Instead of helping desperate NHS doctors like me, Thérèse Coffey is sticking in the boot | Rachel Clarke

Therese Coffey has announced his plans to address the NHS crisis by promising to direct a “laser-like approach” on patients’ needs. It’s a promise that might have had more credibility had she not revealed herself last week as the first health secretary in NHS history to worry. more on commas what do you eat

Yet he wanted, in fact was desperate, to believe him. You would be too if you worked inside a hospital. After all, it’s easy to miss the dire headlines about the state of the NHS. But for frontline staff, those crisis conditions are vivid, immediate, and hit us in the face every day – felt, heard, touched, and smelled. Deaths in corridors, rotten meat, features of relatives contorted with justified rage, blankets lifted on more than one occasion to reveal a fragile octogenarian skin, unforgivably matted in dry excrement. Cartoons I will never stop watching, scenes to shame a nation. I’d better have a plan, I’ve found myself muttering, because we can’t go on like this.

In laying out his priorities in Commons today, Coffey chose to co-opt the “ABC” approach that clinicians are trained to use to assess critically ill patients in need of advanced life support. Famously, the ABC acronym used in trauma around the world today grew out of a particular plane crash on a Nebraska prairie in the 1970s. James Styner, the American trauma surgeon who piloted the plane, was horrified by the chaos, incompetence and hesitation that nearly cost his four young children their lives in a small rural hospital . The acronym he developed is based on the principle that when someone is seriously injured, time is of the essence. Airway, breathing, and circulation problems should be fixed in that order, before moving on to the next, because they are more likely to kill the patient faster. The genius of the acronym lies in its simplicity. It gives doctors, nurses, and paramedics a scaffold to cling to amidst the shock and mess of a major disaster, providing emergency treatment one step at a time.

But when your party has held office for 12 straight years, it’s a bold move to borrow language that explicitly defines the NHS as needing life support. Coffey has basically painted Andrew Lansley, Jeremy Hunt, Matt Hancock and Sajid Javid as a series of delinquent drivers who have unfortunately hit an unlucky pedestrian. How plausible is his plan to rebuild the NHS that his predecessors have collectively trashed? For Coffey, “ABCD” stands for ambulances, delays, care, doctors and dentists, and rightfully so. It is a national scandal that patients die in the back of stationary ambulances, that 6.8 million people are now on hospital waiting lists, and that more than half of the inpatients ready to leave the hospital are unable to do so because the care they need in the community not available. His priorities, at least, are correct. I wish your solutions were fit for purpose.

Take, for example, Coffey’s approach to general practice. She chose to track”our plan for patientswith a government press release stating unequivocally that GPs will, from now on, be required to see patients within two weeks. This led, unsurprisingly, to a new round of attacks on GPs in the right-wing press. “Your doctor is due to see you in two weeks,” read the front page of the Daily Express, for example, with an accompanying editorial celebrating the fact that irresponsible GPs would finally do put online”. By the time the actual plan was published, Coffey’s claim had been mysteriously watered down to mere “expectation,” but by then the damage had been done. The morale of GPs, already bitterly accustomed to being scapegoats for the government, had just received another blow.

If Coffey seriously thinks that expelling NHS staff is good for patients, he is short-sighted and has a grammatical fixation. The NHS is facing its worst jobs crisis in history, with 132,000 positions currently vacantincluding more than 10,000 doctors and 47,000 nurses. Recent figures from the Health Foundation show a shortage of around 4,200 full-time equivalent GPs, with the number projected to rise to around 8,900 by 2030/31.

Instead of addressing the chronic mismatch between supply and demand in general practice, however, one of Coffey’s first acts has been to exacerbate it by subtly blaming the very doctors whose morale he should be trying to boost. Doctors will vote with their feet. Worse still, he treats the public like a fool by pretending that the announcement of “31,000 more phone lines for GP practices” will somehow reduce waiting times for GP appointments. No wonder Hunt, a man barely known for holding Conservative governments to account, responded witheringly: “GPs alone have 72 targets. Adding a 73 will not help them or their patients because it is not more objective National Health Service needs, they are more doctors”.

Coffey has come up with a novel, albeit ridiculous, solution to the broader job crisis. Instead of doing the obvious – funding an expansion of places for more UK doctors, nurses and allied health professionals – he has asked the public to “do their part” as part of a “national effort” to support the NHS and social care. . In short, he wants the million people who volunteered during Covid to offer their services once again to get the NHS through the winter, forgetting, perhaps, that the country is no longer in lockdown, the furlough scheme is over and we are entering a catastrophic cost of living crisis. Pat Cullen, Executive Director of the Royal College of Nursing, scrapped the plan as panicked and inconsiderate, adding, “The basic problem, which these plans don’t address, is that we don’t have enough nursing staff.”

Coffey’s plan is depressingly strong on rhetoric that fails to survive first brush with reality. Even the announcement of a £500m emergency welfare fund helping to get medically fit patients out of hospital is compromised by the fact that it does not appear to be new money, but must come from existing NHS budgets. Far from taking an ABC approach, Coffey has chosen to play the brink of an NHS in crisis while remaining resolutely silent on the root causes of it: underfunding, understaffing and staff’s insidious confrontation with patients. . It’s like watching a critically ill patient bleed to death before your eyes, while you assiduously attend to his bunion.

  • Rachel Clarke is a palliative care physician and author of Amazing: Inside the NHS in times of pandemic

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