Doctors' leaders warned yesterday that the medical profession was falling into a state of "clinical depression" as it struggled to provide proper care for patients in an overstretched NHS. Ian Bogle, chairman of the British Medical Association, said it was no longer accurate to talk about a winter crisis in the health service, because problems of under-capacity and overwork continued all year round.
Reporting on the association's council meeting on Wednesday, he said: "The mood was one of despair and powerlessness to influence what is going on, because of not having the workforce or capacity." The condition of GP representatives could best be described as "clinically depressed".
Dr Bogle supported the government's NHS reform plan in July and was present in Downing Street on Monday when Tony Blair launched a winter planning strategy for the service. But his members have become increasingly disillusioned by the speed at which extra resources earmarked for the NHS can be translated into a better service for patients.
The BMA published results of a Mori opinion poll showing the proportion of the general public satisfied with the NHS fell from 72% in January 1998 to 58% last month.
When asked who or what was most responsible for the current state of affairs, 44% of the unprompted replies referred unspecifically to "the government", 20% to "the Conservative government", 11% to "the Labour government", 16% to NHS managers, and 2% to doctors.
Dr Bogle said: "The message from the public is clear. Despite increased spending on the NHS, politicians in this government and the last have failed to fulfil the public's expectations. People see doctors as the solution, not the problem."
Ten years ago GPs could almost have guaranteed finding a bed for their patients, but now most hospitals were permanently full. In some regions hospitals were forced to cram too many beds in smaller wards, leading to increased risks of infection.
Dr Bogle said it was commonplace for GPs to avoid sending patients to hospital when it would have been advisable to do so if a bed had been available.
GPs preferred the risk of possible censure by the General Medical Council for unsatisfactory treatment to the certainty that a trolley wait could do even more harm.
The BMA council heard of patients in Leeds being transferred to Nottingham to find intensive care beds. A patient needing orthopaedic treatment had been told the first available appointment was in September 2002.
Dr Bogle said hospitals were buying "trolley beds", a cross between a trolley and a bed, for patients waiting admission. It sounded "like a scene from Monty Python", with hospital managers claiming they had reduced trolley waits by putting people on equipment that looked like a trolley, but counted as a bed.
The Department of Health said the BMA had misinterpreted the opinion poll. It showed 58% satisfied with the NHS, compared with 28% dissatisfied. The satisfaction rating was higher than when the government came to power in 1997.
"The government and the BMA agree that the main problem in the NHS is capacity - not enough doctors and nurses. We are making progress, with over 4,000 more doctors since 1997 and many more nurses," a spokesman said.
The NHS Confederation, representing health service managers, said the decline in satisfaction reflected what people heard from the media and politicians, not the experience of recent patients.
"Doctors should be bringing forward proposals for improving practice rather than wringing their hands about shortages of staff that we all know exist, but can do nothing to rectify in the short term," said Nigel Edwards, its policy director.
• The Mori poll was based on 2,000 interviews throughout Britain in the last week of November.
