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Chief Executive Stephen Fash responds to your comments.
It's a relief to know we're not the only ones. We have to go through this every day at our hospital, as nurses we all hate it, we find ourselves thinking of patients as commodities and not as human beings which is not what we came into the job for. Caring and nursing are going to become a thing of the past.
Lindsay Randall

Our father is a typical 'bed blocker' but for ludicrous reasons. He is a patient in the Royal Surrey Hospital and has been since 29th December 2000, he needs a nursing home bed that meets his needs. We have found one, it is £610 a week. The health authority have offered £500 a week and The Royal Air Force Benevolent Fund have offered the full £110 top up but guess what the health authority have said it is now illegal to top up fees so he can't have the bed so he stays in hospital. Rich beds for the rich and poor beds for the poor.
Rosemary Parry & Sandra Ansley

Having trawled through all the comments I was totally amazed by the lack of radical solutions: only one suggested trying the solutions which work in comparable European countries, (the example quoted was Germany) where the health service is privatised and individuals are insured either by the state or privately. Are we totally brainwashed that we must not even think about a different health system in Britain? Let's start discussing how we can make the change.
Bob Cranmore
Lancing, Sussex

Whether we like it or not, advances in the field of medical science seems only to place additional financial burdens upon the NHS which is rapidly reaching breaking point. In my youth people accepted that diseases and medical conditions that are curable today were beyond recovery. But now in this age of miracles advancing age and sickness, however extreme, are to some extent understandably considered by many to be no barrier to effecting a cure at whatever cost. I don't wish to be insensitive but when and where do we draw the line?
P. Hewitt

Thanks for showing the NHS as it really is. We work like that every day. Our bed blockers take six to twelve months to get funding. Before Christmas 17 out of our 33 patients were bed blockers which impacts on all areas of the hospital. Congratulations for an excellent programme
Terry Freeman

Reading through the comments, here is a constructive idea. If the NHS priced a treatment at say £2000 :- give the patient a voucher for that sum towards private treatment. a. waiting lists are reduced. b. no extra costs to the NHS. c. the patient has a choice. d. the private sector still gets their profit. This is not "politically correct" but is surely worth consideration to produce a more refined system with safe-guards.
C.D.Goreham (Mr)

I work in Staines so have some knowledge of what has caused the problems at St Peters hospital Chertsey. Against the public's wishes, who after all are the shareholders of the NHS, Ashford Hospital has been continually downgraded. Its A & E dept has now also been downgraded to little better than an elastoplast surgery. So what we are trying to do is fit a quart into a pint pot. Does not work. I wonder how St Peters would cope with a major accident on the M 25 or a major accident at Heathrow. The service suffers from chronic underfunding and then is expected to not only to deal with the people who actually pay for the service but also half the world's population in the form of so called asylum seekers. How does it feel to have paid all your working life your national insurance stamp to be denied treatment. How does it feel to have freeloaders just milking our system who paid nothing while us who pay get nothing. Vote for Tony Blair - no chance.
Ted Shepherd

A great programme. I am a medical student and my fiancée is a physiotherapy student. We both have one thing to say about the NHS. If things do not change soon, it will die. The staff have a low morale and so do the students in training... I have to train for 5 years on a load of just over £3000 and my fiancée's bursary does not even cover her accommodation - and it is not the Ritz I can assure you. The NHS will be lucky to get the staff rises that this government pledges.... Oh well I suppose it will be the Tories fault or the Lib Dem's fault. The buck has to stop some where Tony!!!
Iain Ballard
Newcastle under Lyme

I noticed that comments from north of the border were very few in number. This could reflect the fact that your programme bears no resemblance whatsoever to the state of the NHS in Scotland. We do not have to employ foreign nurses to fill vacancies caused by a shortage of nurses. Why? because we have plenty of qualified nurses who are seeking work and cannot get it because the Health Trust have no money to fill the vacant posts. I think that this very point is deliberately being ignored by the government in it's bid to make people think that they are doing all they can to help an ailing NHS.
Andrea Stanford

I was extremely impressed by the unbiased reporting on the latest Panorama programme about the NHS. For once I stopped moaning about my own job and was extremely grateful that I do not have to cope with the stresses of working in the NHS of the twenty first century. I cannot see how the situation can improve over the next few years.
Liz Leyshon

What is the reason for the considerably large pay difference between a newly qualified nurse and a newly qualified police office? Considering these are both front line public sector jobs, does it not seem unfair also, that police officers, along with their "free travel" have an extremely attractive package compared with nurses?
Scott C Smith
Ealing, London

