Why are we experiencing an A&E crisis now?
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| 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.
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| 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.
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