NHS Emergency

DOCTORS warned this week that the shortage of doctors and beds in our hospitals is putting lives at risk. Deputy Prime Minister Michael Heseltine admitted he was concerned at the growing crisis. Today the chairman of the NHS Consultants' Association gives this first hand account of the problems facing Britain's hard-pressed hospitals.

FOR the past 27 years I've worked at Horton General Hospital, in Banbury, Oxfordshire. It is the kind of hospital you find all over Britain.

The other Friday evening we started with one bed vacant in the whole hospital. Somehow we managed to admit 10 emergencies by Saturday morning.

I don't know how we did it. We always manage to cope somehow. But it's becoming increasingly difficult.We aren't the only ones. This pressure on beds applies across the whole country, and it's growing.

It's hard to say at what stage the complete breakdown of the health service might occur in months or years. But we are approaching the point of no return. Unless there is a change in policy, the National Health Service will find it very difficult to recover.

You will find that many medical practitioners are reluctant to talk about the problems. The reason I will is that I am 63, getting near retirement and, consequently, I am fairly fireproof.

The evidence of a system teetering on the brink is all around us. Last week a 66-year-old heart attack victim died after being flown 90 miles in search of an intensive-care bed after eight hospitals were unable to admit him.

And yesterday it was revealed that an RAF pilot injured when he ejected after a mid-air crash between two Tornado jets over Lincolnshire was turned away by two hospitals before being found an intensive care bed in Nottingham.

At one of the hospitals, Lincoln County, a doctor admitted that they sometimes had to contact as many as 16 hospitals before a place could be found.

The concern for every doctor in the land is that this desperate search for beds is now the norm.

WHEN we have no intensive care beds available, patients are transferred to our neighbouring hospitals, between 25 and 40 miles away.

We will try to transfer a patient who is getting better to make room for an emergency. But if that's not possible, we have to refer emergency cases to wherever we can find a bed.

As we saw last week, if someone is seriously ill, a journey of 40 miles rather than four may make the difference between life and death. But the problem is wider than simply intensive-care beds, although that is the one that hits the headlines. There is also a nationwide shortage of beds on general wards. Hospitals up and down the country are having to cut their beds in order to meet annual demands for yet more savings. As a result people are being nursed in unsatisfactory conditions, in wards that were not designed or staffed for that speciality.

For example, in my hospital we frequently have to put medical patients - people with illnesses - on surgical wards where people have been admitted for operations. If you have someone in the "wrong" ward, it can introduce risks which would not exist if they were in the correct one.

The people nursing them are not geared to care for that particular problem. The appropriate medical staff are not immediately on hand and their reports tend to go to the wrong place.

Because of the shortage of beds we often have to move patients at all hours, even in the middle of the night, because their bed is needed for an emergency. Of course, this is unsettling. And we end up having to mix the sexes in wards meant to be single-sex.

When there aren't many beds, you can't afford the luxury of keeping both male and female beds available because you simply don't know which sex is going to arrive. The medical profession is under a lot of stress. Nurses are under a great deal of pressure and sooner or later the whole thing is going to break down.

The general approach is that we will manage somehow.

People stay on for longer hours than they are paid for because they have a pride in their job.

BUT this Government's policies have done a great deal of damage to morale. Every year hospitals are asked to make "efficiency savings".

This means doing the same work for less money, or more for the same money. It means we are always having to decide whether we can afford to treat patients as humanely and safely as we would like.

An increase in emergency admissions is now generally recognised. Deputy Prime Minister Michael Heseltine said as much on Thursday.

No one knows why. The Department of Health should set up an inquiry so we understand the causes, and whether they are permanent. Without that analysis we can't plan for the future.

And until it is carried out there should be a halt to all bed closures.

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