NHS Doctor Shortage and High Costs of National Health Care reduce Staffing Levels in Hospitals on Weekends

Posted by PITHOCRATES - June 1st, 2013

Week in Review

Health care workers in the National Health Service (NHS) are government workers.  And one thing we know about government workers is that they don’t like working on their time.  They don’t like working after hours during the workweek.  And they especially don’t like working the weekend (see NHS risk of death from elective surgery far greater at end of week, study finds by Denis Campbell posted 5/28/2013 on theguardian).

Patients who have planned surgery near the end of any week or at weekends are at greater risk of dying than those operated on at the start of the week and especially on Mondays, research reveals.

These risks have been rated “very alarming” by patient safety campaigners, and judged unacceptable by the Royal College of Surgeons (RCS).

The findings come as NHS chiefs try to devise ways of ensuring that the health service offers high-quality care across the entire week, in response to a growing body of evidence showing that a shortage of experienced doctors on duty at the weekends heightens the risks of a poor outcome for patients.

It is only common decency.  If these health care workers can do their job in the normal workweek then patients ought to be able to do the same.  Have their surgery and be gone by the weekend.  Because health care workers have lives, too.  And they don’t want to waste it by taking care of burdensome patients on their time.

The study is significant since it is the first to suggest that patients in Britain are more likely to have an “inferior outcome” if they undergo elective surgery later in the week.

Until now concern has focused on high death rates among patients admitted as emergency cases at weekends – dubbed the “weekend effect” – which is often attributed to a lack of consultants on duty on Saturdays and Sundays.

You see, the problem in national health care is that it costs a lot of money.  Especially when you have an aging population.  Where more people leave the workforce than enter it.  Shrinking the tax base.  And these retirees go on to live a long life in retirement.  Instead of dying quickly to save precious health care money.  No, these people live so long that they can have heart attacks, cancer and dementia.  A single patient can have all of these afflictions today.  And that costs a lot of precious health care money.  Which they just don’t have.  So they have to ration what they do have.  To make their limited resources cover more people.  And one way of doing that is short-staffing hospitals on weekends.

[Paul] Aylin [a clinical reader in epidemiology and public health at Imperial College London] said he could not be sure what lay behind the trend. But he said that as the first 48 hours after surgery were critical to patients’ chances of recovery, the poorer care available at weekends – fewer staff, less experienced staff, perhaps less access to diagnostic tools or emergency surgery – was a likely explanation. Those who had surgery on a Friday would stay in hospital over the weekend…

Peter Walsh, CEO of the patient safety group AvMA, said day-dependent differences in the risk of death of as much as 44% were very alarming” and underlined the need to make the NHS a truly seven-day service.

Operating a good service only on weekdays was a completely out of date notion, he said, adding that patients due to have elective surgery on a Friday could ask instead to undergo it earlier in the week…

Sir Bruce Keogh, national medical director of NHS England, said the service was “committed to providing safe care for all patients, regardless of when they receive their treatment”.

Keogh added: “We have established a forum to develop viable financial and clinical options to help our NHS provide more comprehensive services seven days a week. This forum will report back in the autumn.”

Asking people to reschedule their surgeries may help some.  But if everyone does this will they just reduce staffing levels at the end of the week?  Which would kind of make the problem worse.  And it’s not much of an option for people being rushed to the hospital in an ambulance at the end of the workweek.  For those patients to be so inconsiderate as to have their near-death illness or accident at the end of the workweek.  These people will just have to plan their illnesses and accidents better.  Yeah, that may be hard.  But health care resources don’t grow on trees in the NHS.

Financial options?  You know what that means.  Greed.  Making a profit on the sickness of others.  The thing they want to stop in the United States with Obamacare.  And here the British are using it to try and fix their ‘part-time’ NHS.  That prefers not to work weekends.

The proponents of Obamacare see Obamacare as only a temporary layover on the way to single-payer.  Or national health care itself.  Like the NHS.  Where all of our health care workers will be government workers.  And one thing we know about government workers.  They don’t like working on their time.  Not after hours during the workweek.  Or weekends.



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