Sunday, 13 May 2012

Lack of hospital beds in UK

It is sad that I feel duty bound to use my blog as an author to raise the problems I see with the UK's National Health Service, but where else can one get one's views in the public view? The bloated administration of the NHS is sucking the lifeblood out of the service where administrators with no clinical experience are on six figure salaries. At the same time skilled clinical staff are losing their jobs.

Take for example the reported shortage of hospital beds (BBC article - Nick Triggle). The Government deny there is a shortage, but if you talk to any A& E Matron and you will hear a very different story. Patients are regularly kept waiting because of bed shortages. The hospitals employ "Bed Managers" whose sole job is to chase the clinicians in the hospital wards to discharge patients early.

The problem with hospital beds is that a "bed" has become a unit of accounting in hospitals. The bean counters find it very convenient to work out the "cost of a bed" by taking the total running costs of a hospital ward/unit and dividing it by the number of beds. Don't forget they also impose the "management overhead + PFI costs" into those running costs. It is not just the medicines, doctors, nurses and ward staff. The bean counters then have an easy to use spreadsheet figure called "bed cost". The cost figure gets absorbed into the management mythology and the people using it forget the original components of the cost.

When senior hospital management realise there have/are going to run out of money they'll introduce cost cutting measures. Some bright bean counting spark will say "if we cut 20 beds from the service we'll save a lot of money over five years". As a consequence patients lose access to those beds, but the overhead hospital costs never go away.  Let's be plain about this: A hospital bed only costs about £5,000 When a hospital "closes" a bed, they don't sell the bed to reclaim the money. The hospital still has to pay infrastructure costs, floor rent, the administrators costs are still there, the PFI costs remain.  The action doesn't reduce the number of patients, people still get sick.

The hospital planners/administrators need to get away from the concept of a "bed cost" and use more realistic accounting methods. 

Here's another view of the problems by a Doctor.

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