[jambutty]

In days of old the motor manufacturing industry had huge warehouses full of parts for the cars being made. This was costing them a fortune so someone invented the “just in time system”. This is where the various parts arrived for use no more than a few hours or so before being needed. It seems to work well. Nobody on the production line was waiting for a part to assemble and huge warehouses were no longer needed.

But it also looks like the NHS has also been forced to adopt a similar scheme for patients.

Once upon a time most wards had a couple of spare beds all the time, that were being kept empty for emergencies from A & E. In fact I’ve been in wards, either as a patient or visiting someone, where half the ward was empty. Then someone had a bright idea. “Lets put all the spare and empty beds into one or two wards then we can close them down and save money by getting rid of some staff.” They failed to voice the bit about leaving more of the budget to pay the managers more.

Thus we now have a “just in time system” where no sooner has a bed been vacated it is filled by a new patient, usually from A & E after waiting for several hours on a trolley. Indeed there have been occasions where the situation was so critical that patients were sent home before their clinical time, just to vacate a bed. This also meant that there was no time to disinfect the bed, locker and surrounds properly before a new body is admitted.

My last visit to the A & E at BRI saw me spend nigh on 24 hours on a trolley in A & E, a good portion of the time in the corridor before a cubicle became available. The cubicle became empty just in time to admit me. No food or drink except a cup of luke warm water, until a sympathetic nurse made me a cup of cup-of-soup, which I suspect was for her lunch, to quell the rumbling noises coming from a starving stomach, that could be heard for miles around. A bed was eventually found for me but at Queens Park.

My point is, that as someone else has already mentioned, bigger is not necessarily better. Have the bean counters never heard of “Never put all your eggs in one basket”?

Could it be that some years down the line it will become easier to privatise one large hospital rather than two or three smaller ones? Think about it!