‘Correlation is not causation‘, I’m going to say, among some other things but first from the Herald today:
Another piece of bottom-feeding for the Herald’s Health Correspondent, Helen McArdle, fed by the Conservative Shadowy Health Secretary Sandesh Gulhane.
McArdle is not entirely devoid of principle, just mostly, and her struggling wee conscience lets this chink of light in:
So, A&E waiting times are longer and more folk are dying in A&E but though those two things seem intuitively to be meaningfully connected, no one can say, credibly, that more are dying in A&E because more are waiting longer there. As for the ‘associated’, what on earth does than mean and what’s the source, a trade union?
As McArdle admits, many, who knows what proportion, because we do not have the evidence, could not have been saved anyway.
It’s possible that more are dying in A&E because staff are trying harder and longer, maybe with new procedures, to save them.
It’s possible that more are dying in A&E for other reasons that I feel sure some readers will have a view on.
Finally, looking back at A&E waiting times in 2022, how did NHS Scotland compare with NHS England under Sandesh Gulhane’s party, the UK Cons, or for that matter, under Labour in Wales, or direct rule (Con), in Northern Ireland?
From December 2022:
In Scotland, during October 2022, 67.6% of attendances at A&E services were seen and resulted in a subsequent admission, transfer or discharge within 4 hours.
In October 2022, NHS England A&E departments saw only 54.8% of those attending within 4 hours. Barking, Havering And Redbridge University Hospitals NHS Trust saw only 33.6% within 4 hours.
NHS Wales data is presented so as to conceal the performance of the major departments comparable with those elsewhere in the UK, but after some adding up and dividing, I get 56.7%, slightly better than NHS England.
For Northern Ireland, the figure is a shocking 45.2% and has been under 50% for more than a year now.
NHS Scotland A&E services are thus 23% better than in England and 49.5% better than in Northern Ireland
Sources:
Talking-up Scotland 'Albatraz' 
McArdle and Gulhane what a miserable life they lead , their relatives , children , will find out about their desperate misdeeds for political party propaganda a future of desperate depression awaits them.
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Indeed the SAME Tory branch office shadow ‘minister’ as in one Sandesh Gulhane, who was ‘called out’ by MEDICAL EXPERTS on his negative and misleading claims on the effects the minimum pricing measures on alcohol, by the Scottish government , were having on reducing alcohol harm.
SNP policy….oh well the first instinct and response HAS to be negative surely…rinse and repeat….meanwhile those members of the public impacted are mere ‘incidental victims’ …fodder even….of that same old same old opposition to all policies that prove to be effective via the Scottish government that, as an ill judged and purely partisan opposition, are then amplified by the opposition’s client media …..
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“Over the past five years”? Can McArdle spell Covid-19?
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Covid and an increased elderly population. The BBC unionists and statistics. Just nonsense. Rubbish at maths and reporting. Elementary maths and sense. Labour mafia in Scotland. The BBC nonsense.
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Covid. The (unionists) health boards would not let Doctors go out to attend to patients in waiting ambulances. Precautions. Did it save or cost lives?
Covid US/Chinese creating viruses to wipe out people. Malicious. Wuhan Clinic financed by US. Costing £Trillions.
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There is a lot that is ODD about The Herald’s amplification of the Tory Party’s big reveal that links increasing waits of over fours in A&E in Scotland and deaths occurring in the subsequent 24 hour period. The article reports that the annual number of deaths has increase from 281 in 2018 to 743 in 2022.
The Herald journalist acknowledges that:
(i) ‘The deaths were not necessarily avoidable’ – presumably this means that evidence of a causal link is, let’s say, tenuous, prompting the thought – what merits the publication?
(ii) ‘research shows that A&E delays are associated with increased risk of death within 30 days.’
Candidly, the latter reference in the context of this Tory inspired article is an unworthy conflation of quite different things: a deliberate ploy (by a specialist health journalist no less) to misinform?
To explain: the data obtained by the Tories refer to 24 HOURS AND NOT 30 DAYS. The most widely circulating research on the matter is that from the Royal College of Emergency Medicine (RCEM) and it is based on especially LONG WAITS OF EIGHT TO 12 HOURS OR MORE NOT JUST WAITS OF OVER FOUR HOURS. Indeed, the article actually refers to details of the RCEM research: ‘’Research by the Royal College of Emergency Medicine (RCEM) has previously estimated that there were 765 excess deaths in Scotland during 2022 as a result of people waiting eight to 12 hours in A&E.’
