Gina Davidson: It’s going from bed to worse . .

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FOR the mother who had spent hours sitting waiting for her baby to be whisked into theatre to undergo a traumatic brain operation, to hear the news that the operation had been cancelled was met with a mixture of relief and disbelief.

All that mental and emotional preparation she had gone through, readying herself for the moment when her daughter would leave her care and lie anaesthetised on an operating table to have her skull removed, reshaped and replaced, all to ensure there was room for her brain to grow, it was all for nothing.

Hours went by while the two surgeons due to perform the ground-breaking operation waited to hear if there would be a bed for the tot to recover in. There was not.

For want of a bed, their day was lost. The theatre staff’s day was lost. A theatre was out of use. And the courage summoned by the mother to put her child through such an event was lost, too.

It was an emotional moment on the recent BBC2 Brain Doctors television series which put the work of neurosurgeons at Oxford’s John Radcliffe Hospital under the microscope. What they did there was little short of amazing, but that one moment highlighted where the NHS is going wrong.

For an operation to be scheduled but not in the secure knowledge that a recovery bed was available surely defeats common sense. It meant a day of expensive time vanished through the inefficiency of the system, although the surgeon seemed to accept this as the way it was and indeed claimed that having empty beds would in itself be inefficient.

I’m not sure that mother – who had to wait a further six weeks for the operation – would have agreed. Surely if an operation was planned a bed should have been made ready?

In an earlier episode, a man left paralysed by a virus which attacked the white matter of his brain was nursed back to a full recovery. Yet during their care for him they, too, had to fret about a lack of ward beds.

While the Government is busy taking a sledgehammer to the beds of those in receipt of housing benefit by refusing to pay enough if it feels people have more bedrooms than they need (who cares if you’re an emergency foster carer, need full-time care yourself, or are a divorced parent with a child who just stays weekends?) another taxing issue around beds is within our hospitals.

Earlier this week, this paper revealed that patients in A&E at the Royal Infirmary were getting “stuck” there for up to 12 hours. The Government target to get in, be seen and get moved on is just four hours.

The problem is not that patients were not being treated by staff – though the shortage of nurses means that waits can at times be longer than necessary – but that there was 
nowhere for those who needed admitted to go. No beds.

It was highlighted by Unison long before a single brick of the new ERI was mortared that this would be a likely problem. The hospital would be too small for a city with an expanding, ageing population.

Twelve years ago, a general surgery consultant at the old ERI, Simon Paterson-Brown, told how 20 operations a week were being cancelled because of a lack of beds as between ten and 20 per cent were being “blocked” by elderly patients with nowhere to go. In 2004, two years after the new ERI opened, the situation was worse as the number of hospital beds in the Lothians had shrunk by 26 per cent.

Even now, despite all the money injected into the NHS by the Labour government, despite the new council care homes being built in Edinburgh, there still are not enough beds.

Last year between April and June, an average of 7.3 per cent of NHS Lothian beds were occupied by patients who were fit enough to leave, but there was nowhere for them to go and still receive the care they required. In those three months, 24,779 bed days – or 270 beds each day – were lost.

To give it credit, NHS Lothian is attempting to deal with the problem. Around 70 new beds are planned for the ERI by summer and the Royal Victoria has had wards reopened to cope with the demand for beds by elderly patients, who may still believe that recuperation in hospital is part of the NHS package.

But with an ageing population the pressure on the NHS is only going to continue to grow while public finances get tighter. The two basics – bed and staff numbers – need to be funded at least to the extent that winter viruses can be dealt with without general operations having to be cancelled.

The Scottish Government loves its free social care for the elderly package, especially as nothing like it exists south of the Border. It holds it up, quite rightly, as an example of a Scotland which is socially just, which knows how to treat its old folk.

It is a great policy, but when times are tight should it be universal? When councils are dealing with a council tax freeze it means fewer resources can be spent on care packages, so more elderly people have to stay in hospital. It’s impossible to have it both ways.

Ultimately, the policy could well become a real bed tax for our hospitals. Something has to give – and it can’t just be the bed springs.