Election `97: Hospitals delay admission to save money

THE MANAGER'S TALE

The contracts manager of a major teaching hospital, who wishes to remain anonymous, says budgetary pressures have forced the National Health Service to turn a fundamental principle on its head. Instead of admitting patients as soon as possible given financial and other constraints, there is now a policy of delaying admission as long as possible to save money.

"An explicit instruction has been given to hospitals by their cash-strapped health authorities to let waiting lists increase and not to admit any non-urgent cases for operation until they have waited for a minimum of 18 months - the longest permissible under the Patient's Charter.

"The implications for patients will be dreadful. While they wait for a cataract operation, they go blind. While they wait for a joint replacement they will be in terrible, grinding pain. Hernias may strangulate and patients with gall stones may end up with jaundice. These operations are not expensive and are known to work. So the health authority makes a small saving and lots of patients wait in misery," he said.

"The irony is that over the last few years, surgeons worked overtime, did extra theatre lists, came in on Saturdays, all to get rid of the appalling waiting lists that bedevilled the NHS. Now, at a stroke, they are effectively being put on part-time working."

The number of routine surgical day cases planned by the hospital this year has been cut by almost a quarter for general surgery and orthopaedics and by half for ear nose and throat surgery compared with last year.