The whose-fault-is-the-NHS-crisis game has taken some strange twists and turns this week, with the debate bouncing from patients costing the health service £1bn last year to Jeremy Hunt having to apologise to patients for cancelling their non-urgent procedures as a result of the increased pressures on hospitals. Political debate tends to prefer black-and-white and easily identifiable scapegoats, but the health service is too complex for that.
Take the missed appointments story. Yes, patients failing to turn up cost the health service a staggering amount. But who are those patients? It turns out that the most likely people to do what the NHS classes as a ‘DNA’ (did not attend) are new mothers with psychiatric appointments, with two DNAs for every five who did turn up. This makes it slightly harder to argue that patient laziness is at the core of the DNA bill: sure, a mother who has ended up with a psychiatric appointment is probably in great need of help, but she may be too ill to be able to recognise that herself, or too rushed off her feet because she has a new baby (which tends to rush any new mother off her feet to the extent that she delays things which would help her own wellbeing in favour of helping her newborn child).
DNAs are a particular feature of wider psychiatry for the same reasons: sick people sometimes can’t get themselves out of bed and onto a bus and into a hospital waiting room.
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