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In The Bleak Midwinter...

Winter is tough on our health services. Increasing cold weather and ice lead to a greater more accidents as well as the problems of poorly heated homes and seasonal flus. A recent poll of doctors by the BMA found that the majority were concerned with the ability of the NHS to deal with the pressures put upon its services this winter.

This is a valid and frustrating concern. Surely, if winter comes around every year (I checked – it does) then why is there such poor provision set to prepare for it? I remember working in a hospital in 2010 which set aside two wards as winter overflow wards. Both have since been opened full time due to the increasing demand throughout the year paired with the gradual reduction in real funding compared to planned funding, inflation and outsourced service price hikes.

The survey result comes at a time when many of us are concerned over the future of a public health service. Vaughan Gething, the Welsh health secretary, addressed assembly members warning that the NHS was not in a ‘perfect position’ this winter, though he was optimistic compared to the BMA Wales’ own statistics. Gething ascribed the raised demand to delayed transfers of elderly patients. If we take this to be the lead cause, then not only to we risk ignoring other pressing issues, but also lowering the standard of care for a vulnerable population if only because they require services the most.

The President of the Society for Acute Medicine, Mark Holland, has been quoted as saying that parts of the NHS will implode this winter. This in light of emergency services been stretched to the limit this summer, usually the period of respite. Instead, he predicts an ‘eternal winter’ meaning missed targets and poor performance across many departments and trusts.

If this new ministry of May’s wants the NHS to continue sustainably (I suspect they don’t) then it must accept that there are three facets to funding healthcare: quality, demand and value. You may pick two. If you want to keep the cost the same in the face of rising demand, then the standards will necessarily slip. Until they realise this, the public may have to winter reduced quality in their health services.

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