NHS CAN'T HANDLE EMERGENCIES

So they lie instead

Doctors are struggling to meet Government accident and emergency waiting time targets because the NHS cash crisis is resulting in a shortage of beds, doctors' leaders warned today. A survey for the British Medical Association (BMA) found that a shortage of hospital beds was delaying the admission of patients from A&E in England. A third of those questioned said that figures were manipulated in order to meet the access targets. A total of 503 members of staff at all grades working in emergency departments responded to the survey. The Government target is that 98 per cent of patients should wait no more than four hours from arrival at A&E to admission, transfer or discharge.

The survey questioned UK staff from the British Association for Emergency Medicine (BAEM), with 86 per cent of the responses received from those working in England. Eighty-seven per cent of doctors in England said that the lack of in-patient beds was the main reason for not meeting Government targets. Staff shortages and patients attending A&E with minor problems were also blamed. Two-thirds of those in England said that patients were moved to inappropriate areas or wards to help meet the target, while 58 per cent said patients were being discharged from A&E to inappropriate areas or wards before they had been properly assessed.

Just over half of those in England said that their department was meeting the A&E target. But 49 per cent said their department had received extra cash to help them meet the target, and 53 per cent said agency workers and staff on short-term contracts had been brought in to help. Almost all of those who replied to the survey in England said that their workload had increased in the past 12 months, with most blaming the transfer of out-of-hours care from GPs to primary care trusts.

Today's survey also revealed that departments are at risk of being downgraded or closed altogether.It found that 48 units in the UK (42 of them in England) were at risk of being downgraded and 23 in the UK (19 of them in England) were at risk of closure.

Don MacKechnie, chairman of the BMA's Emergency Medicine Committee, said: "Many hospitals have cut bed numbers as part of their financial recovery plans and attempts to balance their books. "This means that there are fewer available beds for patients coming through A&E who need to be transferred within four hours to a hospital ward from the emergency department to meet the Government's access target. "The report finds that doctors and other staff are working exceptionally hard and putting in extra hours to meet access targets. Working towards the four-hour target on A&E waiting times has been a fantastic achievement, it has proved good news for patients and the extremely long waits seen in the last decade are now very rare. "However, respondents tell us that despite this success, the level of performance in many departments is proving unsustainable and these departments are finding it difficult to cope on a daily basis."

Martin Shalley, president of the BAEM, said: "Attendances at urban A&E departments continue to rise and pressure on beds remains a significant factor for achieving the four-hour target. "It is vitally important to separate acute and elective facilities so that each can perform efficiently and improve the patient journey." Government figures show that 98.2 per cent of patients were seen and treated within four hours in 2005/06.

Source

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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