Letter: Hospital reforms leave emergency patients facing needless delays

Sir: The publicity arising out of the sad case of the 89-year-old critically ill woman who died after four hours in hospital without having seen a doctor (report, 17 November) has served a useful purpose in drawing attention to the state of perpetual crisis in the reception and management of acute medical emergencies in our major hospitals. This is certainly not confined to Birmingham, Newcastle and Liverpool, the cities mentioned by your reporter Nicholas Timmins.

Throughout the country fully operational medical wards have been closed down wholesale in a desperate attempt to balance the books. Acutely ill patients then have to be admitted to whichever wards they can be squeezed into, and the unfortunate medical team on call finds itself with patients dispersed throughout the hospital.

Meanwhile the 'quality' component of contracts negotiated by general practitioner fund-holders and district health authorities is limited to hardly life-threatening details such as waiting time in outpatients. The patients are frequently waiting in the clinics because their doctors are on the wards trying to locate and treat the inpatients for whom they are simultaneously responsible.

The 'purchaser-provider' split so fundamental to the health service reforms has done nothing to address these long-standing problems. The expense of administering the reforms and the diversion of resources elsewhere has contributed to the crisis faced by the acute medical services.

Yours faithfully,

C. D. HOLDSWORTH

Consultant Physician

Sheffield