ModernityBlog

“Nearly all men can stand adversity, but if you want to test a man’s character, give him power.” Abraham Lincoln

What Tory Reforms Did To The NHS

with 5 comments

Readers with a longer memory than most will remember the changes instigated by the Tories into the NHS.

The BBC highlights the consequence of internal market reforms, vulgar statistics and a management more concerned with pounds and pence, rather than patients:

“The trust had been climbing the NHS ratings ladder during the period in question and was even given elite foundation trust status.

The Mid Staffordshire NHS Foundation Trust Independent Inquiry site.

“The evidence gathered by the Inquiry shows clearly that for many patients the most basic elements of care were neglected. Calls for help to use the bathroom were ignored and patients were left lying in soiled sheeting and sitting on commodes for hours, often feeling ashamed and afraid. Patients were left unwashed, at times for up to a month. Food and drinks were left out of the reach of patients and many were forced to rely on family members for help with feeding. Staff failed to make basic observations and pain relief was provided late or in some cases not at all. Patients were too often discharged before it was appropriate, only to have to be re-admitted shortly afterwards. The standards of hygiene were at times awful, with families forced to remove used bandages and dressings from public areas and clean toilets themselves for fear of catching infections. “

However, I suspect that those useless feckers in New Labour won’t learn anything from this, and will re-hash more Tory drivel rather than do away with those awful internal markets and the poverty of thought that drives this type of thinking.

Update 1: The Guardian reports:

“About half of the patients and relatives who gave evidence to the inquiry singled out difficulty in obtaining food and drink as a major concern. Some patients never received food at mealtimes; some who did found that it was placed too far away for them to reach it and so was removed, untouched.

Intake of food and water, both vital to recovery, was not encouraged. “Frequently the explanation appears to have been a lack of staff but sometimes staff were present but lacked a sufficiently caring attitude,” the report said.

Breaches of patients’ privacy and dignity included patients left inadequately dressed in full view of passersby; patients moved and handled in unsympathetic and unskilled ways, causing pain and distress; and rudeness or hostility.

“However difficult the circumstances, there is no excuse for staff to treat patients in the manner described by some witnesses,” Francis concluded.

Staff were equally critical about the hospital’s management, and described bosses who bred “an atmosphere of fear of adverse repercussions”, stressed NHS targets were the top priority and were secretive when things went wrong.

The trust’s board, which was meant to hold managers to account and ensure high clinical standards were maintained, were aware of the weaknesses but failed to ensure improvements were made, the report says.”

Update 2: The Press Association coverage:

“The inquiry concluded that the trust’s board – which exacerbated its problems by cutting staff to save £10 million in 2006/7 – was “disconnected” from what was actually happening in the hospital.

Mr Francis said “the scale of failure” was greater than has been revealed to date. While he concluded that Stafford Hospital should not be closed, he recommended that Health Secretary Andy Burnham review whether to remove Mid-Staffordshire’s status as a foundation trust – a supposed marker of excellence in the NHS.”

Update 3: Over at the Torygraph:

No one on the board at Mid Staffordshire NHS Foundation Trust has faced censure and all of them were either paid off, walked into another job or allowed to remain in post. The man who ran the hospital trust received a large pay-off despite his part in the scandal.

Martin Yeates, the former chief executive, left the trust “by mutual agreement” with a pay-off of £400,000 and a pension worth £1.27 million, it has been alleged.”

Update 4: The Guardian again on the tick box culture:

“The BMA chairman, Hamish Meldrum, said the inquiry pinpointed a “culture of fear” in some hospitals that prevented clinical staff from reporting lapses in standards of care.

He added: “The fact that Mid Staffordshire NHS foundation trust was more focused on meeting government targets, achieving foundation status and saving money, demonstrates very clearly what happens when financial pressures and a tick-box culture are more important than delivering high-quality patient care. I call on the government and all hospital managers to learn the lessons from Staffordshire and to put patients first.””

Update 5: Few case histories and medical understatement:

“When her son left her that night he remembered that she looked bright and well.
The following day she seemed unable to use her arms. The next day she became extremely confused. There was gauze on the back of her head, and a bandage. After the family demanded an explanation, the ward sister said that their mother had fallen during the night. They had found her nightdress in the bedside cabinet and when they got home discovered it was “saturated in blood”.

The following night Mr Bunn received another call to tell him his mother had suffered a further fall, and he was asked to come to the hospital. “My mother was lying… full stretch out on the tiled floor,” he said. “Some effort had been made to remove the blood. It was smeared all over the floor. You could not see a hair on her head. It was completely swathed in bandages. There was a lady doctor holding my mother’s head in her hands.”

