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Restore the prominence of the medical ward round

BMJ 2013; 347 doi: (Published 31 October 2013) Cite this as: BMJ 2013;347:f6451

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Re: Restore the prominence of the medical ward round

Cohn's points are sound but I do not think that he is denigrating surgical
ward rounds by default.

A more sinister force may be present. This morning I woke to hear the BBC news on the wireless informing the nation that the important work of the NHS in hospitals was being prevented because of people called "bed blockers".

My consultant physician colleagues tell me that they are under pressure from managers to declare patients as medically fit for discharge and that such demands can be made as late as 2200hrs. The domestic circumstances of such patients are often completely unknown to the luckless physician and, invariably, certainly not to the junior doctors who are charged with producing a discharge document.

Elderly patients are dumped locally to facilities jointly funded by social services and the NHS at a rate cheaper than a hospital bed for thirty days and then usually discharged home.

Why do the Health Secretary and the Prime Minister believe that we have an NHS which is the envy of the world?

Competing interests: No competing interests

24 November 2013
Michael G Bamber
general practitioner
Colsterworth Medical Practice
Back Lane, Colsterworth, Lincolnshire NG33 5NJ