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When government-run health care systems encounter difficult problems, the bureaucrats ”solve” them by imposing new regulations and guidelines. Thus, when wait times in British emergency rooms (or A&Es, as they refer to them across the pond) became a national scandal, the government decreed that no one would wait for more than four hours.
Unfortunately for the patients, this command from on high had no effect on the underlying causes of the ever-lengthening wait times. So, the only effect of the four-hour target was the creation of perverse incentives. The NHS trusts knew they couldn’t meet the targets, but they didn’t want to incur the wrath of the Government. The Daily Mail reports the result:
Thousands of people a year are having to wait outside accident and emergency departments because trusts will not let them in until they can treat them within four hours, in line with a Labour pledge.
How many?!?!
Figures obtained by the Liberal Democrats show that last year 43,576 patients waited longer than one hour before being let into emergency units.
Why are wait times so egregious? Because, in order to keep physicians from jumping ship over low pay and long hours, the Government gave GPs a little more control over the latter. This created a shortage of after-hours GP care, so patients end up heading to the A&E.
And what do the health care bureaucrats say about all of this? Why, they deny it, of course. They claim that the figures actually mean something else than what they appear to mean. In the end, however, there will probably be a special inquiry and a blue ribbon study.
We in the U.S. are, of course, not without our own ER wait time issues. And, just as they are in the U.K., these problems are caused by government meddling in the health care market. Canada’s ER wait time issue are also traceable to bureaucratic incompetence. Anyone see a pattern here?
February 22nd, 2008 at 4:32 pm
Being in the industry, and having seen numerous ER’s in Canada, and some in the U.S., gov’t meddling is not the main issue for wait times. Speak to any nurse, I do on a daily basis. They will tell you that 70% of wait times are due to the fact that ER space is being taken up by patients that shouldn’t be there. There are plenty of after hours walk in clinics, yet people still go to emergency. Why? Staffing is another issue. But these two issue’s hold true whether you are in a universal system, or the U.S. system. At least my emergency visit, as well as every other Canadian, is fully covered.
February 24th, 2008 at 10:38 am
Hard evidence is that lack of bed space on the wards is the real issue not clinic patients coming to emerg. The simple fact is that the two types of patients (ambulance vs ambulatory) go down different tracks. There is definately room for improvement and proper clinic space is part of it. Bureaucratic meddling is not the problem. It’s a funding issue and the age old question how much is too much. I’d be interested to know how long wait times are in the US if you included county and VA hospitals in the mix? Wait Times Blog