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Bureaucracy is strangling the NHS

I have just completed a letter to a hospital department requested by another consultant within the same hospital.

The two doctors probably eat in the same dining room. The same consultant would not hesitate to cross-refer in a private hospital.

We are often asked to send letters which are practically the same, with the only difference being the date. This is gaming of appointment waiting times and finance.

It is also clear that people are being discharged too soon from inpatient and outpatient clinics and then need referring back. This improves performance against targets but costs more money overall to both the GP and the hospital.

There are often less obvious causes of unnecessary hospital appointments.

The chronic kidney disease targets will produce many unnecessary referrals to a renal physician. Overenthusiastic blood pressure and lipid control will also cause more referrals. The ill-thought-through withdrawal of co-proxamol will also produce many more cases of constipation and intestinal obstruction with possible fatalities and many more referrals to pain clinics.

The fundamental cause of these problems is the bureaucratic explosion in health services, both in PCTs and hospital trusts. The individuals responsible are not clinicians and lack common sense.

This Government seems intensely bureaucratic. The real saving would be to get rid of most of the bureaucrats and PCTs and go back to a sensible hospital administration. This would save a vast amount of money.

But this Government seems too died in the wool and unlikely to change. We must hope a new government will contain more graduates of the university of the bleeding obvious and more graduates of the school of common sense.

Dr G Barrowcliffe, Dronfield, Derbyshire

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