Crisis in the National Health Service - “It’s politics, and it’s not fair on your patients”

Submitted by Anon on 22 October, 2004 - 11:04

By Gerry Bates

Luke Gallimore died because of the New Labour government’s obsession with targets, marketisation, and “mission statements”.

Luke, aged 16, was in hospital, sick with leukemia, when his condition worsened drastically on 11 July. His doctor called urgently for an ambulance to get him to the Intensive Care Unit.

Luke had to wait two hours, slipped into a coma, and died 16 days later. There is no guarantee that he would have survived had the ambulance come quicker, but his doctor was clear from the start that the call was “extremely urgent” and “absolutely critical”.

At the time Luke was slipping towards death, and his doctor was frantically demanding an ambulance, there were three ambulances stood waiting outside the hospital’s Accident and Emergency department, a mile away.

Why didn’t one of them come? According to the Guardian of 18 October, the supervisor in the ambulance control room told the doctor: “It’s politics, and it’s not fair on your patients”.

The tragedy was not a freak mishap. It flowed from a consistent, settled policy.

The official target is for all Accident and Emergency patients to be dealt with — assessed, treated, and discharged or admitted to hospital — within four hours.

Only hospitals often do not have enough spare beds to manage that. If they did keep spare beds consistently, then they would be classed as inefficient according to the government’s targets and criteria.

To keep up a show of meeting the four-hour target, when they see a backlog building up of patients waiting for a bed, A&E departments then keep new patients outside the door. They keep the patients in ambulances — waiting, but in time that does not count against the four-hour target — until the backlog eases.

The Accident and Emergency department at the hospital did not want to release an ambulance, because that would mean missing the four hour target with a patient.

The obsession with meeting spin-doctor-designed targets does not stop there. An ambulance worker told Solidarity: “We have a target of reaching category A [emergency] calls in eight minutes. One day we got sent to an elderly woman who was having difficulty breathing.

“There was no way we could make it in eight minutes. So, when we had nearly got there, we got sent off on another calls — just to ensure that the other call was answered within eight minutes, and we only had one missed-target call, not two.

“In the meantime the elderly woman had a cardiac arrest”.

For many years the National Health Service suffered cuts. The government has increased NHS spending recently. But too much of the cash has gone into paying private profiteers for PFI (Private Finance Initiative) schemes and into the bureaucracy of target-chasing.

In any case, there is not enough getting through to provide an ambulance for Luke Gallimore and beds for the three patients who were sitting in the ambulances. The government just covers up the problem with endless targets.

The government’s idea for the future of the National Health Service is to increase “choice” and “efficiency” by more contracting-out. But to develop competition between units in the NHS does not make it more efficient — as Luke Gallimore’s family, friends, and doctor discovered, it destroys the fabric of the NHS as an organisation for care.

And already a major factor in the NHS is that the contracting-out of cleaning to private profiteers has reduced hygiene to a level where patients getting sick, or even dying, from just being in hospital, is a problem.

The government’s increased spending on the NHS has damped down the agitation that used to exist for its rebuilding and restoration. But Luke Gallimore’s death shows us that agitation is still needed.

The labour movement must stop the process of contracting-out, marketisation, and creeping privatisation in the Health Service, and demand it be rebuilt as an integrated, all-publicly-owned service planned for need.

Control of the planning should be in the hands of health workers themselves, not of spin-doctors and bureaucrats imposing a blizzard of arbitrary targets.

And those health workers themselves should plan for what extra spending is needed, and where. If getting back the money currently drained away in PFI schemes and over-bureaucracy is not sufficient, then the rich and big business should be taxed to ensure a health service which will not fail another young life as it failed Luke Gallimore’s.

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