Wednesday, March 18, 2009

Third World Hospitals

Nearly three times more money, and it comes to this

We've all seen the shocking reports of disgusting conditions at Mid Staffordshire NHS Foundation Trust: lack of trained staff, lack of equipment, filth, unreported superbugs, patients left in pain, targets given priority over patient care, etc.

Commissar Johnson was on telly last night claiming it's an isolated case - another one (cf the Kent and Snuff It etc etc). But as the Doc points out:

"Every single one of the problems listed above has been covered time, after time, after time, after time by NHS BLOG DOCTOR...

Be under no illusion. What went on in Staffordshire is probably going on in a hospital near you. It may not be as bad. Yet. Or, it may be just as bad, but even now is being hushed up. Maybe you do not believe it. But one day soon, you (or more likely your elderly mother or father) will be admitted to hospital. Then you will know."

Judging from our own experience, almost everyone already knows. They're both angry and worried sick.

So one more time:
  • Stalinist healthcare has had its day - if it ever had one
  • Commissariat targeting has been a disaster - it has given us box-ticking at the cost of patient care
  • Authority must be returned to the frontline - shooting failed managers is useless if they never had the right authority in the first place
  • Customer power must reside with patients not Commissars
  • Government inspectors are no substitute for customer power - inspectors somehow deemed this hospital suitable for Foundation status despite its manifest failings; worse, the failures were eventually flagged up not by the official inspectors, but by a privately conducted statistical analysis of comparative mortality rates (Dr Foster Intelligence)
  • We need continental-style social insurance soonest - choice and competition really are the only way to drive sustainable improvement

Before Labour came to power - 12 WHOLE YEARS AGO - supporters of the NHS used to argue its third world healthcare resulted from underfunding. They pointed out that the UK spent much less of its GDP on health, so of course the results were worse.

But under Labour, NHS funding has gone through the roof. This year we'll be spending around £110bn, up from £40bn in 1996-97, an increase of 170%. Over the same period, the CPI - the government's preferred measure of inflation - increased by a mere 25%. Tyler's fag packet says that our total healthcare spending (public and private) is now running at around 8.7% of GDP, which is roughly in line with the OECD average.

Unfortunately - as we've blogged many times - much of this extra money was wasted on grandiose top-down masterplans like the supercomputer and the so-called Quality and Outcomes Framework (QOF - see the Doc's latest blast here). Costs escalated wildly, including PFI costs that will hang round our necks for decades to come.

And our hospital standards still seem to fall way below those in comparable first world countries. For example, here's a chart from the European Antimicrobial Resistance Surveillance System (EARSS), showing MRSA infection rates:

Why should we have to put up with this?

Surely it's time for Cam to recognise that more of the same - only somehow better managed - is never ever going to deliver the improvements we need. We need a radical change of direction.

And he's the man - the only man - who can deliver it.

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