BUREAUCRACY TRUMPS PATIENT CARE IN BRITAIN'S EMERGENCY ROOMS

Casualty departments have revealed that they are jeopardising patient care and deliberately distorting official waiting times in a desperate effort to meet government targets. Eight out of ten accident and emergency units admit that they discharge patients too soon, give them sub-standard care or send them to the wrong wards to deal with them within the four-hour target.

Today’s major survey by the British Medical Association also casts serious doubt on the accuracy of government statistics on A&E waiting times. Three-quarters of hospitals say that they use a range of tactics during monitoring periods to manipulate the figures. Half say that extra staff have been brought in during weeks in which monitoring takes place, while a quarter admitted that non-emergency surgery was cancelled. One in six hospitals even resorts to the “direct manipulation of the data” to make it appear that they have met the A&E target.

The news turns the spotlight on government claims about NHS improvements, pushing health to the top of the election agenda. It also comes the day after Tony Blair was publicly criticised by a gynaecologist who told him that target-setting in A&E was “actually jeopardising patient care”. Amara Sohail from Basingstoke said: “As someone working within the system, we don’t see more money coming in. Targets don’t work.” She said that the pressure on emergency medical staff would lead to “serious mistakes”.

Mr Blair told her: “If you went back a few years, I think most people would say that accident and emergency departments are a lot better than they were.” He added that he was prepared to look again at the issue of A&E waiting times to ensure that they were “sufficiently flexible”.

The target — that 98 per cent of patients be seen, treated, admitted or discharged within four hours — is due to come into force at the end of this month. The Government says that by the end of last year 96.8 per cent of patients were being seen within this time. But the survey backs data collected from patients by the Healthcare Commission, which also suggested that targets were far from being achieved.

The claim has met with an angry response from the Government. John Hutton, the Health Minister, said it gave “a deliberately distorted picture of the changes that have taken place in A&E departments”. He went on: “Chief executives of NHS trusts are responsible for signing off their performance data. If any doctors have concerns about patient care or fiddling of figures, they have a clinical duty to take them up with their medical director or chief executive or, failing that, with their strategic health authority or the Department of Health. To date we have received no formal complaints.”

The survey was sent to all 200 A&E departments in England, and 163 of them replied. Of the half that said they had failed to meet the Government’s 97 per cent end-of-year target, most cited a lack of beds, delays in accessing specialist opinion or diagnostic services and staff shortages.

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