Efficiency versus capacity in intensive care

Conservative politicians claimed yesterday that there are not enough intensive care beds in the UK to cope with the surge in demand that may occur over winter if the flu pandemic re-emerges. They have called on the government to increase intensive care capacity.

But there is a problem. The only way to ensure that resources such as intensive care are able to cope with large surges in demand (such as that anticipated with a major flu pandemic) is to build in significant redundancy. It means that units need to have more equipment and staff than they need to cater for normal demand. Staff is the biggest limiting factor to increasing intensive care capacity, and difficulty in finding enough staff makes it difficult for many units even to meet usual levels of demand.

But if we assume that such practical problems can be overcome, the call for increased capacity comes at a cost of efficiency. It means that intensive care units have to be less efficient than they are at present, something that administrators and politicians may find difficult to accept in the current economic climate.

Medical services are usually designed to cope with the normal fluctuations in demand that occur. But should we build into our medical systems the capacity to cope with extraordinary surges in demand. If so, which other medical services will we decide not to fund or provide, or alternatively are we willing (are conservative politicians willing) to allocate more money to the heath budget?

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