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No excuses

Still practising

Chris Preece

Tuesday, 28 February 2017

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no excuses_shutterstock_581975776.jpgA few weeks ago Jeremy Hunt publically acknowledged that some parts of NHS care are now “completely unacceptable”. At the time it felt like his statement was a reflection of how bad things had become – a couple of weeks later and it’s now looking like he simply knew what more was to come. NHS Trusts in England have posted an overall deficit of £886 million, leading the Chief Exec of NHS Providers to comment, with admiral understatement, that the NHS’s financial position was “not sustainable”. 

Meanwhile, the Journal of the Royal Society of Medicine published a paper attributing 30,000 excess deaths in 2015 to cuts in NHS and Social Care Funding. This resulted in the DH rather dramatically declaring the paper “a triumph of personal bias over research”. The statement appears to have been delivered without any apparent trace of irony, almost as if the whole “weekend effect” debacle had never occurred.

Of course, Mr Hunt’s comments have left some people asking why, if the position of the NHS is completely unacceptable, he has somehow managed to keep his job? He stated at the time that there was “no excuse” for the failings identified, which is absolutely true, but he’s going to need to find someone to pin it on soon. To that end, ever the philanthropist, I thought I would help him out by suggesting who he can blame for the current situation.

  • Firstly, look for whoever’s responsible for not funding the NHS and social care adequately. This one’s an obvious one given the deficit. We all know the numbers by now: the NHS has had an average increase in funding of 4% since the late 70s, but it’s now dropped to just 1.1%. Or alternatively that we now have some of the lowest funding per GDP in Europe (based on figures from the OECD
  • Whoever continued the reforms from the 2012 Health and Social Care Act is another possible culprit. Obviously the architect of the reforms was, quite sensibly, replaced after it became clear that they were counter-productive. To quote the leader of the House of Commons Health Select Committee it “led to greater fragmentation at a time when our demographic changes demanded a different approach.” So who thought it would be a good idea to carry on regardless? Maybe point the finger at that guy.
  • Definitely get rid of whoever thought it would be a good idea to scrap nurse bursaries just as we face a shortage of nurses. Particularly now that we’re unsure how easy it will be to recruit additional nurses from Europe in the future.
  • Figure out who was responsible for cutting hospital beds - such that we now have 20% less than we did 10 years ago – without bothering to invest equivalent resources into community services. This has left already stretched community teams buckling under the weight, whilst Casualty departments up and down the country become a bottle neck.
  • Speaking of scaring people off, perhaps also have a long word with the guy that thought it would be wise to have an incredibly acrimonious battle with junior doctors over their contracts, resulting in widespread loss of morale, and a record number of much needed doctors applying to work abroad.
  • Finally, perhaps consider blaming whoever keeps pretending everything’s OK. It’s a curious situation to be in, watching the NHS falling apart around our ears, with a Health Minister who is prepared to admit it’s unacceptable, but still have a Government claiming that everything’s going to be just fine. Believe it or not on the very same day that Mr Hunt stated that there were “no excuses”, someone from the Department of Health claimed that they were “doing what we can with extra financial support for the NHS this year” despite real terms cuts in funding over the coming years. Again, perhaps the individual concerned should reconsider their position?

So there we go, it’s not an exhaustive list, but it’s a start. All Jeremy Hunt has to do is to establish the individual ultimately responsible for all of the above and then ensure that they never work in healthcare again. Let’s hope he identifies him soon, as it seems a lot of people already think they have.

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Chris Preece

Chris has worked as a GP Partner in North Yorkshire since 2004, and still relishes the peculiar challenge of never quite knowing what the next person through the door is going to present with. He was the chair of his local Practice Based Commissioning Group, and when this evolved into a CCG he joined the Governing Body, ultimately leaving in April 2015. He continues to work with the CCG in an advisory capacity. When not being consumed by all things medical, Chris occupies himself by writing, gaming, and indulging the whims of his children. He has previously written and performed in a number of pantomimes and occupied the fourth plinth in Trafalgar Square. Tragically, his patients no longer tell him he looks too young to be a doctor.
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