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Monday, 11 November 2013

The Prime Minister is presiding over an A&E brain drain

Two years ago, the battle over the Health and Social Care Bill was reaching its peak. Doctors and nurses knew the dangers of reorganising the NHS at a time of financial crisis. They pleaded with the Prime Minister to call it off. He refused.

The result has been two lost years. At a stroke, minds focused on the managerial merry-go-round rather than more important issues, such as the recruitment crisis in England’s A&E departments. As this newspaper has revealed, millions were siphoned out of the NHS front line to fund thousands of six-figure payoffs. Now we also have the return of the NHS winter crisis.

In fact, it’s worse than that: 2013 has been the worst year in A&E for at least a decade, with one million people waiting more than four hours to be seen and the first summer A&E crisis in living memory. The NHS stands in an even worse position than last year, with fewer nurses, fewer beds, a shortage of senior A&E doctors and social care support further reduced.

New figures today show that in the past three years half of all vacancies for senior A&E doctors — 383 specialist registration posts — went unfilled, according to the College of Emergency Medicine. In terms of capacity, that takes out the ability to see 766,000 patients each year.

This year the problem is getting worse, with experts warning of a vicious circle: the worse things get in A&E, the harder it becomes to attract the best doctors to work here rather than overseas.
Sadly, it isn’t any wonder A&E departments are struggling to recruit. The pressure has become intolerable since alternatives to casualty were taken away. The dismantling of NHS Direct, a trusted and established service, ranks as one of this Government’s worst acts of vandalism. The privatised 111 service has replaced nurses with call handlers and computers who too often send people to A&E unnecessarily.

To add to that, we now learn from an NHS regulator that a quarter of NHS walk-in centres have closed since the election. This comes as people are finding it harder to see a GP, since the Government scrapped the guarantee of an appointment within 48 hours. To complete this miserable picture, severe cuts to council budgets mean that many older people are no longer getting social care support at home and are turning up at A&E in ever greater numbers.

David Cameron’s fingerprints are all over this A&E crisis. But his response so far is: “Crisis, what crisis?” The NHS urgently needs him to snap out of this complacency.

(This article was originally printed in the Times on Monday 11th November)