Young asthma death symptom of dying system, not doctor incompetence

Sad news as a young girl dies just minutes after being denied a GP appointment in South Wales. Ellie May-Clark, 5, was sent home for being just 4 minutes late, dying of an asthma attack soon after. With the GP issued a formal warning, and local media in outrage, blame has been laid squarely at the doctor’s feet. Although now moved to another practice, a career may be destroyed for a moments decision. The real question is why such decisions are forced in the first place.

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A system overburdened

It is no new story that the NHS is in trouble. A growing population, reduced real time funding and growing staff loss are just part of the puzzle. Old age brings greater need, and we are living longer. The basic model of care, with ‘primary services’ such as GP’s dealing with the majority of health problems, are under greater threat.  As the UK moves toward ‘Americanized’ models, a fear of privatization looms. Through repeated service failure a strong argument can be made for selling up.

A recent report by The Telegraph  found that 9/10 GP’s did not feel confident offering ‘safe care’. The study conducted by the British Medical Association found that out of 5000 GPs questioned, 60% felt their workload unmanageable.

“Many practices are being overwhelmed by rising patient demand, contracting budgets and staff shortages which has left them unable to deliver enough appointments and the specialist care many patients need.’ Dr. Chaand Nagpul said to the Telegraph.

Justified but misdirected anger

It is clear that policy makers are aware of the NHS’ problems, but so far little has been done to demonstrate a real commitment to reversing them. As the recent survey demonstrates, service provision, that is life saving treatment, is woefully underwhelming. When practitioners are so consumed with seeing patients, running late can push others back. With uncertain problems, delaying the next patients appointment could be missing a silent heart attack, stroke or worse.

Although blame cannot and should not be laid at the family, being late is a natural consequence of any public system. You cannot account for traffic, acts of god or people crossing the road. I would also argue that blame should be carefully applied to the GP, but forgiven due to the pure nature of work encountered.  Such a death is a rare event, so rare that the original Express Story  resorted to complete hyperbole and avoided the deeper issues. Moral outrage trumped deeper thinking.

In my personal opinion, the real questions should be laid at the feet of healthcare service provisioners. The problems are known and treated poorly, ironic considering the case at hand.  It is reasonable to question why more money; doctors or time was not made available before tragedy struck? What was the decision making, financial, ethical, practical?  It is clear that the NHS needs work, but work and money go hand in hand.

It is the ones carrying the purse strings that deserve the hard questions. So I say to Jeremy Hunt, Health Secretary

‘Why are you not funding the NHS enough to prevent such deaths?’

#onthehunt #nhsnotforsale

Dr Ben Janaway MBChB  // @drjanaway

Any opinions above are the author’s alone and may not represent those of his affiliations. Any comment is based on the best available evidence at the time of writing.  All data is based on externally validated studies unless expressed otherwise. Novel data is representative of sample surveyed. Online recommendation is no substitute for seeing your own doctor and should not be taken as medical advice.

 Dr Ben Janaway is a medical doctor and Editor for the online healthcare and education source ‘Mind and Medicine’.  He writes regularly for patient.co.uk and The Canary, amongst and other national news sources. He is also working on a number of literary pieces.

Contact Dr Janaway at www.twitter.com/drjanaway with stories, commissions or for discussion.

Sources/ Links

http://www.express.co.uk/news/uk/772235/girl-five-dies-asthma-attack-late-gp-appointment-ellie-may-clark

http://www.telegraph.co.uk/news/2016/11/28/nine-ten-gps-cannot-offer-safe-care-new-survey-indicates/

 

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