Riches galore
Of embarrassing material to write about that is, what with the report on neonatal services, the shortage of obstetric care services, the announcement of the Tooke Review though it tries to lay the blame on overseas doctors, the interim Darzi Report (with its £250 million for the procurement of GP services & polyclinics - anyone smell a large contract on the way?) & of course the elephant in the room, Maidstone!
As I roll up to work in my now officially recommended short sleeved shirt (and jeans that are not, recommended that is, have been wearing both for years, non-conformist that I am), what I think about politicians & the senior management of the health service would land me in a lot of trouble if written down. Actually it has been, though in not so many words & I’m sure I have lost out commercially as a result. Well, am not one to care, so will continue shining light on dark corners.
One of the prime duties of a manager is to say no when appropriate. But the simple fact is that too many people take the path of least resistance to asinine diktats from those above them in the pecking order. “I was only following orders” did not work at Nuremberg & there is no reason why it is acceptable here though I notice that the rules are being redefined at Haditha & Abu Ghraib. And when the lines of accountability are so diffuse that it is difficult to pinpoint one person or team for specific failures, you will have the same situation repeated throughout the land. Things must be really bad if the Economist calls for more regulation & compares the relatively larger (60 times larger for an industry double the size) regulatory capacity in the USA favourably with that in the UK. Sacrificing the odd chief exec & withholding their severance pay is a joke.
LIKE Agatha Christie’s “Murder on the Orient Expressâ€, a whodunnit in which clues implicate all the main suspects, investigations into the sad tale of Northern Rock are turning up so many potential culprits that no one of them, it seems, can be held responsible for Britain’s first bank run in more than a century. On October 9th lawmakers quizzed Sir Callum McCarthy and Hector Sants, the bosses of the Financial Services Authority (FSA), Britain’s financial regulator and supervisor of its banks. With public money underpinning Northern Rock, parliamentarians wanted to know who had let the bank get into such a sorry state, and who managed its bungled rescue. Instead they were led on a merry dance through the Kafkaesque world of bank supervision, in which fiasco marks success, no one is in charge of anything and the net of culpability is cast meaninglessly wide.
This could also have been written for the health service or indeed any other large govt department. DEFRA comes to mind with its handling of the Foot & Mouth crisis.
Maidstone came to light because they were put under the spotlight. Do the same to any other trust & you will find similar results, though probably not on such a scale. But when you are dealing with a hospital that is running at 110% occupancy, where ambulances queue on a daily basis to offload people but the AE dept breaches the 4 hr limit (!!@*&%*$*%**£*£) a few times a day and the managers are running around like mad trying to find beds for these patients, where the doctors struggle to do the basics before the patients are pushed to a ward in the outer reaches of Mongolia, where every shift is at-least a few nursing staff short (from an already stretched roster) & not infrequently short of doctors too & where there is no money for training but where the PCT was keen to close the hospital down to cut beds last year in order to save money & this year having magically found a few million that puts it in the black is now keen to stick to the status quo but not fund any improvements that would help the hospital run like mad to keep its place on this mad conveyer belt, then you might begin to think like I do. And this is just from an A&E that I occasionally help out at. I could go on about the rest of the place but it is early & I don’t want to have a cloud over my head for the rest of the day.
“Seek & you shall find” is right but just how much appetite is there for a search party?
10 years of misdirected funds, of spending levels that do not even begin to correct historic deficits but are touted as bringing us up to the European average when we try to do a lot more on a lot less but with one hand tied behind our backs, of more than 20 years of idiots with less than one brain cell between them braying to the gallery.
Well, they will get their way, slowly but surely, egged on by the asses in the media who parrot the messages they are fed by corporate masters looking to raid the kitty (Camilla Cavendish in the Times yesterday really got me angry), the break-up & privatisation of the NHS is happening & then let us see what good healthcare really costs.
One thing I can assure you is that it will cost a lot more than the £53 your GP gets to treat you for as a whole year or the £1200 (range £900 to £1700) that the PCT receives per person to cover your entire medical costs. In comparison, U.S. per capita spending in 2004 was $6,037, compared with $3,094 in the Netherlands, $3,169 in Germany, and $3,191 in France. When you consider that by Purchasing Power Parity (PPP) £100 is equal to 120 US dollars, the real consequnces of a shift to the US model become clear. Yes, there is waste & poor performance in the NHS, just as there is in any other large organisation. Just find me another healthcare insurance policy that will cover you to the same extent for these amounts of money & then I will listen.
Another take from the Economist on setting up a new healthcare system in China makes for interesting if predictable reading for those with experience of places where patients simply do not have the money to pay.