for more and more statistics.
These comments, in no way detract from the selfless work of nurses, doctors and other medical staff, who everyday face an uphill struggle against circumstances not of their making. The way in which the NHS generally has become over years a “political football” with interference from successive ministers each with their own agenda's and reorganisation schemes all of which have been reversed or overturned by the next Minister of Health, is a scandal and a disgrace which should cause outrage amongst all of us. From personal experience and anecdotal reports, I am well aware of the high volume of work carried out both in A&E and on the wards, particularly over the recent holiday period. These staff should be applauded rather than be subjected to the implied criticism of politicians seeking to score points off the other parties over the past few days.
This A&E crisis, so widely reported in the media and on television has not suddenly come about since January 1st 2015. It is a problem and crisis which has been festering for decades and only now has been given such intense exposure. Forget the statistics trotted out over recent days. Forget the headlines Aging population, Winter illnesses, Cuts to social care, Long waits to see a GP, NHS 111and all of the other hysterical words designed to generate alarm. All of course true but they are not new! They have been around for some time but only now repeated with monotonous regularity for the sake of expediency.
Why are we experiencing a crisis now the article asks. The short answer is that we are not experiencing a crisis now, as the crisis has been with us for years. Only now in the election year of 2015 does it suit Andy Burnham, Jeremy Hunt, Nick Clegg large sections of the media, to argue that they and only they have the solutions to the NHS problems and seeking to convince the rest of us that we should vote for them on May 7th.
Andy Burnham & Jeremy Hunt

However, we all know that once elected, which ever party or coalition should form the next government, the crisis in the NHS will remain and we should expect the same or similar stories next winter and for the winters thereafter. The only scenario that the NHS has to look forward to is more reorganisation and more cuts in real terms no matter how much additional cash may be allocated for it.