Behind The Headlines: Good has to come of this...

IT’S hard to imagine a bleaker story surfacing about our health services in the rest of 2012 than the one involving the tragic death of 87-year-old Phyllis Asten.

Mrs Asten was with her great-grandson on Tuesday afternoon when she had a fall in the garden. Within five hours, Mrs Asten lay dead in the resuscitation area of Northampton General Hospital following a catalogue of delays, including five 999 calls and a long wait on a trolley in a corridor at NGH caused by a backlog of patients waiting to be handed over by paramedics to A&E staff.

The Chron’s exclusive story yesterday was followed by the usual pledges of full investigations by both the ambulance service and NGH while Northampton South MP Brian Binley also personally intervened to demand a preliminary explanation of what happened. What cannot be changed, however, is Mrs Asten’s family have been left grieving and looking for answers, answers that may well be difficult to pinpoint in some instances.

Hospital chiefs have said it, ambulance bosses have said it and now patients are saying it: Accident and emergency at NGH is struggling. Record high numbers of patients per day and several “black alerts” (when it is fighting to meet demand) seem to have been a factor ever since the winter of 2010 when cold weather froze the county sending unprecedented numbers of people with trips, falls and breathing difficulties through NGH’s doors. But while the thaw came, the number of patients arriving for treatment did not drop off.

NHS Northamptonshire does not have an answer – officially at least – as to why this is happening, but equally it is not standing idle either. It is campaigning to reduce the number of 999 calls when the situation is not life-threatening – 40 per cent of A&E arrivals are re-directed to places such as the nearby minor injuries unit (MIaMI) or Nenedoc.

But a lack of real answers to the problem has prompted speculation, one theory of which is Northampton’s growing population in general and growing elderly population in particular.

Privately, health professionals have told the Chron that society may be simply turning towards a “me, me, me” approach where people think they can receive and more importantly deserve top grade treatment every single time they dial 999.

Clearly, there remain very many people living in Northampton who, for whatever reason – they are not registered with a GP or simply don’t understand the system – use A&E as some kind of panacea when in many cases a practitioner, pharmacist or NHS Direct, to name just a few outlets, may be a better point of call for all concerned.

The separate issue of ambulance overloading is endemic not just here but nationwide, exemplified by the breathtaking statistic that across the East Midlands on a particular day, there was a total of 1.6 miles of ambulances queuing outside of A&E departments. Paramedics can’t simply bundle a patient through the A&E doors and get off to the next shout. Sometimes they have to wait for hours for that patient to be admitted or otherwise dealt with, tying up an ambulance in the process. Again, a simple problem caused by that vicious circle of over-capacity.

Bed blocking is another blame factor. Having full wards means people do sit and lie on ambulance trolleys in corridors and the capacity of the A&E department has rapidly become insufficient, a problem that will ease in the spring when work to install more cubicles in A&E is completed and more staff are taken on. To help matters further, the NHS is finding ways to get patients into community beds such as Danetre Hospital in Daventry and specialist centres such as the newly opened Cliftonville Care Home building.

NHS trusts are all working together to solve the problems and some of the smaller issues are in fact being addressed despite the experience of some patients and their families.

More than 60 years after it was founded, the NHS remains a revered institution which, by and large, has an affectionate place in the hearts of an ever more demanding British public.

The Government famously declared it would not be cutting NHS budgets when it took over the reins at Westminster in 2010, but the truth is that tiny percentage increases in funding get overtaken by the real costs of running a modern day health service. Drugs cost more, new treatments are developed and so on.

Nobody is saying this single tragedy was caused by money but it has demonstrated that parts of the system are creaking.

The debate as much as anything now is how much longer the NHS can remain free at the point of need. Politically, reforms are a massive hot potato and there is no desire to go down the road of the US system, but perhaps a French-style healthcare model, for example, may be looked at in the future.

Whatever happens in the future cannot change the present. A pensioner lost her life this week in the most tragic of circumstances. Lessons must be learned from this single incident. On that, there is no debate.