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As A Doctor I Will Always Do Everything I Can To Protect My Patients, Now It's Jeremy Hunt's Turn

13/01/2017 10:52
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The government has repeatedly tried to play down the suggestion of a 'crisis' in the NHS, but as a doctor I cannot think of a more appropriate description for the challenging situation we are currently facing.

Leaked figures have shown that in the past week nearly a quarter of patients waited longer than the four hour A&E target, while there were more than 18,000 "trolley waits", with patients waiting in corridors for four hours or more. The Royal College of Nursing has said conditions in the NHS are the worst that nurses have experienced, doctors have warned that lives are being put at risk, and the British Medical Association (BMA) has accused the government of "wilfully ignoring the scale of the crisis".

Not for a second am I suggesting that patients should panic that they won't receive treatment. The core principle of the NHS is that everybody gets the care they need, and doctors, nurses and all NHS staff are working flat out to ensure that happens. Red Cross volunteers have even been called in to help A&E departments across the country and hospitals in my region have recruited their volunteers to make sure that patients waiting to be admitted get food and drink and to ensure we have the equipment we needs as stocks quickly run low. However, the service is being stretched to a point that is just not sustainable and we need to open our eyes to the effect that repeated cuts have had on our health service, with the current funding no longer meeting patient demand, particularly as patients often need far more complex care.

The reality now for doctors is that we are often forced to choose to prioritise one patient over another, and we have found ourselves having to treat patients on the wrong ward or having to delay their care as we simply don't have the room or staff for them.

Over the past few weeks, there have been cases across the country of seriously ill patients with no intensive care beds available for them; NHS staff have had to decide who are the 'least sick' patients to move to a general ward so that we have room for new patients in A&E; I have seen hospitals so full that they have had to put temporary partitions within cubicles to accommodate two patients in each one; and in some cases elderly patients - sometimes in their 90s and 100s - have been waiting far too many hours on trolleys for treatment.

In order to address these problems in A&E we must look at the system as whole. A shortage of social care beds - from a 25% cut in the social care budget - has created 'exit block' in hospitals, meaning patients who are ready to be discharged can't be because there is simply nowhere for them to go. This, together with a shortage of beds and a shortage of doctors, leads to delays in admissions and patients being forced to wait on trolleys or admitted to an inappropriate ward.

The NHS is on its knees and will only improve if every part of the system - from general practice to social care - is appropriately funded and supported with the necessary resources and staff. Yet the government continually fails to grasp the seriousness of the situation; a situation that is unfair on patients and unsustainable for NHS staff.

As doctors, we don't choose medicine as a career thinking we'll clock in at nine and out by five, but the pressures facing us now are unsustainable, and are leaving staff stressed and exhausted and at a much higher risk of making mistakes. On top of the growing demand, poor workforce planning means the NHS does not have enough doctors, leaving my colleagues and I repeatedly working over shift - for example, before Christmas the service needed me to work an extra six and a half hours on top of an eight hour shift. In the past few weeks in local hospitals, some doctors have had to come in from leave to help, while others have been drafted in from other specialties and areas of the hospitals to help out in A&E.

One of the health secretary's solutions to this crisis is that the four-hour A&E waiting time target will only apply to urgent patients, but while this might make his figures look better it will do nothing for patient care and change nothing to the situation I see in A&E day in day out. Investment in the NHS needs to keep up with patient demand and staff shortages must be urgently addressed. My biggest fear with this crisis is that I can see no light at the end of the tunnel unless the government and health secretary recognise and accept the situation, and right now they are stubbornly refusing to do so.

The health secretary has said that ensuring patient safety is his top priority, but by refusing to accept the current situation in the NHS, he is doing the complete opposite. As a doctor I will always do everything I can to protect my patients, now it's his turn.

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