Thousands of older patients are being forced to stay in hospital long after they are fit enough to leave, doctors are warning — and the problem is being exacerbated by the coalition's cuts to council budgets.
In a survey of 502 doctors working in UK hospitals, 251 (50%) said the problem known as "bed blocking" — which costs the NHS tens of millions of pounds a year and forces needier patients to wait on trolleys — was worse now than a year ago, while 200 (40%) said it had not improved.
This is how the NHS will fall over in the face of government cuts. These cuts are being planned chaotically and not systematically. In other words, no one is joint up any of the thinking. That failure to plan does however have implicit in it the assumption that any open decision has no externalities or unforeseen consequences elsewhere.
That, however, is not true. A lack of council care will mean bed blocking rises, enormously. Doctors will not release patients if they cannot be cared for after leaving hospital. And cuts in social services and access to welfare facilities will all have a consequence at the other ned of the NHS - as they will massively increase demand for GP services if they are the only point of contact with the welfare state that is left for some people.
The assumption that demand on the NHS will only increase as a result of an ageing population and new technology will in this circumstance prove to be hopelessly inaccurate. The increase in demand will be the consequence of other cuts, and a service already near breaking point will tip over into chaos all too easily as a result.
And remember, GPs are meant to manage this demand at the same time as they are expected to also cancel many surgeries to cover the new demand to commission.
The equation does not and will not work. And the impact will be seen very quickly. The ConDems have got this one very, very wrong.
Disclosure: my wife is a GP
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I have a disclosure to make aswell. My wife is a nurse. Your report is bang on (not that we discuss her work! albeit I am a part time agony aunt)
According to ‘Richard Blogger’, the PCTs are already beyond putting back together too… and how is any reorganisation going to be implemented let alone 20bn efficiency savings? I can’t see how there are not going to be unnecessary deaths directly attributable to this conservative plan of deliberate chaos … surely there must be sensible Tory MPs… why are they not making their voices heard?
@Syzygy
I read that too http://liberalconspiracy.org/2011/01/05/why-2011-will-be-the-year-the-nhs-will-almost-collapse/#more-20818
I am really fearful on this one
Lansley will last just long enough for 20 year contracts to be issued for commissioning and then what do we do?
@Syzygy
A former Tory Secretary of State – Stephen Dorrell has commented on this policy and apparently he was not enthusiastic. But as in education the Government is intent on ‘creative destruction’ (apologies to the economist Schumpeter) and I expect that Lansley is hoping that he will not be around when the errors of his ways are visible for all to see.
Notwithstanding the certain destruction of the NHS by the ConDems, one of the issues here is longterm care of the elderly. This has got to be addressed. During the election the Tories were promising that a small one-off voluntary contribution would ensure free care – a complete lie, to counter Labour’s mooted policy of a sizeable chunk from Inheritance Tax (parodied as the Labour Death Tax).
Today I heard on radio that the care industry cannot recruit enough staff because of the block on non-EU immigration. Well, isn’t it quite obvious that they need to pay more than the minimum wage? However, care home fees are already a real problem and worry for everyone. The crunch is coming.
It’s quite clear that what looks like idiocy on the part of Lansley and this Conservative-led govt is in fact a calculated plan to destroy the NHS. Ironically they will be using one of New Labour’s favourite financial wheezes to do it – long term private sector contracts. Labour used them for capital spending (e.g. PFI), the Tory-led govt will be using them for long-term contracts to US-style HMOs.
The plan is quite clearly to bind the Labour govt that they arehalf expecting to win in 2015 into complicity with the destruction of the NHS because the private sector management contracts will already have been signed.
There is a way round this for a future Labour govt but it’s fairly radical: they would have to buy up the private sector contractors (or at least the UK-based parts of their operation) and bring them inside the NHS. I think the next Labour govt is going to end up doing the most nationalisation since the Attlee administration: healthcare, public transport, PFI contractors, forests – they will all need to be taken over. Attlee took over after a world war, Ed Miliband will be taking over after a war on the public sector. Just as in 1945, radical action will be necessary.
I just hope Ed and his team have the vision to deliver on this.
@Howard
We’re in complete agreement on this
And your 1945 comparison is apposite. Of course we won’t have suffered a war – well at least I hope not! – but the damage to the economy caused by a failed dogma will be enormous
And you’re right – I hope Labour do have the vision to deal with this
What the Labour Party should be doing is declaring that when they get back into power they will do what Howard is suggesting. They could do a lot more too to spike some of the most heinous ConDem policies by threats to revert.
I also hope that Labour have the vision to re-nationalise the NHS.
(Congratulations Richard .. no trolls, just others who are as profoundly concerned about the NHS as myself.)
@Syzygy
Nice when that happens, isn’t it?
Maybe they’re shying away from this one
I wonder why?
Does anyone else get the feeling that the tories MO is just deliberately sabotaging entire industries to make them look bad which helps pave the way for privatisation? Then their rich buddies can get richer even though it is against the public’s best interest.
With regards to long term private sector contracts, could there be an argument that they are not even legal? How can you have a mandate to bind future tax payers in theory for ever, even though you may only hold power for a short period of time?
Imagine if a government literally promised to pay £1 million to every person they wanted to, every year for the next 100 years. Would that promise be legally binding on all tax payers for the next 20 years even though it was against the public’s interest and is completely unfeasible?
Richard,
This tangential to your post, but you include – again – the claim that GPs are already stretched to breaking-point. I don’t believe it.
How many ‘sessions’ (half-days) does the average GP work? I happen to have seven close-friends whom are GPs. None of them work more than 4 days a week. One is particularly go-getting and ambitious, the remainder – as in all walks of life – less so. The aforementioned go-getter will be working her ‘day-off’ as a new commissioner (assuming elected) and will be compensated accordingly.
Whatever the merits of abolishing PCTs I see no evidence GPs work even close to the hours of other professionals in London. I’m sure you can point me to some bleating survey from the BMA which says otherwise, but the majority of London workers work 50 hour weeks in comparison to the ~36hour weeks my GP friends work.
Oh, and they are all earning ~£70k* at ~30 years of age.
*and oooh shall we say another £20k or risk-free pension entitlement?
@Tom
I too know a lot of GPs
And it makes most jobs look impossible
GPs trade income for time off to preserve their sanity – it’s as simple as that
The fact is most of us don’t spend part of every day dealing with dying people, the really sick, the worried and sometimes the plain annoying who don’t believe they are well really
When it comes to stress being a GP is long hours (10 – 11 hours a day seems common) and about as much stress as most humans can take
And remember GPs are people too
Sorry, but I thought I knew about how tough it was to be a professional until I married a GP