The public won’t be fooled by the government on the NHS


Last week was a momentous one for the NHS. Health secretary Jeremy Hunt’s announcement on Lewisham Hospital occupied all corners of the press.

NHSAdded to this we had the action of Lord Owen, who joined the March to save Lewisham Hospital and launched his Amendment Bill to re-instate the core principles of the NHS and protect services from marketisation.

The Labour Party and the National Health Action Party have declared their support – and in the face of the current assault on the health service by the coalition it is a much needed move from within the parliamentary portals.

To return to the outside world, now that the reality of Hunt’s decision about the Lewisham hospital #Lewishambles has started to embed itself in the national reality it’s time to cast our eyes further afield.

Not only have we witnessed the government announcing their decision to dismantle a brand new, successful and solvent A&E and accompanying acute facilities in Lewisham, but we can now see that the whole A&E system is about to be dragged into it’s very own emergency situation.

To look at the specifics: The coalition has missed its own reduced waiting time targets for the last 17 consecutive weeks, with an extra million patients waiting more then four hours.

Even worse, the ambulance back-up situation is nearing breaking point, with patients waiting for up to 11 hours in ambulances before entering A&E (moreover, I have just heard of one elderly patient waiting in an ambulance for over 18 hours).

In some regions, fewer than seven in 10 ambulance calls are reaching the most serious cases within the eight minute target – and more than 11,138 ambulances are waiting over 30 minutes outside of A&E departments.

Far from protecting the NHS – 5,000 nursing jobs have been lost since David Cameron became PM and one in six hospitals now have inadequate staffing levels in A&E – the government is plowing on with a wholesale destabilisation of the NHS and lying about it.

Tomorrow we will see the release of the long awaited Francis Report, which is sure to reveal shocking levels of maladministration and malpractice in Mid-Staffordshire Trust – which was overseen by the current NHS CEO, Sir David Nicholson.

With the pressures which the current regime are placing on the system it’s likely there will be more rather than less terrible instances like that seen in Mid-Staffs.

However, if the government see fit to try to use this to smear the NHS, they may find the public aren’t so easily duped.

This entry was posted in Public Services for All and tagged , , , . Bookmark the permalink. Post a comment or leave a trackback: Trackback URL.
  • LB

    20-80,000 people killed a year by the NHS

    Cars kill 2-3,000

    Ho hum, must defend the killers.

  • Newsbot9

    Yes, you are. You keep defending not treating the poor at all.

  • Old Albion

    Oh! you mean the English NHS ! Why didn’t you say so?

  • Mick Saunders

    Will you stop trying to give the impression that there’s a standard pan-UK NHS? We know that health is a matter that’s handled by the devolved legislatures, and that people in England pay by far the most at the point of delivery, and get by far the least bang for their buck. As you’re in the business of running a political blog, it’s your job to be as clear and specific as possible.

  • Jos

    When you say England – do you mean that patients in Scotland and Wales get better value? Indeed the Health & Social Care Act is only applicable here and it is in specific Enlgish hospitals that the A&E cuts are biting badly as the data has shown – which far from expressing the view that the NHS is standard, demonstrates that the postcode lottery is alive and well.

  • blarg1987

    And how many are in America? I accept the NHS has its flaws and been poorly managed in recent years (PFI and outsourcing of cleaning etc). But what is a better alternative that offers good value for money?

  • LB

    Well the NHS is bumping them off at an alarming rate.

  • LB

    The main structural issue with the NHS is that its insurer, supplier and regulator rolled into one.

    So, if you’re crap as a supplier, what better than to self regulate? That way, you just say you’re good. Hence Stafford. If you’re insure and supplier, what the heck, you don’t need to be efficient. Where’s the average person going to go? We can post code lottery, increase waiting lists, and deny treatment that way.

    So we need to separate supplier, from regulator, from insurer. The supplier insurers do not need to be monopolies.

    So which feature of the NHS do people fear losing if it goes? They fear being uninsured, and they fear not being able to afford the payments.

    So lets deal with them in turn. There are plenty of countries, for example Switzerland that has universal coverage. There are 3 rates of payment. Children, 18-25 year olds, and those above. Each with a fixed rate. You have to have insurance.

