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Not enough hospital beds and GPs closing Not enough hospital beds and GPs closing
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Letters
Tue 3 Oct 2017 18.24 BST
Last modified on Mon 27 Nov 2017 16.00 GMT
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Though thin on detail, CQC chief inspector of hospitals Professor Ted Baker’s belief in “an NHS fit for the 21st century” refers to the FYFV/STP’s app-driven, remote access and remote monitoring, downskilled vision of a tech-heavy health service. Here, increasing numbers of older people will not become acutely or terminally ill in a way that requires admission to an inexorably reducing number of hospital beds, services and staff per capita, because this will have been prevented by sheer willpower, neglect of the facts, and narrow repetition of misused research statistics. For instance, it is sheer and demonstrable nonsense to suggest that half of patients in hospital “don’t need to be there”. Probably 5%, maybe up to 12%.Though thin on detail, CQC chief inspector of hospitals Professor Ted Baker’s belief in “an NHS fit for the 21st century” refers to the FYFV/STP’s app-driven, remote access and remote monitoring, downskilled vision of a tech-heavy health service. Here, increasing numbers of older people will not become acutely or terminally ill in a way that requires admission to an inexorably reducing number of hospital beds, services and staff per capita, because this will have been prevented by sheer willpower, neglect of the facts, and narrow repetition of misused research statistics. For instance, it is sheer and demonstrable nonsense to suggest that half of patients in hospital “don’t need to be there”. Probably 5%, maybe up to 12%.
Presumably, hospital staff are “piling patients into corridors” because of an embedded culture of cruelty, not due to year-on-year defunding of essential services in a safety-critical system. With record deficits in 2016 of £3.6bn (not £700m as stated by DoH), did hospitals throughout the country really become fiscally incompetent suddenly since 2012?Presumably, hospital staff are “piling patients into corridors” because of an embedded culture of cruelty, not due to year-on-year defunding of essential services in a safety-critical system. With record deficits in 2016 of £3.6bn (not £700m as stated by DoH), did hospitals throughout the country really become fiscally incompetent suddenly since 2012?
The NHS’s adaptation to the loss of nearly two-thirds of its beds, while maintaining a world-leading health service, is itself evidence of huge productivity gains and is indicative of the NHS’s ready adaptation to incorporate new technology, care pathways and patterns of working according to the changing times and evidence.The NHS’s adaptation to the loss of nearly two-thirds of its beds, while maintaining a world-leading health service, is itself evidence of huge productivity gains and is indicative of the NHS’s ready adaptation to incorporate new technology, care pathways and patterns of working according to the changing times and evidence.
The King’s Fund report on hospital bed numbers is clear evidence, and a warning, that safe capacity in the NHS has been exceeded.The King’s Fund report on hospital bed numbers is clear evidence, and a warning, that safe capacity in the NHS has been exceeded.
Prof Baker’s blaming of hospitals is really shoddy and invidious, distorting critical research evidence on this subject. His judgments appear to be neither independent nor to grasp the realities of the situation that the NHS faces today.Dr Nick MannLondonProf Baker’s blaming of hospitals is really shoddy and invidious, distorting critical research evidence on this subject. His judgments appear to be neither independent nor to grasp the realities of the situation that the NHS faces today.Dr Nick MannLondon
• It is shocking to learn of so many GP surgeries closing (Why are so many GPs shutting up shop? 27 September) due to added pressures on GPs’ workload. The suggestion of introducing plans for new walk-in centres to alleviate this pressure does not take into account the necessity of a doctor-patient relationship built up over time. This special relationship is crucial for GPs to observe changes in their patients because of familiarity with that person, and also for patients to feel able to discuss difficult problems because of a buildup of trust in that GP. A known GP in one’s life gives a sense of security, as a child needs a parent-figure for security, especially for those who are more needy, isolated or vulnerable in our increasingly fractured society.Penny Elder Psychotherapist/Balint Society UK leader, London• It is shocking to learn of so many GP surgeries closing (Why are so many GPs shutting up shop? 27 September) due to added pressures on GPs’ workload. The suggestion of introducing plans for new walk-in centres to alleviate this pressure does not take into account the necessity of a doctor-patient relationship built up over time. This special relationship is crucial for GPs to observe changes in their patients because of familiarity with that person, and also for patients to feel able to discuss difficult problems because of a buildup of trust in that GP. A known GP in one’s life gives a sense of security, as a child needs a parent-figure for security, especially for those who are more needy, isolated or vulnerable in our increasingly fractured society.Penny Elder Psychotherapist/Balint Society UK leader, London
• We are in no doubt that general practice has the potential to play crucial roles in maintaining and improving the health of local communities. However, the evidence is clear that funding in general practice is lower than current needs. In addition, and critical for population health, the workforce is unevenly spread across the country, with the fewest doctors in the areas of greatest need. This has the potential to exacerbate health inequalities. However good our doctors and nurses are, if we do not equip or support them properly to deliver quality work, they will not be able to do so.Michael Craig WatsonAssociate professor of public health, University of NottinghamDr Emily Clare BaxterSt George’s Medical Practice, Barnsley• We are in no doubt that general practice has the potential to play crucial roles in maintaining and improving the health of local communities. However, the evidence is clear that funding in general practice is lower than current needs. In addition, and critical for population health, the workforce is unevenly spread across the country, with the fewest doctors in the areas of greatest need. This has the potential to exacerbate health inequalities. However good our doctors and nurses are, if we do not equip or support them properly to deliver quality work, they will not be able to do so.Michael Craig WatsonAssociate professor of public health, University of NottinghamDr Emily Clare BaxterSt George’s Medical Practice, Barnsley
• Join the debate – email guardian.letters@theguardian.com• Join the debate – email guardian.letters@theguardian.com
• Read more Guardian letters – click here to visit gu.com/letters• Read more Guardian letters – click here to visit gu.com/letters
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