Taking the RCEM’s estimate at face value – and not all do – did the journalist not for a moment question how the RCEM’s 2022 figure of 765 deaths WITHIN 30 DAYS as a consequence of 8 HOUR OR LONGER WAITS had become in the Tory view 743 deaths WITHIN 24 HOURS associated with (just) OVER FOUR HOUR WAITS?
And then to compound matters which SHOULD have prompted a sceptical thought by a professional journalist, we are told that the following large health boards DID NOT PROVIDE ANY DATA to the Tory Party – Ayrshire and Arran, Grampian, Greater Glasgow & Clyde and Highland – whilst the RCEM’s claim by contrast is BASED ON AN ANALYSIS OF THE TOTALITY of A&E waits in Scotland.
So the Tory contention amplified by The Herald – based on a partial population of A&E attendances and using a lower waiting time benchmark and a much shorter post-A&E time frame than the RCEM – arrives at a mortality figure for 2022 that is 97% of the RCEM’s much more expansive statistic. How to explain this? Has the RCEM got this so very, very wrong? Perhaps The Herald can sort this out in advance of using RCEM research evidence again or alternatively, before amplifying Tory ‘gifts’ to The Herald again?
The Herald does provide this: ‘’Dr John-Paul Loughrey, RCEM Vice President for Scotland, said: “While it would be wrong to conclude that all those people died directly because of the time they waited, long stays and extreme delays are shown to be associated with excess mortality.” Note “long stays” and “extreme waits”: these parameters are NOT THE EQUIVALENT of the Tories’ benchmark of over four hours.
Oddly, The Herald itself provides information that may further indicate that something is amiss with what it is amplifying for the Tories:
– ’the number of patients actually dying whilst in A&E departments appears to be roughly stable, or falling’
– ‘In NHS Lothian, the total number of patients dying in emergency departments – REGARDLESS OF HOW LONG THEY HAD BEEN THERE – fell from 233 in 2018 to 94 in 2022.
I repeat, did The Herald’s health expert not pause and reflect on any of this? Or was the attraction of the Tory’s ‘gift’ to the paper to use against the Scottish Government just too good to resist?
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50,000+ people die in Scotland each year usually after a long? and ‘happy’ life. 218 is not major increase. Covid. Viruses created by UK/China. Wuhan. Ruining the world economy.
Covid is a factor in a higher death rate, which will stabilise over time. Less deaths the next year %. 79 life expectancy. Highest life expectancy 85 Japan. 84 Spain. Women outlive men by 5 years on average, worldwide.
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On top of Stewart’s salient observations on the distorted basis of the article, and patziwinter observing the 5 year period spanned Covid, when Legerwood highlighted the article, it was accompanied by “…presumably they were getting treatment during that ‘long wait’ “.
The false projection of ‘nothing being done’ during “waiting times” is the most insidious aspect of this propaganda game – Monitoring the patient will make up a large proportion of those on ‘long waits’, even those sleeping off inebriation at A&E of a weekend will skew the data.
Gulhane criticises SG on data over which they have no control, arising from decisions by medical experts on how long they should monitor the patient.
Should a heart-attack victim simply be chucked out when they’re breathing regularly again, without awaiting observations from the cardiologist who comes in in 9 hours or tomorrow ?
Then there’s the RCEM ‘analysis’ – However interesting the study, the effects of the pandemic and rise in heart complications is ignored by the media.
I’d be willing to bet the majority of those waiting 8 hours or more were being monitored because they were at greatest risk of death, viz heart complaints – Treatment can minimise the risk of further heart attacks, but it cannot prevent them – That 765 died within 30 days may be statistical fact, but it does not make it a tool by which to predict death by dint of long “waiting time” for this or other reasons.
It is beyond time politicians and media were told to stop playing stupid games over peoples’ health.
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I think you are getting to an important point in this post. If someone presents at A&E with a serious condition and treatment begins promptly, to stabilise the condition, it might well be unwise to move the patient from A&E during this period. This is a possible reason for the stay in A&E being greater than 4 hours. However, when discharged to another hospital department, because the initial condition was serious, there is probably an increased risk of dying despite being in a specialist department.
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