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Views And Reviews Acute Perspective

David Oliver: Blaming hospitals for systemwide problems will make winter bleaker

BMJ 2017; 359 doi: (Published 03 October 2017) Cite this as: BMJ 2017;359:j4553
  1. David Oliver, consultant in geriatrics and acute general medicine
  1. Berkshire
  1. davidoliver372{at}

Our increasing inability to meet the four hour target for emergency departments has been used as a surrogate for all the NHS’s ills. Stories of overcrowding, long waits on trolleys, and ambulances stacking up outside make the headlines week after week. But there have been lamentably few informed discussions in the media of the complex underlying systemic causes behind the pressures at the hospital front door.

Last week a Department of Health spokesperson said that “we have robust plans for winter,”1 in response to the Labour Party’s call for an urgent £500m cash injection.2 We can all keep calm and carry on, then?

Dangerously full hospitals, struggling to cope with demand they can’t control, are no longer just for winter but a year round phenomenon.34 But fears of …

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