If NHS urgent care was a car, it would be “close to failing its MOT”, a senior health service official said yesterday.
Keith Willett, director of acute care at NHS England, said that different funding models for different parts of the NHS made it difficult for them to share out the workload.
At a hearing of the public accounts committee, he said: “If you want to take the car analogy, I think we have got a car that we all recognise is now running very hot and very close to failing the next MOT.
“For that we recognise that we have got to make more than just change the gearbox or change the clutch. We actually have to look at the whole of the car to ensure that we get it running properly.”
At the same hearing Simon Stevens, chief executive of NHS England, said that pressure on out of hours services was partly down to a lack of in-hours primary care availability, blaming the European working time directive for a lack of GPs.
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The directive, which has applied to NHS staff including junior doctors since 2004, reduces the working week to an average of 48 hours and stipulates certain break and holiday allowances.
Mr Stevens said: “One of the things we have to do is make coming in to GP training more attractive, including attractive relative to hospital medicine. One of the great unplanned consequences of the last ten years is that whereas GP numbers are up by between a fifth and a quarter, the number of hospital consultants is up by 76 per cent […]
“My personal point of view is that one of the things that has driven that is the way the European working time directive has been implemented. It has had the effect of sucking doctors into hospitals to create legal rotas and to some extent training has been the tail that has wagged the dog.”