I understood occupancy rates used to be considered acceptable at lower levels because the need for a vacant beds margin for merely fortuitous fluctuation in medical demand quite apart from crisis was well understood in hospital administration before the introduction of ‘managerialism’. The pressure for 95 or 100% occupancy comes from the political introduction into the NHS of an inappropriate business model drawn from hotel occupancy which doesn’t need to accommodate fluctuations or crises, and the pressures of cuts. I recall health service politicians making statements about reducing the older wider margins as ‘wasteful’; the sources could probably be found. When was the period of closing hospital wards some years ago when this was so prevalent? The question isn’t the recognised trends leading to less hospital treatment in some specialisms but what fluctuation margin needed to be retained within that decline – that’s where the ‘business’ rather than medical approach has failed to meet demand.

 

As for Parkinson, that may be the case for elective surgery but how can it be for crises? People don’t have medically-certified emergencies just to fill vacant beds.

 

Dave – Wallsend isolation hospital is now Rising Sun country park studies centre.

 

John VW.

 

www.staff.ncl.ac.uk/j.veit-wilson/