    Interestingly insurers can refuse to insure you. With refusals, you go to the local administrators, and they pick an insurer out of the hat, pro rata to market share, and they become your insurer at the standard cost. Everyone gets to be insured, insurers know they will get a market share of the bad risks, and not all of them. Since insurer isn’t supplier, it doesn’t affect your treatment.

    That leaves those without the money to afford health care. Same as the UK, if you can’t afford food, you get money from other people via the state.

    Last time I looked, its was 10% more than the UK, but the quality I would put at double that here.

    I’ll compare two. My brother ripped his hand between his ring and middle finger, down to his wrist. Terminator style, in that you could see the tendons working. 8 hours in A&E and they sent him home. GF got bitten by a dog on the hand, tearing the skin off the back of her hand. Friday night, in Zurich. Off to A&E. Triage nurse, then A&E doctor, then the head of A&E, then they called in an hand surgeon. The concern with injuries like this is that you get an infection, and it damages the nerves cause long term issues. They are a different order of quality.

    We need to separate out the three strands. That removes the conflict, and it drives up quality. People might also realize just what it costs too. They then use it carefully, or they drive the price down, or push for increases in quality because they want value for money.

    America is a shit system, which is why the left spout on about it. Then when they lose that, its losing the NHS means pre-Victorian surgery. Or that you won’t have hospitals without the NHS, except that most of them were set up before the NHS’s existence.

    Time to move on, and get a health system that works, rather than one that kills 20,000+ a year.

    PS, if you chop the wrong leg off in CH, you won’t be working again as a doctor in that country. In this country, literally, you get away with murder. And I’m quite serious having seen on surgeon kill off one of their mistakes.

  • blarg1987

    I think there are many flaws but one of the biggest has been self inflicted in that we have wanted more monitoring and better value for money, nurses used to treat patients and that was it, now they have more paper work then ever, matrons have been replaced by managers all in the name of efficency and accountability.

    All sysstems have a certain amount of burocracy and paper work, trouble is we have gone to far, how many times do we hear accountability during the election, the NHSS has become an ass covering exercise as things only go downhill.

    If the NHS goes back to basics and simplifies by just getting on with its job which is to treat people, not have centralised targets or makie savings but give people the treatment they need for the patients long term need then quality will rise.

    This will mean lesss paperwork which the media will scream as losss of accountability but be interesting to compare the papwer work NHS staff have to do here compared to USA and other european models I bet it is a hell of alot more.

  • Newsbot9

    Yes, alarmingly low for you.

  • LB

    Doesn’t work. Regulator is still the NHS, Supplier is the NHS. Insurer is the NHS. The need to be split.

    The US is crap, hence the left loves using it as the bogey man to scare people. Even you did, what’s the scores on the doors between the US and the UK when it comes to killing people.

    However, at least in the UK, if your bread winner is killed off, you stand a good chance of getting money from the people who killed them. Here is the victim’s family who pays the price. Have a couple of grand and run along now my dear boy.

    Heaven help if you’re maimed.

    Stafford is the norm. Expect lots more

    And back to the cash front, there are the state debts. 7,000 bn plus when you use proper accounting, instead of fantasy, Bernie Maddoff accounting.

  • LB

    The other problem, you’re deluded that its paperwork. If only we could cut the paper work. It’s not, its far more basic.

    So why do you think paperworks the issue, but if we control and put more paperwork (regulation) on business it solves things?

  • blarg1987

    I accept their needs to be a bare minimum amount of regulation, paperwork is something that has grown in many services, police is another example, where evrything must be quantified.

    There is a difference between regulation i.e. a company must ensure all its staff is safe and papwer work, i.e. you must repeatedly log every minute task you have done several times on different databases.

    Add to that the NHS is run along marketised lines of targets which you do not find in other health care systems and it is a recipe to go wrong.

  • LB

    There is a difference between regulation i.e. a company must ensure all its staff is safe

    ————–

    And the NHS that has to make sure its staff are safe, but when it comes to the patients, 20-80,000 a year killed according to their own statistics, where they contribute to the deaths.

    Initially I thought that was a misprint, but on further consideration, the 20,000 low end is certainly going to be right. Here we have one hospital, whose killed off over a thousand. We then here 5 others of the ‘worst’ cases are under investigation. There are way more than 5. I’ve direct experience of 4 people killed, one of which I would convict the surgeon of murder. Deliberate killing.

