May scapegoats #GPs but it only takes ONE line to see WHO’s to blame for #NHScrisis

amb queue darlington.jpg

In a landmark speech to the Fabians on Saturday, Labour leader Jeremy Corbyn called out Theresa May’s approach to the NHS and the ‘humanitarian crisis‘ unfolding in it, calling her:

A Prime Minister who would much rather listen to spin doctors than real doctors

Mrs May’s latest spin-doctored idea is to blame GPs for the current A&E debacle, while simultaneously claiming, via Tory MPs speaking to news channels, that she does not want to set one part of the NHS against another.

Yes, Tories never use ‘divide and conquer‘, do they Mrs May? In a context where over one in seven of England’s NHS hospitals declared a ‘black alert’ – the worst possible emergency – on a single day, her stance is ludicrous.

Nonetheless, Tory rags will be spitting out lines after line of ‘on-message’ propaganda on Sunday to back up May’s claim, but it only takes one line to put beyond any sane doubt just who is responsible for the disaster in our country’s greatest treasure. This one:

ae waits.png

As the header suggests, this line shows the percentage of patients visiting Accident & Emergency (A&E) who had to wait more than 4 hours to be treated. The switch from red to blue shows when the last Labour government ended and Tory/coalition began.

The line shows an inexorable rise in what is considered the key measure of the NHS’ ability to cope since the Tories took power in 2010, from an average of around 2% through the last 5 years of Labour government to around 12 in September 2016 – and projected to be a staggering 22% or higher this winter.

The percentage under Labour in 2003 was high, touching 12% – but 2003 saw an unprecedented 18% jump in A&E attendances and even though they continued to rise in the following years, the graph shows Labour quickly got on top of the situation and kept it under control throughout the rest of their government. Figures before 2003 are not available, because the 4-hour measure was not in place before then.

If that graph looks stark, it’s actually understating the seriousness of the situation the Tories have created – because the ‘four hours’ do not even start to be measured until patients enter the A&E department. This means that patients waiting in ambulances – potentially for hours – are not reflected in the above graph and ambulance waits were virtually unknown before 2010.

In 2013, after 3 years of Tory-led coalition government, the phenomenon of ambulance waits started to really come to public attention:

amb waits Mail.jpg

The BBC reported that the 2014 figures had risen significantly and were already on the rise again in 2015, then last autumn – but only after a Freedom of Information Act request forced them to do so – the government disclosed that the number of ambulance waits had jumped by an incredible 64% in just one year.

So the numbers in the blue half that telling line above would look much, much worse if it were not for the fact that the drastically worsened ambulance-wait statistics are not reflected in the graph.

While formal figures are not yet available, empirical evidence suggests that the beginning of 2017 shows that the situation continues to worsen drastically. Dr Clive Peedell of the Narional Health Action party tweeted just three days ago a picture of no fewer than 12 ambulances stuck outside the A&E in the small town of Darlington:

As Dr Peedell observes, Health Secretary Jeremy Hunt is in denial about the situation in our NHS. His boss is not only in denial but is now attempting to point the finger of blame at GPs. Tories do love a scapegoat.

But GPs did not all suddenly stop seeing patients on the day the Tories moved into 10 Downing Street.

There’s only one place to lay the blame for the planned disaster engulfing our NHS at the moment. And that’s squarely on the heads of Theresa May, the awful Jeremy Hunt and the NHS-hating Conservative party.

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  1. There was not an “unprecedented rise” in A+E attendances of 18% in 2003. That apparent rise was an artefact of a new way of recording A+E attendances. Up until then it was just what is now called type 1 A+E attendances that were recorded. From 2003 types 2,3 and 4 attendances were recorded. That explained the sudden and otherwise inexplicable apparent rise in A+E attendances that year. It’s worth noting that types 2,3 and 4 “A+Es” are not proper A+Es, in the normally understood sense of what an A+E is – they are urgent care centres, minor injury units, specialist dental or eye emergency departments. Type 1 remains what most people consider a normal A+E – attached to a hospital, receiving all comers including blue light ambulances and, crucially, with admitting beds for medical and surgical emergencies. It’s the type 1 A+Es that are having the problems with failing to meet the 4 hour target, massive increase in trolley waits and so on because the A+E crisis is a beds crisis – there simply are not enough beds. A+E is the bottle neck. Patients can’t be admitted to beds so fill up the corridors in A+E; ambulances can’t hand over their patients and get backed up outside the hospital, unable to attend their next call and leading to ambulance performance delays. The lack of beds is due to two things: actual bed cuts and patients who can’t be moved out of hospital due to social care cuts. Both these are the effects of government policies which is why they are trying to deflect attention from those facts. Types 2,3 and 4 don’t have beds, don’t admit people and therefore have no difficulty meeting the 4 hour target. Their 4 hour target performance is therefore combined with the type 1 performance to make the overall A+E performance seem better than it is. The only data people should look at to understand what is going on in our hospital A+Es is type 1 data. Its all available on the NHS statistics website but is 6 weeks late by the time it is published owing to a decision by the Government 2 years ago to stop publishing the much more useful – and damning – weekly data.

  2. It seems to me that the Tory response has been a slew of comments that the NHS is broken and we need a ‘grown up’ conversation about this. This position is being supported by the right wing of the Labour party. No one mentions the ‘P’ word but the implication is that if we had other ways of funding somehow the problem could be magiced away.

    1. The implication – and I think this has been the plan all along – is that we need to question whether universal care free at the point of need is ‘affordable’. Bastards.

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