No accident that emergency waiting times are longer

The number of patients waiting in Accident and Emergency for treatment for over four hours has increased by 63 per cent compared with the previous year, following Andrew Lansley’s scrapping of the waiting time targets imposed by the previous government.

Andrew-Lansley-David-Cameron Today’s Guardian reports:

“An extra 73,000 patients were left to wait for over four hours in the last three months of 2010 compared with the previous year, according to data obtained by BBC Newsnight.

“In total, 184,000 patients waited more than four hours in A&E departments between September and December 2010. If the increased numbers remained the same over a full year, it would mean an extra 300,000 patients facing long waits compared with a year before.

“The number of patients waiting over four hours increased in 129 of the 149 trusts where data was available.”

As Left Foot Forward’s Trevor Cheeseman wrote last October:

“The Coalition is walking away from any role in or accountability for maintaining core standards.”

Now we see there is evidence that this ideology has resulted in declining standards in hospital care.

Percentage-of-patients-waiting-more-than-four-hours-for-treatment
In 2009 David Cameron said:

“It (the NHS) has to change because for many people, the service isn’t good enough. Mostly, that’s not the fault of those who work in the NHS. The fault lies with big government. With their endless targets and reorganisations, Labour have tried to run the NHS like a machine.

“This lever-pulling from above - it has got to stop. With Andrew Lansley’s reform plans, we’re going to give the NHS back to people. We’ll say to the doctors: those targets you hate, they’re gone.”

So far every one of Mr Cameron’s above points has been shown to be wrong or flawed. The British Social Attitudes (BSA) survey suggests that the NHS has never been so popular since the survey started in 1983, government targets, as seen above, have had positive effects in key areas of care, and Lansley’s reforms have been rejected by Doctors, by Lib Dem Lib Dem party members, by Norman Tebbit and by at least some of the people.

http://twitter.com/johnedginton/status/55310620362416128 John Edginton

RT @leftfootfwd: No accident that emergency waiting times are longer: http://bit.ly/fHEp9f writes Dominic Browne
http://twitter.com/josies_/status/55311154897100800 Josie S

RT @leftfootfwd: No accident that emergency waiting times are longer: http://bit.ly/fHEp9f writes Dominic Browne #savethenhs #demo2011
http://theoldpolitics.blogspot.com/ oldpolitics

What do you see as the causal mechanism here? Have front-line staff got lazier since there is no target? Have medical workers changed priorities away from A&E because there is no target, or have accountants allocated money away from A&E to different departments because there is no target? Or, indeed, has reporting got more honest because there is no target?
http://twitter.com/cllrkrichards/status/55359726204100608 Kevin Richards

"Lansley scrapped waiting times but its not working" @leftfootfwd: No accident that emergency waiting times are longer http://bit.ly/ihwIw5
Mr. Sensible

Oldpolitics, I expect that cuts to services are having an impact…

Couldn’t agree more Dominic; there’s a lot of ridicule of targets in the media, but I think it’s important that if I need to go in to hospital for any reason, I should be guaranteed certain minimal standards. It is, after all, a National Health Service.

And any dishonesty in reporting is not due to targets; it is due to individual hospitals.
http://twitter.com/miss_mcinerney/status/55401098546130945 Laura McInerney

Scrapping ER waiting times means they've increased rapidly http://bit.ly/e6TVzt – No shit, huh?
http://twitter.com/carolynanderson/status/55559735738507264 Carolyn Anderson

No accident that emergency waiting times are longer | Left Foot Forward http://goo.gl/iJJp2
Andy

Even assuming that the figures are 100% accurate, all that has been stated is that the percentage of patients waiting more than 4 hours for treatment has increased since that target was scrapped.

This type of thinking is the very reason why these targets should be scrapped. Targets (unless they are designed extremely well) are a poor proxy for the quality of patient care; perhaps now some patients are waiting longer because other patients with more serious problems are being given the time and attention they deserve.

In a perfect world, of course it would be wonderful if everyone could get seen very quickly, but in the real world we live in I would much rather see health professionals treating people based on their clinical needs rather than rushing around to meet arbitrary targets.
http://theoldpolitics.blogspot.com/ oldpolitics

Fine, but cuts are separate from an end to targets, aren’t they? Presumably if you impose this level of cuts, something has to give. If you set a target for x, the cuts will fall on y instead, that’s all.

As for dishonesty in reporting being down to the hospitals not the targets, fine, but gaming of various sorts has been present wherever there have been targets throughout human history.

I might write a blog, actually, I’m interested – a move from 2.5% to 3.5% doesn’t necessarily tell us much, it may be that the 1% are stupid cases that shouldn’t be there and don’t need treatment, but refuse to leave, and were in the past being prioritised to meet the target, making urgent cases wait slightly longer, whereas now that isn’t happening…
http://twitter.com/status/status/ Daniel Pitt

No accident that emergency waiting times are longer: http://bit.ly/fHEp9f #ConDemNation
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