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Friday, June 4, 1999 Published at 03:00 GMT 04:00 UK


Doctor shortage 'is killing patients'

Fewer doctors per patient could be harmful, says study

Patients are more likely to die in an English hospital if it employs fewer doctors for each hospital bed, a study has found.

And if there are more people per GP in the town you come from, you are also more likely to die, as your condition may be far worse before you are sent to hospital.

A massive study of 7.5 million hospital visits at 183 NHS hospitals was undertaken by researchers at Imperial College School of Medicine and Harvard Medical School.

They found that death rates varied widely - from 3.4 per cent of those admitted, to a massive 13.6 per cent.

The main factor affecting this was the number of emergency admissions taken by the hospitals - emergencies are more likely to have a fatal outcome.

But a low number of doctors per patient, or GPs per head of population locally, were the next most important factors found at hospitals with high death rates.

Overworked GPs less effective

The report says: "When general practictioners are relatively overworked the patients whom they send to hospital may be relatively sicker, and these areas patients are more likely to be admitted as emergencies."

The study was co-authored by Professor Brian Jarman, who helped the government to create a "deprivation payment" scheme in which GPs are paid more per patient in deprived areas to reflect the extra healthcare they will probably need.

England has one of the lowest number of physicians per head of population of all the member countries of the Organisation for Economic Co-operation and Development (OECD).

In 1994 it was only 59 per cent of the OECD average rate.

Doctors' leaders seized upon the report as evidence that a lack of doctors is harming patient health.

'This is dynamite'

The British Medical Association has been calling for the government to act to increase the numbers of consultants in British hospitals.

Dr Peter Hawker, chairman of the BMA's Central Consultants and Specialists Committee, said: "This report is the dynamite that's needed.

"More people in this country are dying than is necessary - this proves it.

"England is an international disgrace. In the developed world, only North Korea and Turkey, I think, are worse."

[ image: Dr John Chisholm:
Dr John Chisholm: "Patients deserve better"
Dr John Chisholm, chairman of the BMA GP's Committee, added: "England is a rich nation, yet we have one of the lowest ratios of doctors per head of population within the OECD countries. Our patients deserve better.

"Increasing the number of GPs will be good for patient care and increase job satisfaction for doctors by giving them more time with their patients."

A spokesman for the Department of Health said that it was wrong to compare the OECD figures as they did not necessarily represent "like for like".

She said the government was increasing intakes at medical schools, and paying for an extra 7,000 doctors by the year 2002.

The issues of consultant numbers and workload would be discussed during current negotiations to redraw the contracts of NHS consultants.

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