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Monday 9 January 2017

Dear Jeremy Hunt, why do you fiddle while you watch the NHS burn?




When I worked in hospitals, back before 2000, I remember patients having to wait in corridors after treatment, or when waiting for treatment.  It was not nice, and it was not dignified.  And it was not as safe as it should have been from a clinical perspective.  But things got better, or rather less worse. Winter is a terrible time for the NHS and it is normal for the NHS to expect a surge, but this year people working in the NHS seeing patients were expecting hell.  And it has happened.  Or, according to the government, not.

The red cross has issued a statement saying that the NHS is in crisis and that both the NHS and social care need more funds.  The government has stated that there is no crisis, as have NHS England.  And today, Jeremy Hunt has made a statement in Parliament that many in the NHS will find to be interesting.

When it comes to the statement, Jeremy Hunt mentions that the number of elderly that are present has increased.  This is in part due to the NHS and the care it offers.  And this has placed an increased need for decent social care provision.  But what is interesting is that others in the Conservative party have blamed the issues that the NHS is facing on other issues.  Such as immigration, and also, around this time, the pressure that drinking causes the NHS has been in the news.  But, after mentioning the ageing population, Hunt has stated that as a result, demand is unprecedented.  He mentions that the Tuesday after Christmas was the busiest day in the history of the NHS and that some hospitals have reported that NHS attendances are up to 30% higher than last year.  Sadly, many people are directed to A&E due to NHS111 sending them there.  The difference between that and NHS direct is that NHS111 has fewer clinically trained staff, and therefore tends to send people to A&E more often.  But, things cannot just be blamed on that, as thresholds for treatment have changed, which means that a patient who would have asked for advice five years ago is more likely to be sent to hospital for certain conditions now.  But another issue is the service that GP’s can offer, and general practice is failing.  Despite the promises to improve general practice, and promises of more money (which has not been spent to improve general practice) people have left primary care.  Where I work, since I started, the surgery has lost two partners and four salaried doctors.  One has retired early, and others are working as locums (agency workers) where they earn more money for less hours and less responsibility.  Basically, fewer people want to work as a GP.

He thanks those who are working in the NHS and in social care, forgetting that the numbers needed are not enough for what the nation needs.  We face shortages in paramedics, nurses and doctors and many doctors have left our nation to work abroad formore money but more importantly, a better work life balance.  Hunt (later) cites increased numbers of doctors and nurses working in the NHS, but the call of those who are really working in the NHS is to ask where they are.

And he also states that the NHS has made more preparations before this winter than ever before.  But it was felt by many that the NHS has not been so ill prepared for a long time for the winter with many stating that it would not cope.  Warnings that the government ignored, and still refuses to admit occurred.  His statement that the NHS system as a whole is doing better than last year is one what those working in the NHS do not think to be true.  And the Nuffield Trust can prove it to be otherwise as well.

When he cites that GP’s can be released to support urgent care work, he is to take GP’s away from a system that is already under pressure to support one that is under pressure, in part because there are not enough GP’s working in primary care in the first place! 



But he does say one thing that I do agree with.  That being the four hour wait.  I do think that it is important for conditions that are deemed to be urgent, but for those which are not urgent, I do not see the need for those patients to have been seen within four hours.  But that is not the reason for patients waiting on trolleys to be admitted to hospital, for those patients have attended A&E appropriately and are waiting to be admitted as it is now harder to send patients home. 

When asked questions in Parliament Hunt cites waiting lists being higher under Labour, which is true.  But forgets that Labour also sorted them out and since the election in 2010, they have increased.  A&E target times have been met more under the Conservatives, but only because they have moved the goal posts!  Also he cites social care being an issue in Labour councils when the Conservatives have limited the cash they have.  In addition he cites money going to the NHS, correctly stating that the NHS has increased funding, but forgets that the increases it has are less than before.


In summary, the idea of getting rid of the four hour wait and the focus on mental health in his statement is a good thing.  But he has twisted the truth on the crisis that the NHS is facing in A&E's across England.