Well there can be no denying that winter has arrived, and with the disruption facing the delivery of mail as a result of the inclement weather, it is quite possible that you may only be reading this well into 2011. What certainties is the New Year likely to bring our way? VAT will increase, and public spending will decrease, and the phoney economy in the NHS will continue to squeeze everyone where they can least afford it. In anaesthetics, despite our undisputed contribution to the running of vital hospital services, from A&E to ICU, from high revenue generating elective surgery to invaluable support through Critical Care Outreach on every ward in the hospital, we will remain to every department in the hospital, an expense. We appear next to equipment, drugs, etc on their balance sheets as a monthly expense, a costly service that can be scrutinised, earmarked for pruning, perhaps even considered for out-sourcing, or erasure altogether. Despite being indispensable to something like 60% of a typical hospital's income, because of the way healthcare delivery is structured, and the illogical way income filters through a hospital, anaesthesia to a manager is merely a financial liability.
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