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Friday, January 8, 1999 Published at 23:22 GMT


Scottish chief quits over beds crisis

Edinburgh Royal Infirmary has had patients waiting on trolleys for hours

The head of one of Britain's biggest accident and emergency units has resigned because of the NHS beds crisis.

Dr Keith Little of Edinburgh Royal Infirmary told BBC Radio Scotland that he had quit because he was unable to do his job properly.

Dr Keith Little: My problem is simply with the Accident and Emergency department
"I was unable to function as what I felt was an efficient clinical director," he said, adding that he believed he could not deliver an "optimal" service to patients because of a shortage of beds.

He continues as a consultant at the hospital.

Although Dr Little refused to be drawn into the politics of his resignation, he supported criticism of the hospital by Dr Brian Potter, the Scottish secretary of the British Medical Association.

Unbelievably awful

Dr Potter said the NHS was in "an unbelievably awful state" after he witnessed patients at the hospital being forced to wait for up to eight hours on trolleys.

Dr Little said: "Dr Potter's description of the A&E department on the day he visited is entirely accurate. Comments beyond that are not in my remit."

Dr Little, whose resignation has only just been made public although he quit in December, says the bed problems began last May or June.

The hospital had tried to deal with the problems, but had made little progress.

"Patients wait on trolleys for many hours, waiting for an appropriate inpatient bed," he said.

"And for 14 or 16 patients to be waiting in my department simultaneously for four, six or eight hours is not good for patients, appalling for the relatives, and incredibly frustrating and distressing for the staff involved."

Intolerable odds

He added that the hospital's problems were no different to those being faced by A&E departments up and down the country.

However, he said he was unaware of any other hospitals in Scotland having a problem which was quite so serious as Edinburgh Royal Infirmary's (ERI).

Dr Potter said Dr Little's resignation was "a natural consequence if you keep putting people in a position where they have to cope with intolerable odds".

He said the situation had been bad for many years and was not getting any better under Labour.

He blamed the private finance initiative, under which hospitals are built by private companies and leased to the NHS, for part of the problem.

"It is ripping the heart out of the NHS," he said. "It means we have a system where investors with money at stake have a say in the running of the service."

Joe Owens, chief executive of the ERI said he regretted Dr Little's decision since "a significant number of measures" had been put in place to tackle the problem but would take some time to have an impact.

The BBC's Colin Blane: "A difficult week for the Scottish health minister"
The Scottish National Party called for the resignation of Scottish health minister Sam Galbraith because of the NHS crisis.

Mr Galbraith has refused to comment on Dr Little's resignation.

Beds situation

The British Association for Accident and Emergency Medicine blames the current crisis on the government's stress on reducing waiting lists.

It says this "has resulted in a reduction of beds for emergency cases" and has been exacerbated by a winter increase in acute admissions, mainly due to respiratory problems such as the flu.

[ image: Dr Little says hospitals up and down the country are struggling]
Dr Little says hospitals up and down the country are struggling
The association welcomed the government's call for hospitals to prioritise emergency cases, but called for an increase in bed provision and a sustained rise in staffing in A&E departments.

Although Scotland appears to have escaped the current flu outbreak, hospitals around England are bracing themselves for an expected peak in admissions over the weekend - and the outbreak is said to be sweeping south.

The Association for Influenza Monitoring and Surveillance says the rate of infection in England rose to 188 per 100,000 of the population this week.

Those most at risk include the elderly and the very young.

Doctors are urging people to get vaccinated against the virus.

The Emergency Beds Service, which monitors spare intensive care beds for hospitals which are full, said on Thursday that there were no spare beds in Yorkshire, the Midlands or the South East.

But the crisis had eased slightly in the London, the Thames Valley, North West and South West areas, where up to 20 intensive care places were available.

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