    It’s widespread. That’s with the huge increase in spending. It’s not a money issue, its back to the structure.

  • Gaz

    Why haven’t you mentioned the 1200 deaths at Mid-Staffs, why don’t you direct your lefty outrage there ? I can’t think of a better reason for reform of the NHS. It’s currently run for the benefit of those employed in it (administrators, doctors – witness the all-powerful BMA and nurses), not for patients.

  • HJ777

    You speak far too much good sense to be appreciated here.

  • LB

    Maybe.

    The question is then, why are people so attached to the NHS, and blind to its killing so many people?

    Largely, its because the NHS serves the NHS, not the public. Too many people have a vast monetary interest in keeping it that way.

    It’s not about the patients, its about the cash. Follow the money.

  • HJ777

    Yes, producer self-interest is a major factor. And nowhere is it stronger than in the NHS with its unions and Europe’s highest paid medical staff and generous pensions. The last thing they want is competition

    But much of the left also are hostile to anything that isn’t run by the state and put political ideology above evidence or the interests of the public.

  • LB

    I can’t remember where the NHS ranked in number of employees. I think it was behind the Russian army and the Indian railways

    The problem the left has is that at some point they have to ‘fess up to spending people’s pension money, and that people are going to be desitute because they can’t pay.

    http://www.ons.gov.uk/ons/dcp171766_263808.pdf

    Bottom of page 4. Now its 5,300 bn of debts, off the books.

    That’s the big herd of elephants in the room.

  • HJ777

    The left generally don’t do numbers, only ideology. They engage with numbers only to try to deceive.

  • LB

    The right too. I had one MP, Steve Baker, expend all his energy trying to find me in his electoral register so he could refuse to answer the question on how much they owe for the pensions.

    John Redwood made it an election pledge. Repeatedly pushed him since the election. He thens says, its been published, but won’t say where, and “Its not the way it works”. Hmmm.

    Well the way its going to work, is you won’t get the 20p in the pound that the state pension pays out.

    If you take a median wage earner, and back test NI contributions in the FTSE against the state pension, that 26K a year worker has lost 430,000 pounds.

    Not surprisingly, they won’t discuss the loss.

  • blarg1987

    I assume you work in the NHS from yourt first hand experiences?

    However to play devils advocate how many fall under DR at the patients request?

    I only ask as like with alot of surveys etc it is all the data not necessarily the actual number believed killed by accident etc.

  • LB

    Well, the NHS estimate is 20-80,000 a year where the NHS contributes to the death.

    Personally, I’ve known 4 killed. One I put as murder. The surgeon made such serious errors, and then bumped up the morphine dose to dispatch them. Notes disappeared, ….

    Another, friend was killed by errors, 1 week after giving birth.

    Another friend, brain dead, died 4 days latter because they intubated him for an operation into his stomach, not airway, and didn’t monitor his O2 levels even though he had turned blue.

    Next died of toxic shock after being sent home from A&E. Didn’t do a simple blood test.

    The guy I sit next too stopped a nurse from overdosing and killing his daughter with chemo drugs. End result, they shut down the ward.

    All anecdoctal, but combine that with what we know about Stafford, and all the others. They didn’t even detect the biggest mass killer in the UK either.

    However to play devils advocate how many fall under DR at the patients request?

    Not a case where errors contribute, so doesn’t get included. Oh, I get it, you want to diminish the effect of LCP, bumping people off without their permission.

    So if someone has DNR, and dies, but didn’t give permission, that’s murder isn’t it? Or if the doctor is lucky, manslaughter. So where are the prosecutions?

  • blarg1987

    It depends on who gave the permission i.e. if the patientis of sound mind and requests DNR but family do not then would that be murder if the patient is of sound mind?

    Just to clarify the friend who was brain diead was that a result of what had happened or brain dead beforehand or after the operation as it sounds a litttle confusing.

    I am not saying mistakes are not made like with organisation, question is how does it comapre with other countries?

  • LB

    Nope, it was the anesthetist who killed him. If you intubate someone for an operation, the tube goes into their airway, not into their stomach. Your chest may look like its going up and down, but that is just your stomach inflating. Your lungs get no oxygen. So you should monitor the patients O2 levels. If they drop, you know something is wrong. If they go blue, something has gone very wrong. They did neither for 4 minutes, by which time he was brain dead.

