NHS cut to the bone, say doctors

A 72-year-old breast cancer patient faces a 10-week wait for surgery; a woman with kidney cancer is threatened with the loss of her home as she tries to meet the cost of a private operation because she is too scared to wait six weeks for it at a local hospital; and the relatives of a 43- year-old man club together to get him life-saving heart surgery because they fear he will die before his turn comes in the health service.

This, doctors claimed yesterday, is the "sheer cost in human misery" of a National Health Service which has been "cut to the bone" by the Government's drive for efficiency savings, now running at 3 per cent per annum from every hospital and health authority.

The examples were drawn from the experience of one GP, Dr Sam Everington from Tower Hamlets, London, but he is not unique. Dr Sandy Macara, chairman of the British Medical Association council, said on the opening day of its annual meeting in Brighton: "Almost every GP could show you similar cases."The language was strong and emotions were running high as GPs and hospital consultants told of life in a health service which they say needs at least pounds 6bn to meet current needs.

James Johnson, chairman of the BMA consultants' committee, said patients were being prepared for surgery, only to have it cancelled at the last minute because an emergency admission had taken the bed they needed. "We can't go on treating people like this," he said. "We must have more intensive care beds."

Dr Everington, a member of the BMA council and an adviser to Labour's health team, said a 10-week wait for breast cancer surgery at the Royal London Hospital's Trust was more than three times that recommended in national guidelines.

"This is not just one example. The same thing happened last year. I had a list of 12 women who were waiting." It was only by "virtually begging" that he managed to get his 72-year-old patient seen at another hospital, he said. The current wait at the Royal London is now six to seven weeks.

Mr Johnson said the efficiency savings demanded by the Government over the past 12 years were a "con trick, a cynical political ruse to cut funding ... they are nothing to do with efficiency. The Secretary of State has got to end this 3 per cent cut."

The BMA says that counting the efficiency drive as growth means that nominal growth of 39 per cent in the decade to 1995/96 is reduced in reality to 15 per cent. On that basis, the service faces a 1.9 per cent cut, this year the association claims.

Mr Johnson continued: "The need to ferry critically ill children around the country in an ambulance in search of an intensive care bed is a bizarre and cruel deception of the public, especially when it is excused under the guise of efficiency."

Doctors have a reputation for whinging about resources but there is a mood of desperation at the meeting of 550 representatives of the BMA's 110,000 membership.

Stephen Dorrell, Secretary of State for Health, conceded the NHS was under pressure, but insisted that funding had increased continuously since 1979. In 95-96, it would increase by pounds 500m, he said. "There are difficult choices to be made always at the margins about how the service grows.

"It doesn't alter the fact the health service is treating more patients with a wider range of care this year than last, and last year treated more than the year before." NHS managers condemned the BMA's demand for pounds 6bn as "unrealistic". Karen Caines, director of the Institute of Health Services Management said: "An additional pounds 6bn is the cost of the police force of this country. Is Dr Macara suggesting we take the bobbies off the beat and give them a stethoscope?"

Marco Cereste, chairman of the NHS Trust Federation said the money would be "wonderful to have, but unrealistic." While the NHS was under severe financial pressure this year, claims that it was falling apart were "nonsense".

Letters, page 13