The future of the NHS

This week I have been working with our medical correspondent Stephen Adams on an investigation into A&E, maternity, paediatric and other ward closures in the NHS.

We analysed every English trust (Scotland and Wales have separate NHS systems) and checked out services for acute care across the board.

The findings are quite shocking. More than twenty A&E wards are threatened with closure or have already closed, and only a slightly smaller number of maternity wards have either closed or may do so when proposals by trusts are completed.

In addition, paediatric heart surgery has been scaled back from ten centres to seven. Centres of excellence like the Royal Brompton in London will no longer be saving children’s lives as the NHS is streamlined and savings are made.

These are called ‘public consultations’, but did we, the British public, really know this was happening to our health service on such a scale?

There is a genuine debate over whether reorganisation of services into larger units with more doctors can benefit patient care – but travel times are a real factor.

A&E and maternity units are services that people can’t hang around for, in the cases of heart attack and stroke victims or mothers giving birth, for example. And with tens more miles to travel, the guarantee of better care at the end of the journey may not be of comfort while patients are in transit.

London is particularly affected by the shakeup, though Manchester has seen many of these changes already to a largely positive response.

Better care, further away, or closer but patchier provision? It would be ideal if the British public didn’t have to choose between the two.

Class and health in Scotland

The link between health and class was reaffirmed today in analysis of an ONS/NHS report about the likelihood of death or emergency hospital treatment due to accidental causes.

By me in today’s report in the Scotsman:

“Adults and children from the most deprived areas of Scotland are twice as likely to die from an accidental injury than those from the most affluent postcodes, new figures show.

Some 1,364 deaths were recorded in 2010 in an Office of National Statistics (ONS) report for NHS Scotland as due to “unintentional injuries” such as road accidents, poisoning, and violent crimes like stabbings and shootings. However, the vast majority were from falls.

Of these deaths, the bottom fifth of the population in terms of deprivation was listed as having a Standard Mortality Ratio (SMR) for children of 119.3, compared with just 54.7 in the top fifth.

Figures for adults were similar with an SMR of 125.2 for the bottom 20 per cent and 65.1 for the top 20 per cent.

The SMR is a measure of deaths and is based on a calculation of actual and expected numbers of fatalities.”

I also put together an interactive visualisation of every emergency hospital admission in Scotland for ‘unintentional injury’ (accidents) in the last seven years. View it here.

Cutbacks come to Liverpool

This article originally appeared in the April 4 edition of The Nation.

Town hall meetings are rarely brief and certainly never quiet in Liverpool. The one on March 2 was no exception, as the council of the city that ranks as the most deprived local authority in England worked through the finer details of $147 million in cuts to its $647 million annual budget.

Liverpool is at the very heart of the Conservative-led coalition government’s plans to shrink the public sector, reduce welfare to the bare minimum and “reform” Britain’s National Health Service (NHS) by tendering contracts to private companies while firing a whole swath of healthcare personnel. At every point in the life cycle of a “scouser,” Britain’s affectionate nickname for the city’s residents, the government is seeking to slash services, freeze pay and make life immeasurably harder for some of the country’s poorest and most vulnerable people.