Having just read everybody's comments, I have to ask 'where have you all been for the last 20 years?'. These problems haven't suddenly arisen and every time there is an election you have a choice of who to believe! Nobody likes paying taxes but there is no such thing as a free lunch. If you want the sort of services that a civilised country should have, we all have to pay. But and this is the crux, the tax has to be ring fenced for the purpose for which it is given. In fact, I really believe the NHS should be taken out of the political arena and the only argument should be how much we pay towards it. There is so much interference by governments in such things as Education and the NHS, it's no wonder that it's all falling apart. The time for wringing of hands is well past and all of us have to now take some responsibility. I know who I will be voting for at the next election. Unfortunately they won't get enough votes to win yet, but at least I will have done my best to stop the rot.
Wendy Ford
St. Helens, Ryde

Your programme was accurate to a point. I was appalled at your use of the ageist word "bed blocker". Patients may be inappropriately placed in a hospital bed for a variety of reasons including lack of other facilities. Your programme concentrated on surgical shortages and "bed-blockers" and omitted the main reason for the bed crises namely the rising numbers of emergency medical cases (as opposed to surgical emergencies). Often the medical emergency patient does not require admission but all medical staff are fearful of litigation and bad press thus practising US style defensive medicine leading to inappropriate resource utilisation. You mentioned a novel scheme of GP beds at St. Peter's - there is nothing new about this. Hospitals which serve large rural populations have always had these schemes in their Community Hospitals which will be renamed as "Intermediate Care Facilities". There was no mention of the desperate shortage of medical and therapy staff who are just as important to the smooth running of the NHS and may even be able to deal effectively with your "bed blockers" who could possibly be discharged home thus saving considerable Social Service resource. I feel that with a little more thought your programme could have been far more incisive.

You should come to the North of England before commenting on the state of the accident and emergency departments in the south. They looked well provided compared to many other parts of the UK.

I am leaving A&E and nursing in 2 weeks, with much sadness after 11 years experience in the speciality and extensive training. The situation in A&E's nationally is incomprehensible. I can no longer stand having so much day to day responsibility managing an inadequate system, BUT feeling so utterly powerless to effect it. In 3 weeks, 3 senior nurses, with combined experiences of 35 A&E years have left my department, nobody has asked why, or what it would take to make us stay. Your programme reflected with effect, the huge logistical problems in shuffling patients and the long waits they endure. What another problem might show is the depth of human suffering and degradation incurred in that time and the skill of senior management in ignoring the reports of their ground force and leaving them to sink alone. Thank you for showing the nation just what it is like and for any patients who are victims of the system, please complain and complain in droves. Do not accept the system for fear of upsetting us nurses or doctors. You'll be helping in the long run.
Rachel Hudson

I am a nurse in an Acute Medical Assessment Unit, and I was so pleased to see a programme which showed the direct link between bed blocking and the problems we face finding beds for acutely unwell patients in need of emergency treatment. I have become only too aware that my senior nursing colleagues in the ward spend more time finding beds for patients than nursing! How is that an adequate use of resources. Meanwhile our registration body expects us to keep up to date, continue our education and more and more procedures which were once carried out by junior doctors are being carried out by nurses. Most demoralising of all however, is the inability to meet patients' and relatives' expectations which are usually unrealistic given the constraints on nursing time and resources. I have been in acute nursing since I qualified 2 years ago and I am increasingly wondering how long I can continue in a setting where I do not have the time to spend with patients. Trained nursing staff are only a part of this. As demands grow on us, untrained nursing staff are being relied on more and more to carry out tasks once performed by trained nursing staff. This is not acceptable, particularly as basic nursing care appears to be the aspect which suffers most.
Sheena Lawson

Alan Milburn is responsible for the NHS and Social Services, but there is still a gap between the two from the top to bottom. The lady who had to stay in St Peter's Hospital, Chertsey, was not accepted on medical grounds for admission to Norfolk House, Weybridge, which does offer a full range of nursing services, at about £500/week. The Surrey social service scale is capped at £275/wk, and I suspect that the question was "Who will pay the additional £225/wk?" In adjoining outer London boroughs, up to £700/wk is payable by social services. It costs £1,100/wk to have someone stay in St Peter's, so there is an extra cost, as well as a bed blocked. When can we expect joined up NHS and Social Services action?
Gerald Gilbert

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