We are into the period when the political parties try to
bring out their eye catching policy initiatives.
David Cameron has said that if in government they will bring
about 7 day working for the NHS. http://www.bbc.co.uk/news/32094681
This is of course a discussion that has been going on for at least the last 5
years. It is clearly desirable for patients that there should be access to
services 7 days a week, but there are also reasons why so far the move towards
this is patchy.
The responses to the proposals so far seem to be on the
lines:
- · It won’t happen.
- · There is no money to pay for it.
- · Where are you going to get the staff?
Personally I think that it would happen – but at a cost.
It is clear that there is no additional money on the table
so how could 7 day working be made to happen?
If we were in a position where hospitals worked in
co-operation with each other, one could imagine the creation of networked
provision so that there is cover for a range of different conditions provided
in different centres during weekends. This would make good use of existing
facilities.
But we are in a position where hospitals compete with each
other, and there is insufficient funding, especially for acute & emergency
services, and there is a finite pool of staff in many areas. All of this means that only a limited number
of hospitals will in the end be able to provide 7 day a week services.
Ability to provide seven day consultant services will in
these conditions become a proxy for a hospital’s ability to survive in a
situation where there is competition for scarce resources, and media focus on hospitals "failing" to provide a seven day service will drive patient choice.
The reason why I think that this policy will seem attractive
to some is because it will drive the centralisation of services. The provision
of 7 day services will happen in the big centralised hospitals, and the smaller
DGHs will see another step in the downgrading of what they can offer to their
communities.
There is also of course the potential for private enterprise
to set up or run acute centres to provide the weekend cover.
So yes – expect 7 day consultant services to become a
reality, just don’t expect it to be in a hospital near to where you live.
