Airlines the paragon of virtue on safety?

Airlines the paragon of virtue on safety?

It's common for certainly amateur commentators on patient safety to say that since airlines wouldn't fly without the correct number of crew, wards that are understaffed should be shut (although unlike aircraft, no one can put an exact figure on the minimum number of staff in a particular ward). This is such a ridiculous notion, it doesn't warrant too much time analysing it - it's not as if these wards can eject their patients the moment they are one member of staff down. It's also not a valid comparison, like for like.

Why is this? The cost-critical aspects of commercial aviation are space and fuel, not staff. This is not the case with healthcare, with staffing the major cost. Space is at a premium in an aircraft - we all know how cramped it is in economy. However, does this have a safety implication? Yes, it does - the risk of a deep vein thrombosis and subsequent pulmonary embolism is now well recognized. The magnitude of these risks were suppressed in the early days by airlines. The other main cost is fuel, which largely reflects the weight of the aircraft (for a given aircraft) and we all know that excess baggage is expensive, and this is because it requires extra fuel. The precise amount of fuel is calculated so that there is no excess weight. Of course there is a margin built in case of a diversion, but still that margin is not massive. 

Knowing that weight and fuel economy are crucial, we understand why expense on hi-tech materials in aircraft make big savings in the long term. Likewise, the NHS should be investing in technology that frees up staff for the important tasks by reducing paperwork where possible.