Clearly the health service has remained the main political talking point both locally and nationally over recent days, and I had a very instructive time at the William Harvey hospital at the end of last week. I spoke not only to senior management of the East Kent Hospitals Trust but to doctors, nurses, and patients in A and E, where inevitably the winter pressures are most intensely felt.
From all of them the message was consistent. They have been having a very difficult time over Christmas but the main problem is not inside A and E but elsewhere in the health system. They want to move people on but either there are no beds available on the medical wards, or it is taking too long to find a suitable social care placement, or specialist mental health care.
This is the long-term answer to the question people are reasonably asking, which is how can we avoid this sort of problem recurring every winter, even when plans have been made and money has been spent as it has over the past few months. There needs to be a much faster flow of patients through the health system, which means that the various parts of it need to work much better together.
Although we all talk about the NHS as though it was one organisation, in fact the various parts of it find it difficult to work together, even though everyone involved is dedicated to doing the best for patients. The task facing NHS leaders, as well as the parts of local government that are responsible for social care, is to make the system much better integrated.
Everyone agrees that although the Accident and Emergency wards see the queues, this is a symptom rather than the cause of difficulties. However it is still the case that the number of people arriving at A and E is a vital determinant of how long the waiting times are, and what the experience is like for the patients who are there.
For example when I was in the ward the waiting time was 36 minutes, well below the four-hour target. But on the previous day twice as many patients had arrived, and the four-hour target had been breached.
The East Kent Trust is happily no longer the worst in the country in terms of waiting time, but we all know that there is more to do. The staff are stretched, but are as dedicated as ever.