Doctors claim four-hour A&E target is putting patients at risk

Monday, 14 March 2005 12:00 AM

Patients are being put at risk by the Government's target that all accident and emergency patients should be seen within four hours, according to the British Medical Association (BMA).

Its survey reported that 80 per cent of trusts said there had been clinical problems associated with target pressure.

Fifty-two per cent said that patients had been moved to inappropriate areas or wards, 40 per cent said patients had been discharged prematurely, and 27 per cent said that care of seriously ill patients had been compromised.

But, the BMA said that 97 per cent of patients were being seen, treated and discharged within four hours - in line with the Government's target, but that the pressure was leading to clinical problems.

Donald MacKechnie, chairman of the BMA's A&E committee, said: "A&E doctors, nurses and support staff have all been working exceptionally hard to meet the Government's four- hour waiting time target despite an overwhelming increase in attendances. Our survey shows that waiting times for patients visiting A&E have significantly fallen since 2003 and this is a fantastic achievement.

"But I am appalled to hear that some A&E staff are being put under intolerable pressure, even bullied, by their trusts as they attempt to treat and discharge patients within four hours. It is absolutely right that patients visiting A&E are seen and treated as quickly as possible but not if staff are being forced to make inappropriate decisions and patient care is any way compromised."

Health Minister John Hutton said the survey gave a deliberately distorted picture and that any doctors with concerns should take them up with hospital management.

Mr Hutton, said: "This BMA survey gives a deliberately distorted picture of the changes that have taken place in A&E Departments. NHS patients tell us that A&E is better than ever."

He added: "If any doctors have genuine concerns about patient care or fiddling of figures, they have a clinical duty to take them up with their Medical Director or chief executive, or - failing that with their Strategic Health Authority or the Department of Health. To date we have received no formal complaints. If we were to receive specific concerns, we would investigate them immediately."

Mr Hutton said A&E services were "unrecognisable" from a few years ago and pointed out that the BMA signed up to the four-hour target in 2000 and had raised no formal objections.

But Shadow Health Secretary Andrew Lansley said the report showed that though staff were working hard, the system was failing them and patients.

Saying today's report is a "damming indictment" of the current system, Mr Lansley added: "It shows that money specifically provided for A & E departments isn't getting through. It shows that patient safety is being compromised by the requirements of a Government imposed target that has no clinical basis to it."

He said the Conservatives would abolish all targets enforced on hospitals.

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