Flimflam
The National Health Report by Health Squared Communications, a quarterly review of the UK public and patients’ opinions on healthcare, has found that 73 per cent of the public does not believe there has been any improvement in NHS services over the last five years.
Half said their worst fear about treatment was contracting MRSA. Almost 60 per cent of 2,300 people polled said that hygiene was average or not good. Only 9 per cent had no concerns about the NHS.
Additional tax to pay for the NHS?
New papers released by the Smith Institute show how Mr Balls talked up the prospect of a specific tax hike for the National Health Service at a meeting held by the Institute in March 2005. Mr Balls was speaking in his final days as a paid senior research fellow at the Smith Institute.
Weeks later he began his formal political life as the Labour MP for Normanton. According to the minutes, which were posted on the Smith Institute’s website, Mr Balls told the meeting: “The very interesting thing is that, when you look in the polls and you ask people, what is the thing which defines what it is to be British, what institution defines it, people don’t say the Queen or the monarchy, they say the NHS.
“Labour did have a campaign for a year to raise a tax for the NHS and it still has 70pc public support. The interesting question is why that isn’t still part of our political discourse. I don’t know what the answer to that is.â€
Having seen a lot money go down the drain the first time around, I don’t think there is the support in the wider public for any such tax. Cleaning up the Aegean stables is a more immediate concern.
Professor Allyson Pollock is still on the case of the PFI illusion.
A study by the University of Edinburgh of the Treasury’s statements about the success of the private finance initiative (PFI) found that the evidence for the claims to be “either non-existent or false”.
Strong words there.
Researchers at Edinburgh investigated the Treasury’s claim that 88 per cent of PFI projects were delivered on time and within budget while most publicly funded projects (70 per cent) are delivered late and 73 per cent cost more than expected.
Of the five studies cited by the Treasury, they found two were based on National Audit Office reports which concluded it was not possible to judge how the procurement method affected the results. A third contained no comparative data and a fourth was withheld by the Treasury on grounds of “commercial confidentiality”. The fifth report “artificially inflated” the cost of traditional public projects, according to the Edinburgh study.
Most observers knew this but it is good to have objective proof.
Dentistry is again in the news with a suicide (never a good sign) & queues round the block to register.
In scenes more typical of the January sales, patients arrived at first light at a new practice in Titchfield Common, Hampshire. Before the doors had opened, 2,000 people had registered online and over the phone. Hundreds more arrived in an attempt to grab the 1,000 remaining places. By the time that the surgery was opened at 10am, people were queuing around the block.
One short flight to Eastern Europe & all the dental work you need. If you can afford it of course.
The OFT investigation of pharmaceutical distribution arrangements continues to receive scrutiny with comment in the FT from the corporate perspective with unrelated news of GSK’s troubles in Russia adding to the bad news.
“Preliminary investigations showed that the doctors, seeking material benefits, conducted clinical tests of the vaccines with no regard for the children’s lives and health,” they said. “The parents believed these were routine vaccinations, they were not told that new vaccines were being tested on their children.”
I have previously pointed out the weak ethical foundations of clinical trials in deprived markets.
The scandal has triggered a bout of hand-wringing in local and national media about how Russia is allegedly being used as a laboratory for questionable experiments by unscrupulous foreign firms.
The same is happening in India & other areas where the clinical trials industry is booming. Not so much hand-wringing as concern at the wilful blindness to the practical realities of conducting trials on poorly informed & desperate patients.
Patientline comes in for more stick, tinged with sympathy. The FT gets a word in edgeways.
Seven years ago the company won contracts with NHS hospitals to provide the consoles, which, at the Government’s recommendation, provided for doctors to access the proposed electronic patient record system and for electronic prescribing and ordering of X-rays, as well as telephone and entertainment services.
The additional services were intended to be integrated into the National Programme for IT, with Patientline being paid for electronic record and prescribing schemes as NHS trusts used them.
After years of delays to the £6.2 billion project (ok, so now we are talking about £25 billion), such systems are not yet online, and Patientline and other companies say that they have been forced to recoup their costs through charging patients to make calls.
But not everyone is convinced.
Patientline might cite mitigating factors. It has a millstone of debt around its neck, having invested £160 million on installing its system at 75,000 bedsides (while not being able to recoup any of this from hospital IT projects, as it had been promised by the Government). Also, an Ofcom inquiry into the dizzy cost of bedside phoning laid the blame not on gouging by the providers of such services, but on the “complex web of government policy and agreements made between the providers, the NHS and individual NHS trusts†(although it suggested that many hospitals banned mobile phones because of pressure from the companies operating their bedside phone services).
Not just in this instance but as with most other DoH contracts, knowing what you are negotiating would be a big improvement on current practice. Pie in the sky, unrealistic politically driven proposals seem to get crammed in with nary an examination of feasibility or the practicalities with damaging consequences for clinical effectiveness & patient safety. I have made my opinion clear about the ongoing Diagnostics contracts & recent events involving Atos Origin in the North West appear to be proving me right so early into the game. Not to mention today’s HSJ titbit that the Audiology contract in the Midlands is behind schedule with Mercury unable to satisfy the local clinical stakeholders. A DoH spokesman said Mercury Health had not yet shown that it could ‘ensure patient safety and high-quality healthcare for NHS patients’. Funny that, given what I know of the Diagnostics deals. Watch out for a lot more to come.
The FT looks at CfH with PACS success being claimed but also showcasing the weakness of Choose & Book. There is also the matter of the recently released BMA guidance to GPs & the ongoing contract revision negotiations to consider.
The push by supermarkets into healthcare retail territory is highlighted with a warning for the incumbents.
More Maternity services stay in the limelight with comment & analysis in the papers with also a few letters.
There is, however, a sub-plot about cost and staffing, and Patricia Hewitt, the Health Secretary, knows how to pick her words. On the BBC Radio 4 Today programme she said that a professionally qualified midwife would supervise the care of every mother who wished it. The key word in this is supervise.
I supervise registrars in anaesthesia when I am on call as a consultant, but am not in attendance all the time; indeed, I may not be in the same building. There is a world of difference between supervising labouring women and attending them.
There is that matter of course of those maternity support workers referred to by her minister of state & which found no mention in yesterday’s announcement.
I was a midwife who left the service some 20 years ago and attempted to return last year, via a return-to-practice course.
I heard that it is common for midwives to work a 12 or 13-hour night shift with one half-hour break, which is illegal, and certainly not conducive to their health or the patients’ safety.
This confirmed to me that the NHS has not changed in the 20 years of my absence, and still relies on the goodwill of its employees.
I decided not to put myself through that wringer again.
Are these the midwives that the govt plans to tempt back? Still there are also stories like this one. 17 minutes from birth to brain damage & they were not able to get it right even in the hospital. Just what chance do you have at home?
Let me help you work it out: One to two minutes to get over the panic, recognise the problem & call for help. 8 minutes minimum call out time for the ambulance to arrive (if you are lucky). You now have 7 minutes to get to a hospital where a paediatric registrar or consultant must be standing at the door to perform endotracheal suction. Oh, I forgot that the nearest paeds A&E was re-configured into one about 30 minutes away so that it could provide “gold standard care”. No, the standard protocols for respiratory distress etc don’t work as seen in the court records & no, the ambulance crew are not trained in neonatal resuscitation, especially with plans to have ambulances manned by only one paramedic & one support worker.