Some months ago I had to arrange emergency hospital admission when my father in law suffered a stroke. The experience highlighted the inefficiencies of the cost cutting process in the NHS; it provided a lesson in the unintended consequences that we should consider.
As it was an emergency the ambulance service was called and attended promptly. They correctly assessed that immediate hospital admission was required. So far so good. But then...
The NHS is going through a period of reorganisation and as a consequence the local hospital had been closed for emergency admissions. It meant the ambulance crew wasted valuable time consulting a check list to establish which hospital they should use instead. Suddenly a simple situation called for additional clinical decision making.
Although slightly odd this early confusion was nothing compared with the consternation I felt when the ambulance arrived at the hospital. What greeted us was nothing like the drama from Casualty, rather a polite request to join the queue of five emergency patients flanked by two ambulance crew each. You see the crew can't leave a patient until he or she has been checked in, and the hard pressed casualty staff were overwhelmed having to manage the admission requirements of three hospitals. As a consequence our crew and others wasted 45 minutes simply waiting in line. The cost must have been phenomenal.
This situation perfectly illustrates the challenges of making cuts and efficiencies. They must be made, at least in part, through investment or there will be human sacrifices. In my situation a man who required swift intervention and treatment was left waiting for 45 minutes; incapacitating several ambulance crew in the process.
Take the issue of the proposed cuts to Disability Living Allowance. I doubt that the government has considered for one moment how the DLA forms part of the charge that local authorities levy on disabled people for the services they provide. And although I thoroughly disapprove of the practice, I likewise doubt that the government has considered how local authorities should deal with the potential revenue loss.
In addition to substantial cuts already planned, people with disabilities will now face further cuts to their services as local authority income levels fall. MPs will sit behind their desks and measure the success in isolated financial terms while the implications of unintended consequences begin to spread. Without thorough due diligence, cuts will almost always result in losses - financial or human. And the burden to rectify the situation will then again fall on a society which can least afford it - at least not without making more cuts somewhere else.