Sobering account of a health service in crisis
- Credit: PA
A new television series about the NHS just underscores what we all fear, says Rachel Moore.
There is no need for anyone waiting for surgery at any NHS hospital to ask why an operation is cancelled any more.
The BBC has lifted the lid brilliantly on why our hospitals are on their knees in its third series of Hospital on BBC2.
Its raw and honest commentary from exasperated staff and how what the headlines mean for real people needing treatment leaves nothing hidden about the crises staff wade through every day to try to get the best deal for their patients.
Filmed in one of Britain's biggest trauma hospitals, Queen's Medical Centre, Nottingham, it could be any big hospital anywhere in the UK.
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It answers the questions we all ask and leaves viewers wondering how our NHS has got into this muddle. Is there any truly any realistic solution to save it or is it beyond repair?
Watching the utmost professionalism and dedication of its staff leaves an uncomfortable feeling that they are being exploited and abused in a broken system because they care too much, because they have a vocation and big hearts and would put up with just about anything to get their job done and provide the care necessary to save lives.
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At Nottingham, like so many other hospitals, patients are literally queuing to get in, and queuing to get out.
They can't get in the front door to find a bed because, in Nottingham, they have 100% bed occupancy. Anything over 85% is considered dangerous.
But staff can't shunt patients out of the 'back door ', as they call it, because there are so many old people with nowhere to go if they passed through that door.
In the first episode, we learned more than 200 of the 1700 beds were taken up by people, mostly elderly, many over 90, who didn't need to be in an acute hospital. Some could have left the wards weeks earlier, if the right social care had been available.
But it wasn't.
Instead people who don't need it and don't want it take up acute hospital beds unnecessarily, costing hundreds of pounds each a day, while people who need non-urgent operations, whose medical conditions are affecting their day-to-day lives, have their surgery cancelled.
While 95-year-olds and octogenarian dementia patients are kept in hospital needlessly, younger people waiting for those beds can't work or contribute to society because they can't access the necessary treatment and care to make them well again.
Whatever it's called, delayed discharge or bed blocking, it's disgraceful and wasting multi-millions of pounds of taxpayers' money every year.
But resources and the right care in the community for the increasing number of elderly patients won't appear by magic.
In the meantime, highly-qualified expensive surgeons are wandering the hospital being paid to do nothing while operating theatres lay empty. Meanwhile, the QMC's £24m deficit is rising by £500,000 a week. If that's not a crisis, I don't know what is.
More than 20 years ago, working on the news desk in Norwich, arguments raged about future health provision for an ageing population, combined with running down social services, the confident predicted rise in day procedures and the reduced number of beds at the then-under construction Norfolk and Norwich Hospital. The cocktail left few people feeling confident about the future.
It's worse than anyone ever believed, and it's only going to get worse.
I can't imagine anything worse than being over 90, with no real health needs, spending what could be my last weeks in a noisy impersonal hospital, taking up a bed that could and should be helping someone else get back to work, play with their children and enjoy their lives.
But as we live longer, and there's no magic NHS money tree, it can only get worse.