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9 April 2024

Our A&E crisis is killing hundreds a week – and government spin can’t hide it

A new programme to increase competition between hospitals is pure The Thick of It politics.

By Phil Whitaker

Were a jumbo jet to come down in central England, killing all 536 people on board, wall-to-wall media coverage would ensue, together with an air accident investigation into what had gone wrong. If two weeks later the same thing happened, there would be an outcry, with inquiries established into pilot training, aircraft maintenance schedules and the adequacy of the air traffic control system. If in a further fortnight another 500-odd passengers perished in an identical disaster, I doubt anyone would voluntarily board a plane, and the government would be forced to close UK airspace until a return to safe aviation could be assured.

Yet we have seen no comparable consternation over the ongoing and unnecessary loss of life being caused by conditions in England’s A&E departments. According to research by the Royal College of Emergency Medicine, an average of 268 people died each week last year because of delays in their admission to hospital wards. The figures are updates from a 2021 study based on five million patients and published in the Journal of Emergency Medicine, which showed that for those requiring admission but stuck in A&E, the risk of death started to climb after five hours and worsened with every hour’s delay on top. The reasons aren’t difficult to understand. Patients crammed in corridors and cupboards – the extraordinary “new normal” for A&Es in one of the wealthiest nations in the world – overseen by too few staff receive neither the treatment nor the monitoring they would get once admitted to a ward. Deterioration for some is inevitable, as is the potential for it to go undetected until too late.

The government’s response has been to focus on resuscitation of headlines, not patients. Its chosen tool has been that staple of Tory philosophy: competition. For the month of March (and only for the month of March), hospitals have been urged to make a special effort to get above an arbitrary and unambitious target of 76 per cent of patients being moved out of A&E in under four hours (in 2010, when the Conservatives first re-entered government, around 95 per cent was being achieved). Of those that manage it, the top ten performing trusts and top ten improvers will each get £2m to spend on spangly new building projects. The ten runners-up will get consolation prizes of £1m.

Writing in the Daily Mail, Rob Galloway, emergency medicine consultant and honorary clinical professor at Brighton and Sussex University Hospitals NHS Trust, exposed the cynicism of this ploy. Hospital managers around the country have been recruiting extra staff for the few weeks of the competition period, but far from improving the care of the sick patients requiring admission, the focus has been on the numerous cases with minor conditions such as sprains or sore throats that can be resolved quickly in the cause of burnishing the hospital’s statistics.

The exercise is so obviously designed to give Rishi Sunak and the Health Secretary, Victoria Atkins, “improvements” to crow about in the media that could have been lifted straight from an episode of The Thick of It. In fact, we need a Thick of It helpline, where civil servants can anonymously blow the whistle when compelled into egregious acts of spin at the behest of their political masters and mistresses.

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Back in the world of seriously unwell patients and the staff trying to care for them in desperately adverse circumstances, mothers, fathers, sisters, brothers, sons and daughters continue to die needlessly. The realities of the news cycle mean that even avoidable harm on this scale won’t keep making headlines every fortnight. But might we hope at least for some critical media appraisal when the inevitable line gets spun? Like so much else this exhausted administration is doing, there is no intent to tackle the endemic crisis its health policies have caused, only transparent attempts to pretend action is in hand. And every fortnight that Rishi Sunak forestalls the chance for a change of government, another plane comes crashing down.

[See also: How to mend a broken economy]

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This article appears in the 10 Apr 2024 issue of the New Statesman, The Trauma Ward