    It’s the only case where they admitted to the error. The others, in one case the family gave up after the medical tribunal which I did (the GPs also made errors, and all 4 resigned from the NHS). However, the surgeon was the real problem. His level of incompetence was the equivalent of not washing your hands.

    The others are going through the judicial process. One will cost the NHS millions. If you kill, as Newsbot puts it, a 0.1%er, you’re liable for a lot of money.

    What’s the reason for the comparison with other countries? 20,000 a year not enough? Pre LCP by the wya.

    So of sound mind, are the relatives allowed to collude with doctors to bump the patient off?

    So of sound mind, are the doctors allowed to bump them off with or without permission?

    Either’s murder in my book, manslaughter at the minimum.

    However, its the NHS, and you can’t criticise the NHS because its a sacred cow. Well one of those has been slaughtered today with Stafford, and its going to keep on coming.

    Notice that the left’s attitude is interesting, even yours, because you’re trying to distract it by roping other countries in to excuse the killing. They will go that its isolated, and a few heads at the top should roll. However, its endemic. It’s across the whole board. Remember until now, the only one I’ve seen convicted have been nurses. One who was like Shipman bumping them off for pleasure, and another who starved a patient to death. There has been one prosecution, for the case at Queen Mary’s in Sidcup.

  • blarg1987

    To answer your point directly, no. it is right to reduce deaths however to play your logic it is funny how the right are unwilling to make comparisons with other countires are they afraid in real terms that although deaths do happen in all countries due to accients, incompetnance etc that the NHSmight have the lowest per head of population? I am not saying it does but to dismiss the argument out of hand without asking that question is a little bit concerning.

    “So of sound mind, are the relatives allowed to collude with doctors to bump the patient off?

    So of sound mind, are the doctors allowed to bump them off with or without permission?”

    I notice you did not counter my point as i said If the patient is of sound mind and does not want to be recusitated should the medical sytaff be prosecuted not the above two scenarios you mentioned which are different.

  • LB

    You’ve answer the question yourself.

    What other countries do is irrelevant for the NHS. What’s relevant is why they are killing 20,000 plus a year, and what to do about it?

    1. Why no prosecutions?

    2. Why the under reporting – cover ups.

    3. Why bugger all compensation to the victims?

    4. Why didn’t they feed and give people fluids?

    ….

    http://image.guardian.co.uk/sys-files/Guardian/documents/2009/03/17/Investigation_into_Mid_Staffordshire_NHS_Foundation_Trust_Summary.pdf

    You don’t need to go overseas.

    http://www.bbc.co.uk/news/health-15897345

    Just compare the rates for different hospitals.

    Look at the low risk conditions, since that’s risk adjusted. It’s not that one hospital gets the serious cases and so has a higher death rate, because its taking the risky patients.

    University College London Hospitals NHS Foundation Trust, 0.21

    University Hospitals Birmingham NHS Foundation Trust 1.99

    Why do we need to look at hospitals in the Third world to see that there’s a major issue in the UK?

  • blarg1987

    On the countrary it is relevent you don’t say something is rubbish unless you have something to compare it to.

    How did I answer my own question All I said is that it is right to try and reduce deaths as it is right for all organisations and groups to try and improve, do you say all companies are rubbish as they are always trying to be better by reducing complaints or cock ups?

    And where did I say third world countries? I said we should compare generally like where we are world wide on list of death per head of population, unless you are admititng all other health care providers around the world are third world in comparison?

  • LB

    My guess, and I’ve no references, is that we are below the US, for people who have insurance, well below Switzerland.

    However, from the link, I’ve hard evidence that Brimingham is 500% worse than London.

    The advantage of that estimate is that it is a consistent methodology, like for like. If you start comparing different countries you don’t know if the statistics have been collected to the same standard and definition.

    So what’s you’re evidence that the NHS is a great service compare to other countries? Prove it.

    What I’m going on is UK research, NHS research, Stafford report, reports in to Maidstone, Basildon, ….

    Pretty clear from that its crap. Too many killed. Too many covered up.

    If you want one explanation. Consider airline pilots, and doctors. Who reports errors, and who doesn’t? Ask yourself why one group reports and the others don’t.

  • blarg1987

    I have no research in front of me to say the NHS is a great service copared to other countries, but at the same time you do not have the ebvidence to support that the NHS is rubbish compared to other countries.

