Friday, 9 August 2013

Cameron's £500m A&E bailout is 'just papering over cracks'

Cameron's £500m A&E bailout is 'just papering over cracks' British Medical Association says cash will not be enough to deal with ever-increasing demands on service
David Cameron's effort to avoid an A&E crisis by giving struggling hospitals £500m is "nothing more than papering over the cracks", doctors have said.
The British Medical Association said it was glad the coalition was "finally listening" to concerns about pressure on emergency care. However, it said this would not be enough as the NHS was "facing ever-increasing demands with diminishing resources".
Its warning was echoed by the National Health Action party, a political group agitating for more NHS funding. Dr Clive Peedell, a consultant oncologist and party founder, described the extra cash as "no more than a sticking plaster over the massive cracks in the NHS".
Dr Clifford Mann, president of the College of Emergency Medicine, raised questions over whether the money would make much difference to fundamental problems in emergency departments.
He told the BBC Radio 4's Today programme: "This £500m is likely in many cases to not be spent in emergency departments. The proposal is this is going to be spent in the areas where they have had particular problems this last winter, but it may well be spent delivering social care services, integrated seven-day working services and all these things are very valuable and important contributions, but they're not going to make much difference to the key problems in the emergency departments."
On Wednesday night Cameron admitted there could be "excessive waits" without a bailout for A&E services this winter. The government will give the extra £500m to the most "pinched" hospitals over the next two years after warnings that some emergency wards are on the brink of collapse.
Hospitals have been battling to cope with emergency patients this spring, with senior doctors comparing A&E units to "war zones" and the head of the NHS watchdog saying the situation is out of control.
Labour has blamed the pressure on A&E departments on the scrapping of the NHS Direct advice line, cuts to nursing numbers and the wider health service shakeup. However, Cameron said the pressure was caused by an extra one million people visiting A&E compared with three years ago.
"Services and staff can find themselves under pressure during the busier winter period," he said. "While A&E departments are performing well this summer and at a level we would expect for this time of year, I want the NHS to take action now to prepare for the coming winter. The additional funding will go to hospitals where the pressure will be greatest, with a focus on practical measures that relieve pinch points in local services.
"By acting now, we can ensure doctors, nurses and NHS staff have the support they need and patients are not left facing excessive waits for treatment."
The funding will go to hospitals where A&E departments are facing the worst conditions, after a review by Monitor, the regulator, and NHS England. Downing Street said the money had come from savings made by the Department of Health, and not cuts from within the NHS.
The NHS Confederation said the extra cash would be "useful in the short term" but called for a longer-term solution to tackle the challenges facing emergency care. Mike Farrar, its chief executive, said: "This money must be used to help divert work away from hospitals as well as to compensate trusts fairly for the extra work they are undertaking.
"This means that commissioners and providers – including community and primary care services – need to work together to get the best value possible out of this additional money, not just transfer financial risk between each other."
Ministers are working on plans to take the pressure off A&E services, including possible local measures for quicker treatment, seven-day social work, and more attention paid to the health needs of the elderly.
There is a separate £3.8bn fund that will be spent on treating people in the community, rather than in hospitals, to ease the overcrowding in emergency departments. Prof Sir Bruce Keogh, the NHS medical director, is leading a review into the demands on urgent care, which is due to be published shortly.
Jamie Reed, the shadow health minister, said the coalition's actions did not go far enough to avoid a crisis in A&E departments. "Today's announcement fails to mention the issue patients really care about – nurses on hospital wards," he said.
"Hospitals are running without enough staff, yet thousands of nursing jobs have been axed on David Cameron's watch. It's time he got a grip. David Cameron's A&E crisis is a symptom of wider problems in the NHS and care system, which this announcement will not address.
"He's spent the last three years taking £3bn from patient care to spend on a pointless re-organisation of the NHS. At the same time, £1.8bn has been cut from council budgets for older people's care. This is now backing up through England's A&E departments." Guardian

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