Dennis Benson

Posts Tagged ‘Waiting Lists’

When I was referred for an MRI scan the two weeks wait was an anxious time. Even that seemed a cosiderable increase over the waiting times in force when I was chairing a NHS Foundation Trust hospital. I have since learned from Bill, a fellow chicken-keeper, that his brother who lives in Hastings has been waiting for six weeks. At first the news didn’t make sense because in my day (as fogies love to remark) we were summoned to London to explain even one target ‘breach’, and we used to travel in some trepidation. At that time, just a couple of years ago, every patient referred to us had to be in full treatment within 18 weeks, which meant that he or she had to be seen almost immediately after a GP referral was received and any required tests had to be dealt at once. Of course the tight timescale made life difficult for clinicians and managers alike, but at least all those suspected of having cancer were spared the stress of uncertainty and the clinical risks associated with delays.

It was only during the chat with Bill that I was reminded that Andrew Lansley’s first act on becoming health secretary was to abolish waiting lists. At the same time he imposed massive cuts to funding and it doesn’t surprise me one jot that hospital Trusts up and down the land found some of the savings by extending their waiting times. One of the first savings would be the amount of hours having to be worked on MRI scans. 

Realising that Bill’s information could be dismissed as hearsay I did some checking of my own. Hastings, the home of his brother, had only 3 patients waiting in excess of the permitted waiting times in April 2010. In April 2011 it had 1255, an amazing increase of 41,733%. So Bill’s brother is just one of many worried sick about their referral. Checking the figures of other Trusts revealed a similar pattern. In Leeds for example, there were only 10 waiting at the end of 2010, the total for this year was 878. Lansley, take a bow!

Across the country the waiting times for cancer testing and treatment have at least trebled and the situation is worsening during the first months of this financial year. Amazingly all the focus on Lansley has centered o his bizarre plans for reform. Fortunately these seem to be heading for the scrapheap not least because Cameron has ruled that GP commissioning will only start when GPs are ready, at which point their commissioning body will include nurses, hospital doctors and patients. In other words Primary Care Trusts are being reinstated under a new name and costs of around £2billion have been incurred.

But all this is meaningless mumbo-jumbo with political point-scoring at the top of the agenda. The point is that massive damage has already been done and without question people who could have been saved will die as vital post-diagnoses weeks are lost.

This is too importat for childish arguments about the respective abilities of Labour and Conservatives. NHS people will tell you that they are both hopeless. Labour imposed 400 targets which was ludicrous, the Conservatives have scrapped the wrong ones which was equally ludicrous.

Our health is uniquely important and we should all worry that a blundering fool like Lansley is in charge. At the very least the minister should be a senior clinician with no political bias.

Unrealistic? If we settle for that we settle for disaster, we betray every individual whose life depends on a rapid response!

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THOUGHTS FOR TODAY;   FAMILY PLANNING;   “Somewhere on this globe, every ten seconds, there is a woman giving birth to a child. She must be found and stopped”…..Sam Levenson    ”Let me tell you a terrific story about oral contraception. I asked a girl to sleep with me and she said “No”……….Woody Allen     “”I have 13 children. It’s not a burden. I love my husband” – “Lady, I love my cigar, but I take it out of my mouth once in a while”……Groucho Marx    “I’m Catholic. When my mum found my diaphragm, I had to tell her it was  a bathing cap for my cat”…….Lizz Winstead      ”Condoms aren’t completely safe. A friend was wearing one and got hit by a bus”……..Rob Rubin    “A friend of mine confused her Valium with her birth control pills. She had 14 kids but didn’t give a toss”……Joan Rivers    “I practice birth control, which is being around my brother’s children”……Brett Butler

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Our first task this morning was to find a number of roofing panels that were blown off during the night. It was as if someone up there decided that we were allowed good weather for the big event, and should now be reminded that the British climate is not to be trusted. Having done that, we left Bob to perform his usual wonders with a screwdriver and spent a blustery hour digging trenches in readiness for the latest burial of chicken output. And it seems that we are not alone in doing a bit of burying. Yesterday the government decided to release some devastating news about the NHS in the certain knowledge that the media would have other things on its collective mind.

Monitor, the quango set up by the coalition to oversee all Foundation Hospitals ( a status planned for every hospital that survives the Lansley reforms), announced that each unit must face funding cuts of 7%, something of a change from all the talk of NHS funding being ‘ring-fenced’). Very few of the large hospitals have any ‘fat’ left after endless imposed ‘efficiency targets’ and several have already made clear their plans to cut services and extend waiting lists. This is a serious development but the spin-doctors got it right, no one noticed the press release on a day when William and Kate entranced us all.

And there was another piece of unwelcome news for David Cameron, which again won only small mention on a day when we were looking the other way. Remember Cameron’s ‘keep calm dear’ remark to Angela Eagle? She was attempting to claim that the story he was telling about a GP who fiercely supported the plan to transfer all commissiong to GP practices, was untrue. This one GP, he inferred, knew far more than the Royal College which universally condemned the idea. The prime minister appeared to be reading from a letter from a Dr Howard Stoate and those of us who know well the workings of the health service were impressed that he had managed to find even one GP prepared to speak out aginst his colleagues in such a forceful way.

