Urgent hospital cases soaring

HOSPITALS are facing dramatic increases in the number of patients admitted as emergencies, according to a survey by the Labour Party. The rise is hitting routine treatment and leaving hospitals and health authorities facing overspends, writes Nicholas Timmins.

The NHS management executive is known to be puzzled by a longer-term increase in emergency admissions since the reforms in the service.

More than 50 hospitals and 20 health authorities in the survey reported financial and contractual difficulties by the end of last year and more than half of these also reporting unexpected rises in emergencies, ranging from about 1 per cent 30 per cent.

David Blunkett, Labour health spokesman, yesterday claimed that, as hospitals were completing their contracts ahead of time, family doctors were 'desperately trying to circumvent normal admissions procedures to get patients into hospital'.

A management executive paper last year, which has prompted a fuller study of the problem, acknowledged that the increase could result 'from GP tactics to avoid long waiting times'.

Also, hospitals have an incentive to charge for emergency admissions which can be paid for outside the normal contracts for routine work. But both the management executive and doctors who are studying the problem say there could be a range of other explanations - including the ageing of the population, quirks in the data, early discharge leading to more readmissions, and medical advances keeping people alive but requiring treatment.

Samples from Labour's survey show the Hinchingbrooke hospital in John Major's Huntingdon constituency, for example, reporting: 'We, like every other hospital in the region, and by all accounts many nationally, have seen a 15 per cent increase in emergency medical admissions over the past 12 months. Almost every weekday we are finding that we have almost no beds left by lunchtime.'

Queen Mary's hospital, Sidcup, reported a 10 per cent rise in emergencies as it faces a pounds 400,000 overspend, while Grimsby reported emergency admissions 34 per cent above plan. The variability round the country is shown, however, by Brighton hospitals reporting emergency admissions almost 9 per cent below plan.