Wednesday, 24 July 2013

Chasing Ambulances

I t was inevitable that the Royal birth would lead to a media frenzy exceeding that even of  the debate over footballer Wayne Rooney's wish to move to London.  Almost all of it has been crass, craven or crabby instead of the simple concern for the dangers and risks and ordinary human good will and sympathy for those involved.

As soon as Her Grace went into labour the wild thunder of the charge of the hobby horses began.  The Prime Minister, David Cameron, led crying Equality for all and promising that if a girl he would press for the completion of the change in the Act of Succession to allow her to become heir to the throne.  This seems to have more to do with marginal electoral arithmetic for the Election of 2015 than any common decency.  This was clearly conduct unbecoming of a gentleman.

One feature of the news coverage will be all those things that do not make the news.  From past experience this will be a golden opportunity for government departments and agencies and others to put out the bad news at a time when nobody will notice and the stories ignored.  In the case of the story about the situation in the Accident and Emergency Wards of NHS hospitals this has not quite happened but coverage lacks the depth and extent it really should have.

My reason for this is that on Tuesday on the news stand while the national press was covering the Royal story in the local newspaper the lead story from the weekend was that of the death of a young woman well gone in pregnancy.  She had gone into the local A&E Ward complaining of severe pain and after a long wait and a few minutes cursory attention sent home with pain killers.  She died not long after from an ectopic pregnancy.

The many and various scandals now emerging over the nature and level of the services given in many hospitals include quite a number to do both with A&E Wards, Maternity Wards, and high risk terminal cases with numbers of children among those who have suffered. 

While our current crop of politicians indulge in the usual blame games, this one has been coming for some time and has only been quiet because of the culture of secrecy, the weakness of our political leaders and the laziness and bias of the media bent on chasing easy celebrity stories.

It is a very complicated story about how developments, decisions and actions have come together to create a crisis.  This is compounded by the search for "efficiency" in narrow management terms.  These involve committees imposing procedures and monitoring that are limited in concept in terms of simplistic definitions and understanding.

These simply do not work because in too many cases the patient is not a single category item.  At its crudest the dying, demented and dangerously ill with other complaints are vulnerable and too likely to have either inappropriate or misguided treatment.  Then there are the drunks. 

The wonders of the night time economy at weekends in many towns delivers hordes of drunks for treatment.  What has never entered the calculations is the knock on effects in the days following and for the incoming patients.

The financial and management mess, let alone the hostile culture in too many places and all that has gone wrong cannot be corrected in the short term.  It is going to take a very long time to create an NHS which is fully effective, responsive to need and able to cater for  all the medical challenges it is going to face.

And our political class and corrupt civil service are the worst people to be in charge.

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