Tuesday, 18 October 2011

The envy of the world?

"The NHS is the envy of the world",  so the campaigners tell us when changes to the NHS are discussed; "the envy of the world". Total crap of course; if it was the envy of the world then surely other countries would be queueing up to copy its features. Instead of which they have a selection of other systems that vary quite widely from the NHS's free state provision model.

Two articles about the NHS that appeared on the same page of Sunday's Telegraph really spoke to me. The first told a horrible story of NHS ineptitude and neglect, here's a brief extract from a harrowing tale:
'When Adam Rodin took his 93-year-old father Sam to hospital for breathing difficulties, he was confident that he was in the right hands.

Not only had Mr Rodin had always had good health, the family were confident they could navigate the NHS: Adam is a a consultant obstetrician and gynaecologist at Barnet Hospital, his wife Bridget is a retired nurse, and his twin brother Andrew is a consultant physician.

But Mr Rodin died five weeks after being admitted with breathing difficulties to a large teaching hospital in

This weekend his son came forward - despite working in the NHS - to accuse those who were supposed to care for his father of a string of failings.
Mr Rodin jnr said that his father was not fed properly, losing a third of his body weight in hospital, that he was shunted between 15 wards in six weeks, that there was a lack of communication among staff, and finally, that a nurse berated his family for giving the 93 year-old water within his earshot.'

The second story is even more harrowing and disgusting and involves the use of 'DNR' orders. This Telegraph article reports the findings of spot checks of 100 hospitals undertaken by the Care Quality Commission (CQC), an official watchdog, earlier this year.
'A charity for the elderly said the disclosures were evidence of "euthanasia by the backdoor," with potentially-lethal notices being placed on the files of patients simply because they were old and frail.'
There are plenty iof examples, here are just a few:
'* Inspectors who visited Queen Elizabeth Hospital, run by University Hospitals Birmingham Foundation trust, found no evidence that any of the patients whose files were marked DNR had been informed about the decision, nor their relatives told. The hospital's own audit showed that in one ward, 30 per cent of cases did not involve any such conversations.

* At University Hospitals Bristol Foundation trust, there was no evidence that a DNR order placed on a patient had been discussed with the person or next of kin. A junior doctor told inspectors that they did "not tend to discuss" such decisions with families.

* At Royal Shrewsbury Hospital, run by Shrewsbury and Telford Hospital trust, a patient was labelled as DNR based on old medical notes from a previous admission – despite the fact their health had improved.

* Asked how decisions to make such orders were made, staff at Royal Devon and Exeter NHS Foundation trust gave an example of an elderly person on the ward with health problems judged to make "resuscitation less appropriate". The doctor involved did not know if the patient or an advocate had been asked for an opinion, or told that the notice had been imposed.'

This Do Not Resuscitate policy comes very close to state sponsored secret euthanasia and should not happen in a modern, caring, patient-centred health service. The NHS seems to be increasingly run for its staff's benefit not for its patients. The last set of findings released late last week showed that one in five NHS hospitals were actually breaking the law and that in 20 hospitals nursing care was so poor that it breached the Health and Social Care Act 2008. If the law was broken, who has been prosecuted? Nurses have tortured elderly patients by depriving them of water, administrators have been complicit in this torture by requiring form-filling to take priority over patient care, and so on.

When I was in my teens and early 20s I knew quite a few nurses (SRN and SEN) and the care they showed for patients and their adherence to rules of hygiene were laudable. Now nursing has become a degree entry career, the nurses are deemed to be above emptying bed pans or giving care and attention to sick patients. Instead these roles are carried out by often unqualified auxiliaries whilst the nurses sit behind desks on the ward and elsewhere and ensure that all necessary boxes are ticked. The death of a patient requires just another tick, caring for a patient means getting up and talking to & reassuring a scared old lady or gentleman.

The NHS needs improvement and modernisation if it it is ever to be the envy of the world. Will the Conservative party be allowed to carry out such improvements by the chattering classes for whom an NHS that mistreats and often no longer really cares properly for patients is still 'the envy of the world'?

1 comment:

Ed P said...

Until they drop the tick-box mentality there will not be improvements. A clear chain of command and responsibility on the ward is needed urgently, like Matrons wielded of old. But the NHS is so ridden with bureaucracy, entrenched attitude and pointless paper-pushing, it might be easier to tear it down, hospital by hospital, clinic by clinic, and start afresh. One of the stumbling blocks to reform is inherent in its founding aims, to provide healthcare for all, regardles of ability to pay or need. This is so outdated and unaffordable that a rudimentary reappraisal of these aims is needed if it is to be salvaged.