A humanitarian crisis – and the goodwill of staff has disappeared. When will the public ask for private A&E?

It’s been going on for some time, but citizens have been ignoring the issue because the majority are “well”. Disabled and elderly users of A&E will have known this “unfortunate truth” for some years now, as they witness the slow meltdown of health through short termism, and perverse behaviours. In this “post truth” world the language of avoidance and obscurement is important….. The decline in standards is the result of the perverse incentives inherent in misguided performance targets throughout the UK health systems. Knowing the rules of the game keeps managers in post, and gaming the system gives them advancement. They have to move on quickly however, before their fake performance is exposed.. The staff have responded with disengagement, and from doctors to nurses, from psychiatrists to dentists, the “goodwill” has disappeared. When will patients ask for private A&E – as they have to for dentistry?

Laura Donelly reports in The Telegraph 7th Jan 2017: ‘Humanitarian crisis’ in NHS warns British Red Cross as A&Es are overwhelmed by demand 

NHS hospitals have been accused of trying to “spin their way out” of the growing winter crisis after a leaked memo revealed that managers are being instructed to play down the scale of the problem.

Yesterday figures showed that record numbers of patients in ambulances are being turned away from Accident and Emergency units because hospitals are so busy.

But the Daily Telegraph has seen an NHS memo telling health officials that the “most important thing” is to avoid language such as “black alert” – the phrase used to denote the most serious level of emergency…..

BBC News reports this as: ‘Humanitarian crisis’ in NHS hospitals, warns Red Cross

The charity said volunteers and staff had been helping patients get home from hospital and called for more government money to stabilise the situation.

It comes as a third of hospital trusts in England warned they needed action to cope with patient numbers last month…..

In the Times there is comment by Janice Turner on her mother’s recent care: “The NHS is in need of emergency treatment. (My mother was sent home from hospital at 92 after a fractured leg at 11.40 at night.. but to a nursing home well aware that this may happen.)

And Kate Gibbons reveals the perverse actions taken by ambulance managers in order to “look good”. Ambulance trusts use loophole to claim faster response times.

Ambulance trusts have been accused of routinely manipulating 999 response times by using a loophole to claim that they reached life-threatening emergencies in less than ten seconds.

Ten of the country’s 11 trusts have taken advantage of NHS rules allowing them to log ambulance response times as near-zero if there was a defibrillator within 200 metres of a patient, and someone nearby was trained to use it.

Chris Smyth reported earlier this year on the perverse incentives in dentistry: The great dental rip-off- Thousands of teeth needlessly extracted as surgeries accused of putting profit before patients and Dental fees leave patients with toothache clogging up casualty, on which he says Toothache patients cost GPs £26m a year

Hunter Davies in the Sunday Times opines: Paying thousands for dental work is extracting the Mickey – Now ‘open wide’ applies as much to the wallet as the mouth, my visits to the dentist are twice as painful

The letters in The Times on the dental contract are here: dental-contract-letters


This entry was posted in A Personal View, Perverse Incentives, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s