A UK health and social care watchdog has warned that the country’s healthcare system is on the brink of collapse, and that many patients – particularly the elderly – are going to hospital for emergencies when they should have been seen much earlier.
In his first major announcement since being appointed earlier this year, David Prior, head of the Care and Quality Commission (CQC) non-departmental public body, has called for an urgent investment in community care.
He also said that the number of emergency-care beds in hospitals
should be scaled back in order to divert much-needed funds to other
areas of the National Health Service (NHS). He voiced his concerns
at a talk on Wednesday at the King's Fund, a think-tank that seeks
to improve the health care system in England.
“If we don’t start closing acute beds, the system is going to fall over. Emergency admissions through Accident and Emergency (A&E) are out of control in large parts of the country. That is totally unsustainable,” Prior said.
He also slammed the decision to allow General Practitioners (GPs) – the name for family doctors in the UK – to opt out of out-of-hours care, advising that they should be on-call and available to patients around-the-clock. “Primary care is in bad shape. I think GPs ought to be responsible 24/7,” he said.
He also pointed out that there is no real market in the British healthcare system, especially in rural areas, leaving many patients at the mercy of their local hospital regardless of its quality.
“The patient or resident is the weakest voice in the system. It is classic market failure. We can talk about competition until the cows come home but if you live in Norwich there is one hospital,” said Prior, the former chairman of Norwich University Hospitals foundation trust.
His comments come amid a slew of scandals involving NHS care and worrying new research that revealed that 1 in 10 patients – about 1 million patients a year – suffers avoidable harm in NHS hospitals and care homes.
The Mid Staffordshire NHS trust is now in administration following reports of “appalling” care that led to the deaths of 400 patients between 2005 and 2008.
Prior said the CQC had identified 45 hospitals – about 20 percent of the total in the UK – which had serious problems dating back five years, and that regulators would not allow underperforming hospitals to carry on unchanged. He also named a further 20 percent of hospitals as “coasting along and not doing terribly well.”
“We cannot give the public a cast-iron guarantee that there will never be another Mid Staffs or another Maidstone & Tunbrdge Wells [ where hundreds died after an outbreak of Clostridium difficile]”, Prior said.
In another blow to the beleaguered NHS, it was reported last week that there have been at least 22 serious incidents and three deaths since the disaster-prone 111 non-emergency phone line was introduced, which is still not functioning in all areas of the country.
Healthcare minister Norman Lamb said that patients have lost faith in out-of-hours care, now that it is no longer provided by GPs. “We have out-of-hours care that too often falls down. People end up with the default option of A&E [accident and emergency] because there is nothing else they are confident in,” he told the Telegraph.
Next week, Lamp will announce a pilot for an integrated care system in a bid to stop the NHS and social services from fighting over who foots the bill for elderly patients stuck in hospital with non-life-threatening illnesses.
Both Prior and Lamb’s suggestions – that hospital beds should be eliminated in order to provide better overall care – was blasted by professor David Oliver, the former clinical director for the elderly. He pointed out that the UK has already lost one-third of its acute hospital beds in the last two decades, meaning that per head of the population it has fewer services than any comparable country.
“How do you take capacity out of acute hospital provision when people are still pilling though the doors in record numbers and hospitals are so pressurized? If you take capacity out, people end up being treated on any flat surface and in the hospital corridors,” Oliver told the Daily Telegraph.