Mr Bunn recalled saying, “Oh Mum, what have they done to you…” to which the doctor replied coldly: “I have got a mother too.” The son later remarked: “There was no compassion in that woman whatsoever.”

His mother was sent for a scan. She had a huge bleed on one side of her brain and her brain was swollen. The doctors told the family it was impossible to operate, and that if she regained consciousness then she would not be the same.

Mr Bunn then learnt that his mother had suffered a further previous fall that he had not been made aware of, and a doctor said to him: “We have let you down.”

Update 6: Over in Wales the BBC reports:

“The seven new health boards which run the NHS in Wales are set to go more than £43m over budget, according to research by BBC Wales.

Six are forecasting a deficit for the end of their first financial year, with all under pressure to make savings.

When they were set up in October 2009, Health Minister Edwina Hart said that they “must live within their means”.

The boards control all hospitals and community services, GP and dentist funding.

The new boards were created by integrating the 22 old boards – set up in 2003 based on council boundaries – with seven NHS trusts which were then running hospitals.

The new boards are responsible for deciding which treatments and services are available and they also have responsibility for ensuring hospitals meet targets on waiting times.

LIKELY NHS BOARDS OVERSPENDS
Hospital worker (generic)
1 Betsi Cadwaladr LHB – Conwy, Denbighshire, Flintshire and Wrexham, Anglesey and Gwynedd – break even
2 Hywel Dda LHB – Ceredigion, Carmarthenshire, Pembrokeshire – £12m
3 Abertawe Bro Morgannwg University LHB – Swansea, Neath Port Talbot, Bridgend – £3.9m
4 Powys Teaching LHB Powys county – £7.6m
5 Cwm Taf LHB – Rhondda Cynon Taf, Merthyr Tydfil – £4.8m
6 Cardiff and Vale LHB – Cardiff and Vale of Glamorgan – £5.5m
7 Aneurin Bevan LHB – Blaenau Gwent, Caerphilly, Monmouthshire, Newport and Torfaen – £10m

Research by BBC Wales into the latest combined financial position shows the seven boards have a running deficit of around £67m, which they forecast being able to bring down to £43m. “

5 Responses

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  1. The smooth managerial types will not be punished. At most they will get a smack on the wrist, which they will ignore with an amused sneer.

    I think the NHS is doomed. Who trusts it, anymore? We all have horror stories, although not to that sort of degree.

    Think also about the numbers. The NHS costs £100bn. There are around 25 million economically active people in this country. Divide one by the other and you get £4,000. That is an awful lot for each of us to pay for a “free” health service, each and every year. BUPA (whom I do not recommend) costs £500 a year if you buy it personally, and in fact companies do a deal with them for rather less.

    Now of course there are all sorts of factors that make it rather less simple than that. But it’s surely indicative.

    Likewise most people who can afford it are now buying private medical insurance, out of their post-tax income. Why? Because otherwise you simply do not get treated for anything but emergencies under the NHS (personal experience). You’re left to faff around for weeks and months, waiting for this “consultant” and that “test” until you die or snap and buy private care. People who are paying twice naturally ask “why” — at which point the NHS is doomed.

    The whole system is screwed. What is the answer? Well, I don’t know. But we won’t get to a solution until we address the problems honestly.

    Roger Pearse

    25/02/2010 at 15:02

  2. This was failure on such an epic scale that I think you can overlook the abdication of basic human decency.

    I don’t care how oppressive the tick-box regime is, or how afraid you are of the boss, if you see a sick fellow human being unable to feed themself and you leave their food out of reach, how can you consider yourself a caring person, never mind a healthcare professional?

    WTF was going on in people’s heads – management and front-line staff – that they could lose sight of this? Why weren’t all the staff whistle-blowing? Were they really more concerned with the monthly paycheck than the humanity of the people they were supposed to be caring for?

    If all you do is shrug and say ‘there’s nothing I can do’ when you see something this terrible at work, you are straying dangerously close to ‘I was only following orders’ territory.

    Julia Smith

    25/02/2010 at 15:27

  3. Your questions are mine. This was murder, of a heinous kind. Why are the management not in prison, awaiting trial? Why are the board not in prison? Why are the consultants? Why isn’t every single person in any position of authority whatever before the courts?

    If we were in the US, a class action against the hospital would be possible. We need that form of legal action here in the UK, to give ordinary people power over these types.

    Roger Pearse

    25/02/2010 at 20:39

  4. Roger, I’m wondering about some kind of corporate manslaughter case. They are incredibly complex and difficult to put together, but if this doesn’t provide grounds then I’m not sure what can. I need to look into it more though!

    Julia Smith

    26/02/2010 at 13:52

  5. I don’t know, myself.

    Roger Pearse

    26/02/2010 at 14:53


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