Are local doctors being wrongly blamed for the Tory NHS crisis?


Accident and Emergency admissions, compared with the target for those to be seen within four hours. This target was reduced from 98 per cent when the Coalition Government came into office.

It’s too simplistic to blame GPs for the increased pressure on hospital Accident & Emergency departments, according to the British Medical Association’s deputy chairman.

Dr Khailash Chand says the crisis is just a symptom of much bigger problems facing the National Health Service due to “political mismanagement of healthcare”. That’s right – he blames the Coalition Government.

GPs aren’t to blame, he writes in GP Online, because they have been facing the same increasing workload as A&Es: “We are in a situation where the NHS is like a balloon, where every part is under pressure. If you poke one part of the system, it bulges out somewhere else.”

The reason for the problem, he reckons, is the “savaging of local government budgets in the past four years and hence the cuts to adult social care”. With less investment going into preventing people from needing primary health care, casualty departments are facing ever-increasing pressure and “exit blocking” (you might know it as bed-blocking, in which the elderly and frail in particular are unable to leave hospital because nobody is available to look after them) is on the rise.

That’s very interesting, from the perspective of a person living in Wales. We’re told that the Welsh Government prioritised social care over the NHS, at least in the early years of the Coalition Government, and that this has led to the problems being experienced in hospitals in south Wales. The response to the claim, used by this blog, is that it takes time to get the proper procedures in place and that positive results may come in the future, if nobody loses their nerve and reverses the policy. Meanwhile, more money has been found to fund the NHS in Wales, meaning it receives between 20-25 per cent more cash now than in 2010-11.

It seems Dr Chand agrees: “The failure to implement policies that promote the integration of health and social care is lamentable, and an opportunity lost. If we are to tackle the increasing demands of an ageing population, we need a considered, holistic solution that is backed by an unambiguous, integrated plan produced in consultation with patients, the NHS and local authorities.

“Attributing this major failure of policy to the NHS staff ignores the basic reasons that explain why the system is so strained.”

He writes: “The key is to ensure that there is properly resourced community care, both to provide better and more care to ailing patients in their own residences and also to facilitate early discharge from burdened hospitals.

“The government must develop long-term and short-term strategies to address the staff shortages across the NHS, and invest in systems and measures that direct patients to the service or setting that is right for them.

“The NHS reforms have categorically failed to address this issue, and indeed might have indirectly contributed to the rising tide of emergency admissions by reducing resources within the NHS.”

Follow me on Twitter: @MidWalesMike

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  1. NMac January 12, 2015 at 12:58 pm - Reply

    I would add to Dr Chand’s statement, “Deliberate and malicious political mismanagement.”

  2. Steve Kind January 12, 2015 at 2:26 pm - Reply

    Really interesting article Mike – the coalition claims most certainly do not stand up to scrutiny. I noticed in one BBC new report a reference to patients presenting to A&E being “more seriously ill than previously” which flies directly in the face of the “official” line.

    I’m also perplexed (and very grateful) that my own GP practice here in Leeds is NOT displaying the problems attributed to General Practice by the media. I have a chronic condition and therefore use the place quite regularly – I usually *choose* to see one of the nurse practitioners, as they have more time to devote t each patient. On the few occasions when they have had concerns about my symptoms they have sought support from one of the doctors on the spot, which has always been forthcoming. If a patient *does* want/need to see a doctor, they are guaranteed an appointment the same day.

    Not saying there isn’t a problem overall – but certainly there is far more to it than the Coalition would like us to think.

  3. concernedkev January 12, 2015 at 7:04 pm - Reply

    Create the problem through top down reorganisation causing total crisis of provision. Put local authorities under pressure to cut back services for elderly and disabled.
    Find someone to blame other than yourself. GPs, patients, the elderly for living too long
    Offer a solution
    Private medical insurance, privatise all provision of health and social care.
    We can do all this now we have hoovered up the majority of the population’s GP medical records it will be easy to work out the premiums and overall risks.

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