There is a Sick Elephant in the United Kingdom’s NHS Room

‘What gets measured gets done’ is the old business truism that can be seen in action once again in the National Health Service in the United Kingdom.   Because bad targets make for bad medicine. The previous Labour government set the laudable target of having all patients treated within eighteen weeks of their doctors’ referral date. The whole thing falls down when the deadline is not met and there is no target for dealing with these cases. So there is now a neglected group of patients who nobody is encouraged to deal with.

That forgotten group (stubbornly holding at around 10% of all NHS cases) is now up to a quarter of a million patients who have not been treated within the time limit and many are still waiting a year later. Andrew Lansley, the coalition health minister has announced a purge of hospitals where this group is not being treated. At the same time he places the blame squarely on the Labour penchant for management rather than medical targets. Well he would wouldn’t he.

The Department of Health have issued a ‘name and shame’ list of hospitals where large numbers of patients have been waiting longer than a year. The wood spoon goes to St George’s Healthcare NHS Trust, in south London with nearly 5,100 1 year plus queuing patients in September. A rising number, up by 2,000 since July. Not good but better was Kingston Hospital NHS Trust, in south London, with almost 3000, but these are over 1,000 fewer since July.

Having denied the existence of the problem for a long time the Department of Health are now listening to the Chief Executive of the Patients Association who says that they are finally beginning to act on this rapidly deteriorating situation. They rightly feel that it is outrageous for so many patients to have been waiting for well over the arbitrary 18 week target time.

But would simply removing the target remove the log jam of treatment? Certainly it would allow hospitals to rearrange the queue on the basis clinical need rather than time from doctors referral and that must be a step forward for the patients. Whereas a witch hunt would only divert resources into duck and cover and away from treatment.

Amid all this talk of targets and political buck passing of course there is a sick elephant in the room. There is no more money for treatment of any kind because the government, the country and the NHS are all deep in debt and on an austerity drive that has only just begun. Everybody knows, and nobody better than the Patients Association that something has to give unless the Department of Health can take some innovative actions tomorrow to hold back the
rising levels of waiting and suffering.

On the sidelines the NHS Partners Network, a coalition of non-NHS hospitals that takes NHS patients is egging on Andrew Lansley in his campaign to deal with the issues, and they are also pressing commissioners to consider their members in the drive to reduce the waiting lines for treatment. They want to see more private hospital participation in getting down the waiting backlog.