Shropshire Star

Star comment: Time for a rethink on future of A&Es

Published

From the reports coming back from the front line at England's hospitals you get the distinct impression that the accident and emergency service is on the brink of a crisis.

There is already the issue of overuse, aggravated by the winter weather which always adds to the burden by cramming hospitals with patients who have become victims of seasonal ailments.

The service is teetering on the edge of a form of medical and operational bankruptcy. It is strained to the limit but is just about coping. The edifice has not fallen in, but you can imagine that if there happened to be a certain nexus of factors that it would be a distinct possibility.

The politicians are squabbling and there is added bite to the arguments because this is an election year. The Government says it is meeting A&E targets in the vast majority of cases, and that it has been spending extra money. Labour can simply point to ambulances queuing up outside the A&E departments with patients inside, and hospitals declaring they are in crisis.

In reality politicians of all parties have been trying to get a proper handle on the running of the NHS for years, so the blame is widely shared. Institutional problems do not arise overnight.

Some serious thinking needs to be done over whether what is happening is a failure of the service, or whether it represents a success of the service in meeting the needs and aspirations of users of the NHS in the 21st century.

People are being urged to use their doctors or pursue other non-emergency avenues, but many are heading for A&E straight away because they are looking for walk-in, on-the-spot, professional treatment.

If this is the way forward in terms of public expectation, there needs to be a reshaping of the model of delivering NHS care for the future to reflect it.

That is not going to happen overnight but the forthcoming election at least gives an opportunity to have a strategic debate in which the views of those who matter most – the public – are fully part of the process.

That is for tomorrow. There are immediate problems today. We cannot go on with the NHS like this. But somehow that is exactly what happens as it stumbles from one problem to the next.

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