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Saturday, 24 March, 2001, 01:00 GMT 02:00 UK
Grim reality of the NHS
Hospital care
Nurses work under intense pressure
Long waits in A&E and cancelled operations are still the grim reality for many patients in the NHS, a BBC documentary has found.

Panorama was given unique access to a hard pressed NHS hospital for two months over the busy winter period.

The film shows that despite the lofty targets laid out in last year's NHS Plan, there is still much to do to transform the UK's overstretched health service.

As sister Julia Stevenson tells the programme: "The winter crisis didn't end for us last winter, it carried on right through the summer."

Sister Juliet Stevenson
Sister Juliet Stevenson says resources are stretched all year round
St Peter's Hospital in Surrey has 280 beds - but the wards were full.

And as a result, the A&E department is frequently over-flowing.

Nearly 60% of the hospital's admissions arrive as emergencies - and almost always they have to wait on trolleys before a bed becomes free.

Then, for those who require further hospital care, there is often a long wait before they can be moved to an in-patient ward.

On one unremarkable Monday afternoon during filming, 14 people were stuck in A&E waiting for a general bed. Some had been waiting for the whole weekend.


I just wanted to know whether I was I going to be in there and come out in my coffin

Bill Hutchison
With intense pressure on surgical beds, hospital staff have difficult decisions to make about who to get ready for surgery.

This is illustrated by the cases of three patients - one with a hernia, one with an abscess and one with a diseased appendix - who all have pressing claims for immediate attention.

Remarkably one suggestion is to accommodate all three patients is to move an in-patient already on a ward back down to A&E.

Cancelled operations

The daily pressure on beds means a daily risk of cancellations.

Bill Hutchison
Bill Hutchison had surgery repeatedly cancelled
Bill Hutchison is 82-years-old and registered blind. He needs to have a cancerous tumour on his kidney removed, but his surgery has been repeatedly cancelled.

Each cancellation was because there was no intensive care bed was available for him to recover in following surgery.

"They came to me and said the operation would not take place because they hadn't got the intensive bed for me, that emergency operations had to come first.

"I didn't mind being put back that once."

But Bill's surgery was not just cancelled once.

"I was upset the second time. Because I thought was I just being made a fool of, and the third time I just wanted to know whether I was I going to be in there and come out in my coffin."

Bill finally got his operation at the fifth attempt - two months after surgery was first scheduled, and nearly six months after cancer was originally diagnosed.

He was treated by consultant urologist Mr Nicholas Harvey-Hills.

Following the operation, which was successful, the doctor was in no mood to mince words.

"I think it's very unsatisfactory in a modern country like this, in 2001, to be treated in that way. I think it's a disgrace."

Claire O'Brien is in charge of bed admissions.

She tells the programme: "If we had a situation where I could give a bed to every patient I would absolutely love it.

"We maximise every available bit of capacity we have, hence the reason why I've got a bed manager here till 8pm."

Staffing shortages

The lack of resources is compounded by a lack of staff.

One in six nursing posts at the hospital is not currently filled, which is not a-typical.

Mr Nicholas Harvey-Hills
Mr Nicholas Harvey-Hills says public expectation outstrips resources
In an attempt to remedy the situation, St Peter's became the first acute hospital trust in the country to employ nurses from the Philippines.

It also has to rely on expensive agency staff - pushing up costs considerably and helping to drive finances into the red.

Stephen Fash, chief executive of the Ashford and St Peter's NHS Trust which runs the hospital, tells the programme: "We have something of a double whammy at the moment.

"We are under enormous pressure in terms of the activity demands being placed on the trust and that's also having an impact on our financial well-being."

The trust is now running a deficit of 3m plus.

Stephen Fash goes on to say, "Now we have the NHS plan which is tremendously exciting in the vision it sets out for the NHS, but it has some very ambitious developments and ones that we all subscribe to but will come at a price.

"Now the government has put substantial amount of extra cash into the NHS. That is beginning to blow its way in.

"I fear that yet more money may be needed in order to deliver that vision for the future."

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See also:

27 Jul 00 | NHS reform
Blair unveils NHS blueprint
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