  • LB

    But as I keep saying, its not the Health Service World cup, with prizes for those that kill the most. It’s you who want to try and deflect from the NHS being crap and killing lots of people because its crap.

    e.g. One hospital with 500% the death rate of another for low risk (ie the same risk), patients.

    Hospitals that starve people to death

    Hospitals that act as god and decide who will live and who won’t, without consultation.

    Hospitals that are cess pits of dirt to the extent that they kill hundreds.

    That’s not a health system fit for purpose.

    And what do the left say? Throw a few at the top to the wolves. It’s far deep, since its engrained in the culture.

  • blarg1987

    Hmmm nothing to do qith targets and running the NHS like a business which was introduced by the right?

    it is important to compare to other countries health systems yes these things have happened and we should do as much as possible to reduce it but if say it works out to be the same per head of population as everywhere else then it is wrong to say the whole system of the NHS is crap.

    What is wrong with comparing it to other countries or systems if they are better then surely we should take a leaf out of their book, but there again if they are worse then maybe we should not.

  • LB

    14 years of Labour. Lots of spending, and this is what happens.

    Problem is that most of the spending went on salaries and buildings, and the rest was ignored.

    Latest research I can dig up, from the BMJ, is that the NHS kills 40,000 a year.

    What’s wrong with comparing with other countries is that you’re just waving a willy trying to say, look, the NHS is great compared to Burkina Faso, [Put your own choice in]

    Instead, why is there a birmingham hospital killing 5 times the number of people as a comparable hospital for patients of the same risk?

    Why is it and has it been covered up?

    Will the NHS compensate its victims? Or do they have to take a walk and suffer?

    Why aren’t there prosecutions? e.g Tom Watson, making a fuss today about horse meat, but not about medical murder. Shows what’s important and what’s a priority. Even Cameron is playing that game too.

  • LB

    Nothing to do with targets.

    Hmmm, what’s your suggestion?

    We set a new target, by picking a country, and its all hunkey dorey if we don’t kill as many as hospitals in say, Siera Leone.

    Why not pick a hospital in the UK, and if your hospital kills more, we target that hospital.

    Like Birmingham, 500% more deaths for low risk patients compared to a comparable hospital in London?

    Basically, you won’t say anything against the NHS, which is the problem. You would rather try and say, look else where, but don’t whatever you do look at the 40,000 killed a year in the NHS, by the NHS.

  • blarg1987

    You did not read what I said or implied, I am saying that what we need to do is work out whether its a few rotten apples by comparing hospitals or if it is a system failure which means comparing other systems and seeing what they do.
    At the moment you are saying a car is rubbish because it does 35 miles to the gallon but another car by the same company does 40. But you are saying we should change manufacturer yet when the suggestion of comparing all cars mpg you say we do not need to now if I was buying a product I would be very suspicious of that sales person.

  • LB

    So why should a hospital in Birmingham kill 500% more patients with a low risk than one in London?

    ie. The same risk in terms of conditions, by 5 times as many deaths?

    40,000 a year killed by error or malice.

  • blarg1987

    Again please read my comment before you reply with yours as you are either missing the point of what i am trying to say or afraid that the alternatives could be worse and do not wish to admit to them.

  • LB

    And the way to tell if we have rotten apples is already in place.

    http://www.bbc.co.uk/news/health-15897345

    We look at the best hospitals. It’s a reasonable assumption that they are doing something right.

    We then look at those under performing, say by killing 50% more patients, for the same risk. [Same risk matters, since some hospitals, such as specialist hospitals will get the serious cases, and their death rates will be higher]

    That mean you can work out which are the bad apples. Do that, and you will see there are lots of them. ie. The evidence is in the link. It’s quite easy to see that its rotting all over.

    The separate question, what should happen is again straightforward.

    You look round the world at other health systems, and you see how they are structured and how they perform. You pick the best system going, and move the UK system to that structure.

    Now its clear, the US system is crap. So you would never pick that. It misses what I would say is a key feature, universal coverage. That means no risk selection. You don’t change people more based on their choices or their conditions. If you don’t like smoking, make it illegal. If you don’t’ like drinking, make it illegal. Or tax it.

    Then you have to separate insurer, regulator and supplier to avoid the conflicts of interest.

    Out of all the systems, the Swiss is the one that fits the bill.