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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.”
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