FROM OUR FILES
15
THE HIDDEN
TRUTH
This article is a quote from a ‘Mail on Sunday’ Article
published on 11/5/13 and written by David Rose. I’m going to post the rest when
I’ve edited it down to a more manageable amount.
Dr Claire Gerada is starting to turn up in all kind of
places, making a stand. I heard her trying to be heard above a din of prejudice
on the BBC Radio 4 Today programme.
Here she is pointing out in The Mail, that we need some
research done before any more A and
E’s are closed. Afterwards it is too late and too expensive to put it all
right;
By Doctor
Clare Gerada, chairman of the Royal College of General Practioners
We are
facing a national crisis in emergency healthcare. The whole system is under great strain – and this crisis is not limited to hospitals. It also affects
community and primary care.
Patients
are waiting much longer to be seen in emergency departments. Trolley-waits,
which had largely disappeared over the past decade, are returning.
GPs have
seen consultation rates explode in recent months and now routinely see up to 60
patients a day – something which, in my 25 years’ experience as a GP in inner
London, might usually occur in only exceptional circumstances, such as a flu
epidemic.
In this
context, The Mail On Sunday’s investigation into rising death rates among
emergency patients from Newark, where the A&E department closed two years
ago, is hugely important – and may well be only a portent of what will happen
on a bigger scale when A&Es close elsewhere.
Without
further analysis, it is impossible to conclude categorically that the increase
in death rates is due to the A&E closure. But this would appear to be the
most obvious and compelling explanation – especially when one factors in the
impact of longer journeys to hospitals elsewhere.
Research
led by Professor Jon Nicholl, at Sheffield University, has already shown that
mortality increases with distance.
In his
study, 5.8 per cent of patients who travelled less than 6.2 miles to A&E
died before being discharged from hospital. Among patients who travelled more
than 13 miles, almost nine per cent died – and it is around 20 miles from
Newark to King’s Mill Hospital, near Mansfield, or Lincoln, where most Newark
patients are now sent.
It is
perhaps no coincidence that both King’s Mill and Lincoln are currently being
investigated because of their overall excess deaths.
The former
chairman of the Lincoln Trust warned in 2009 that A&E was under severe
pressure and that closing Newark would only make matters worse.
Unfortunately,
he was ignored. It is good that the Government has finally recognised that
urgent and emergency care is not as accessible as it should be.
But in
doing so, they are unfairly blaming GPs by claiming that a new contract,
introduced almost a decade ago which allowed GPs to opt-out of providing
out-of-hours care, has led to the current crisis.
This lazy
accusation masks more obvious reasons why some A&Es can barely cope.
One far
more likely explanation is A&E closures put more pressure on remaining
A&E services. The patients who would have used them won’t simply disappear.
It makes no sense to close yet more A&E departments – unless sufficient
resources are provided to pick up the inevitable shift in workload when
closures occur.”
As I said, the rest of the Daily mail article will follow –
it’s an important one.
Neil Harris
(a don’t stop till you drop production)
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