It now  transpires that the greatest PR man of them all read only selected extracts of Dr Stoate’s letter!  The Doctor, and former MP for Dartford, has published a statement. “Doctors do not glibly accept every aspect of the health bill”, he says. He goes on to say that the prime minister was guilty of taking his remarks out of context and stating a conclusion that was “entirely misleading”. He concludes by demanding that “Cameron should stop using the health service as a political football”.

So the news that was buried on the nation’s day of celebration is very bad news indeed. It tells us that the NHS cuts are real and are about to prove very damaging. And it tells us that rather than staging a listening exercise, Cameron and Lansley are being extremely economical with the truth.

As I have remarked before, the view of many senior clinicians is that the NHS is being thrown into a tailspin from which it cannot recover. For once I find myself in agreement with Alistair Campbell when he says that ; “the plans are not thought through, not popular with those who run the NHS or use it, and politically toxic, not least because they have no mandate for them”.

The whole episode reinforced my feelings of yesterday about the importance of the Monarchy. As I wrote then, it seems to me that the Royals have one advantage over any politican of today. They are honest. Meantime we should prepare for the death of the NHS!

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THOUGHTS FOR TODAY;   COMMUNICATION   “I climbed a mountain and hollered, ‘Hellooo!’. A voice came back, ‘The echo is busy at the moment. Leave a message  at the beep, and we’ll get back to you”…….Eddie Izzard   “Mobile phones are the only subject on which men boast about who’s got the smallest”….Neil Kinnock    “When I’m on a train and someone starts to bellow into their mobile phone I shout, ‘Quiet! I’m trying to travel”……Maureen Lipman      “The concept behind the mobile phone is that you have absolutely nothing to say and you’ve got to talk to someone about it right now”…….Jerry Seinfeld     “The cell phone people say there’s absolutely no danger from cell phone rdaiation. Boy, it didn’t tak ethose tobacco executives long to find new jobs, did it?”……..Bill Maher

ANSWERS TO THURSDAY’S QUIZ;    1.  George Lucas   2.   For her sculpture.

TODAY’S QUESTIONS;  1. In which year did President Nasser die?   2.  How did the Japanese writer Yukio Mishima die?

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Another beautiful golden day! The optimists among the chicken-breeders are talking excitedly of a summer to beat them all. The rest of us remember similar delight at this time last year! But we live for the day and this one is brilliant in every sense of the word. However, at least one of our number is not entirely happy. He has been told by his GP that there are now restrictions on NHS orthopaedic referrals and his chance of a hip operation is now remote. I suppose we shouldn’t be surprised since the massive Lansley cuts are slowly but surely taking the NHS performance back many years.

In fact a survey of GPs published yesterday found that cuts are being made not only in areas deemed non-urgent. Over half of the 500 family doctors questioned said that waiting times had gone up for musculoskeletal work, and 42% reported a rise in waits for neurology treatment. Almost a third say that there are now delays in cardiology and one in ten say that waiting times for cancer treatments are rising quickly.

Interestingly the survey was carried out by Spire Healthcare, the second largest private hospital group in the country. And they are not in the least depressed by what their friend Mr Lansley is doing. Dr Jean-Jacques de Gorter, clinical director of Spire, said yesterday that the increased use of the private sector now being enjoyed is to be expected “as a result of health secretary Andrew Lansley’s measures and efficiency savings”.  He reported that his group was already seeing waiting lists for elective admissions and diagnostics going up and patients are “likely to turn to the private sector”.

Spire claims from its survey that more patients are asking GPs about private treatment. It claims that a third of those surveyed plan to make more private referrals this year. Almost half (49%) are said to be asking their patients if they have private medical insurance.

The number of people with private insurance is actually flatlining or even dropping, as people are made redundant and lose the healthcare benefit that went with their job, but Dr De Gorter expects more to pay out of their own pockets as the NHS delays increase.

I honestly believe that, unless Lansley is stopped, the end of the NHS as we have known it is in sight. Private hospitals will lure top surgeons away from the NHS and will step up their GP-influencing campaigns. Of course this is one of the aims of the Conservative minister. Competition, he will argue, will lead to even better healthcare and higher standards. So far as the private sector is concerned that is correct but the massive flip side is that the NHS hospitals, starved of funding from basic work, will deteriorate and ultimately decline in numbers.

The end of the Lansley trail is plain to see. If you have expensive health insurance, or are relatively wealthy, you will notice little difference. If you don’t, you will probably die or at best suffer a lower quality of life.

If we regard that scenario as unduly pessimistic we will delude ourselves and betray generations to come!

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THOUGHTS FOR TODAY;  LUCK:   “Everything went right for him until the day he was born”….Victor Borge   “If it was raining soup, he’d be out with forks”…..Brendan Behan    “Just my luck. I was at the airport when my ship came in” ………Henny Youngman   “As one door closes another falls on top of you”…..Angus Deayton   “It always looks darkest just before it gets totally black”…….Charlie Brown    “Age does not diminish the extreme disappointment of having a scoop of ice cream fall from the cone”…..Jim Frieberg   “What I’m looking for is a blessing that’s not in disguise”…..Kitty O’Neill Collins  “I’m so unlucky that if I was to fall into a barrel of nipples I would come out sucking my thumb”……Freddie Starr

ANSWERS TO YESTERDAY’S QUIZ;  1.  Shane Fenton   2.  Gordon Sumner

TODAY’S QUESTIONS;   1. Where did troops fight for control of Islam’s holiest shrine?     2.Who went out to be Rhodesia’s last British governor?

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