Just been listening to a piece on BBC Radio 5 Live about ambulance waits at Accident & Emergency (A&E) departments – the phenomenon whereby ambulances are unable to discharge patients because A&E departments are unable to cope with demand.
Various callers – doctors, nurses, patients, NHS managers – spoke of the obvious: that massive cuts in funding and nurse numbers have resulted in A&Es straining at the seams as staff struggle valiantly to cope without any realistic hope of doing so. This is exactly what caused the problems at Stafford hospital’s A&E (though not the ‘1200 needless deaths’ fallacy that most of the media trot out – well done 5 Live for not doing so).
Callers were virtually unanimous in the view that funding and staff cuts are a root cause of this problem – as indeed Robert Francis concluded in his report on Stafford. The cumulative effect of these cuts to funds and numbers is a rise of 58% in ambulance waits of 30 minutes or longer .
The government’s ‘solution’ to this situation? Fines.
Cash-strapped hospitals will be fined £200 for every time an ambulance has to wait 30 minutes at A&E – and £1,000 for every wait of an hour or more.
Isn’t this so typical of this deceitful, underhand government? Imposing a ‘solution’ that actually exacerbates the problem it’s supposed to solve – and puts lives at risk as either A&E’s struggle even more, or hospital managers are forced to divert funds from other parts of the hospital to shore up A&E to avoid the fines.
Jeremy Hunt completely ignored Robert Francis’ key conclusion in his so-called ‘response’ to the Francis report. He is wilfully ignoring the real cause of A&E problems and imposing fines that will make them worse. All while planning to close ‘failing’ hospitals.
You have to wonder why that is.
The use of fines in the NHS almost always has deeply unhelpful effects. It is about time that people woke up to this. I know perfectly well that there are ambulance staff all over the country deeply concerned about the pressures that they are encountering, and finding it very hard to be able to warn people about this.
Francis is perfectly clear. We need to stop trying to blame people when systems dont cope. The only way to resolve the problems is to actually try the novel approach of listening to staff!
Fines indeed. If the effects of all this were not so serious it would be funny. A farce
First break the system by closing hospital AnE’s, then fine the ambulances for taking to long to do a handover which breaks the ambulance services, then state “its not working, it must be privatized” and rig the system by offering better working contracts to private companies… jobs a good un… get kicked out at next election but have no worries as you can get 100K for a few days work on the boards of the newly privatised NHS… Kerching!
At the risk of pedantry: a fine is a pecuniary punishment for a crime or offence. Must we therefore believe that this gorvernment is about to introduce statute to make a delay (in something, anything) a criminal offence)
The word that they should be using is ‘mulct’ which applies to civil offences if one has been committed (I doubt there is such an offence).
So the expression they should use is “They are mulcting A&Es for delays.”
Since mulct doesn’t seem to be in common parlance, here is the Wiktionary definition:
http://en.wiktionary.org/wiki/mulct
NB the second use as a verb seems to be appropriate.
Just back from a “Churches in Stafford” service for Stafford Hospital at St Mary’s (Stafford’s central Anglican church). Yes indeed, everyone is involved! The Bishop of Stafford was on the march and spoke to the 50,000 – and has been putting the boot in to the TSA (and anyone else who will listen) fairly heavily on behalf of the poor and impoverished particularly.
Very moving service, orchestra at the back rather than organ, 4 children lit candles at the front at various stages (thanksgiving and regret; healing; hope for the future; community). It’s all part of the on-going momentum. Will it be enough in the end? Let’s hope that an opportunity to forgive isn’t all we’re left with.
And in relation to this blog, you only need half a brain cell to realise that fines for struggling hospitals and rewards for the lucky ones is bound to be counter-productive (and inequitable).
This so called ‘solution’ of imposing punitive fines on a struggling public sector organisation reveals the government’s intent to abandon the NHS. It effectively says “don’t expect to be bailed out by public money when you can’t manage” . And this message is being sent to hospitals after they’ve been deliberately starved of the public investment they had a right to expect by virtue of being publicly owned.
Contrast this to the response of government to the failing PRIVATE sector banks who were rescued by public money not so long ago.
They were considered ‘too big to fail’ because of the health of the economy.
Its clearer than ever that this cabal of millionaires who ‘govern’ us and who don’t themselves need the services of an NHS, don’t consider the health of ordinary people to be worth the same effort.
Hi
I am an admirer of your blog but could not let this go by. Overall capacity (for example staff levels) is an issue that will impact on performance but it is not the only factor. Another is how those staff are deployed and yet another what they are doing.
So don’t spoil an otherwise excellent blog by drawing simplistic conclusions about lack of staff. When asked, NHS professionals will generally say that they are short staffed. And that may be true. But they will remember the occasions when they couldn’t do things and not those when staffing wasn’t a problem.
Thanks, Mike. It’s not simplistic, or at least I don’t think so. It’s obvious that hospitals need to be well organised, and wards staffed with the right people to do the right jobs. However, if understaffing is severe – as it has now become – it doesn’t matter how qualified, capable and well-organised you are, you’re still not going to be able to manage everything safely and adequately. That’s the key issue at the moment, and any solution that ignores it is going to amount to just rearranging the deckchairs on the Titanic.
Anyone concerned, as I am, that the NHS stays out of the hands of the private sector may be interested in this. The danger doesn’t just come from UK private health companies but from international corporations and once they get their hands on it nothing will get it back.
http://www.politicshome.com/uk/article/78150/national_health_action_party_call_on_prime_minister_to_exempt_nhs_from_eu_us_trade_deal_and_stop_irreversible_nhs_privatisation.html
Think I heard some of this on R5. To be fair to the Goldberg guy presenting he made it clear what he thought of the fines thing. Well done to him.
Typical ! Cut funding so they fail then fine them when they do.
What is wrong with just providing enough staff (ratios as in Australia where they get a nurse to every 4 patients) & enough equipment & facilities.
Has anyone in this government ever had to use an NHS A&E dept. ? I doubt they would be so crass in their approach to the NHS if it was their relative lying on a trolley in the corridor or their family member struggling to work on < UK ave. ann. salary, on an overly busy ward with far to many patients to cope with & not even time for a drink which is what my relatives & friends who work in the NHS regularly have to put up with.
We are witnessing the slow death of the NHS & it is a murder being perpetrated by govt. who dress it up as targets & progress all in the name of efficiency.