A nation's greatness is measured by how it treats its weakest members. - Mahatma GhandiFor those who think corruption only occurs when there's money involved, the publication yesterday of Health Service Ombudsman Ann Abrahams's report Care and Compassion should be an eye-opener. But it won't be; the NHS is a totem for the Brits, and none of the gruesome details in the report are in any way news.
Nigel Edwards, chief executive of the NHS Confederation, produced the usual bad faith gloss: "It is of course important to put these 10 examples in perspective. The NHS sees over a million people every 36 hours and the overwhelming majority say they receive good care. But I fully appreciate that this will be of little comfort to patients and their families when they have been on the receiving end of poor care".
How many of those treated by the NHS have any basis for comparison? The ten cases in the report were explicitly cited as tips of a vast, stinking iceberg and even the Independent was moved to comment adversely on the sacred cow:
Ageism is rife in the NHS. That has been established by innumerable investigations over the years. Denial of treatment on cost rather than clinical grounds is less of a problem than it was. But deep-rooted cultural attitudes to ageing remain. As Ms Abraham says, they are personal as well as institutional, a "failure to recognise the humanity and individuality" of the people concerned.I have had rather too many occasions to observe the workings of NHS hospitals at close hand over the past decade and I am in no doubt that the treatment of the elderly is a deliberate, institutional attempt to shift the problem out of the hospitals altogether. Even when Brown was fire-hosing money at the NHS they were closing facilities for the long-term medical care of the helpless elderly and coined the appalling term "bed blockers" to describe them. "Useless mouths" is what they mean, as one would expect of a utilitarian socialist institution.
Thirty years after Sir Roy Griffiths was drafted in from Sainsbury's to reform the NHS, it remains an institution overly focused on the interests of the providers – the staff. In a million ways – from making an appointment to see a GP to getting help with eating on a hospital ward – its lack of focus on the patient is evident.
The moral test of government is how it treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; those who are in the shadows of life; the sick, the needy and the handicapped. - Hubert HumphreyHumphrey and Ghandi would have agreed that NHS abuse of the elderly is only the most starkly undeniable evidence that the soul of the British state is deeply, squalidly amoral.
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Inadequate staffing of public wards as compared to surgical ones is a well-known problem, as is the difficulty of finding out 'Who Is In Charge Here'!
ReplyDeleteBoth of these contribute to galloping morale loss and that sense of bailing out a sinking ship on the part of harder working staff who would be more responsive to the needs of the elderly if that seemed more possible and appropriate.
Difficulty? As in the rest of the state sector, it is IMPOSSIBLE to establish where the buck stops. I have yet to see any "ward managers" personally supervising their wards - they are all run by the staff nurses.
ReplyDeleteEleven years ago my mother died in the Bromley Hospital of a minor infection following surgery. Admittedly she was 74 and in frail health to begin with, but the hospital failed to notice she was running a fever some 72 hours after her surgery and a no doctor checked on her for more than 48 hours before her death. My brother and I remain convinced that she was simply 'allowed to die' so they could clear the bed. Interestingly, as soon as I challenged the fact that no medical professional had checked on her fever, her file mysteriously vanished. Draw your own conclusions, but the Coroner's report identified as the main cause of death and simple bacterial infection of the respiratory tract that could have been effectively stopped by the application of an antibiotic when my brother first drew attention to her fever.
ReplyDeleteThe NHS is, as stated in your post, simply a vast sinkhole run for the benefit of its employees, not for the patients. Why, when I needed a doctor in the UK, did I have to wait sometimes more than a week for an appointment? Here in Germany I am able to go to the GP's surgery, check in with the Receptionist (One, not twelve for five doctors!) and take a seat. I may have to wait, but I get seen, I get treated and if it is something the GP can't deal with, an appointment is immediately made for a specialist and I leave with an appointment card in my hand.
The NHS has become a home for far too many overpaid and over qualified 'Filing Clerks' from the Civil Service. It is no longer managed by medical professionals, it is run by Civil Servants whose only concern is how big a staff they can amass and how big a budget. That is the measure of 'success' in the Civil Service - service delivery is the last thing on their list.
Like too many of our 'service' departments, the NHS is stuffed with people who have no medical training, run by bureaucrats who have no understanding of medicine and who make decisions daily that kill patients - yet this is routinely covered up in Whitehall and Westminster by the politicians. It is well past time that Civil Servants were made fully answerable for their failures. They routinely ignore the advice of professionals on everything, summarising or 'interpreting expert reports and advice and frequently deliberately mis-inform Ministers in order to hide their incompetence and mislead Parliament and the public that pays their wages.
Sending a few behind bars would be a good start, but it will take years to repair the damage to our country and to our public services.
I've had treatment in NHS hospitals as good as anywhere else I've lived; but I have also endured some (and observed a great deal more) outright malpractice and negligence that would get the hospital sued for millions elsewhere. The point, surely, is that negligent state employees are almost unsackable and their managers are almost completely unaccountable.
ReplyDeleteEuthanasia is practised in the NHS under the title of "The Liverpool Pathway" - basically sedation and withdrawal of fluids. Beds can be "unblocked" to a time table by this method. I assisted a clergyman on a hospital visit and we were warned that "nil by mouth" must be observed, so the patient could not receive communion. She was drifting in and out of consciousness anyway, so she was anointed instead and that seemed to give her some comfort.
ReplyDeleteLike Stravagantissimo, I have had excellent treatment in the NHS, some not so good and have also seen appalling lack of basic cleanliness.
There is a tendency to "tick box" nursing and care - so that a patient's record can (for instance) show that he had a meal when he was unable to feed himself and the meal was just put down and picked up uneaten.
In the Staffordshire hospital near us where up to 1200 people may have died from neglect, nursing staff said they feared for their jobs if they spoke up. Patients were so desperately thirsty that they had to drink water out of the flower vases. This is basic lack of humanity. I cannot imagine any of the older generation of nurses tolerating such conditions in silence - and the medical staff would have backed them up. Both seem to be in fear of "management".
And this was a hospital which was "meeting all its targets" (i.e. ticking boxes) to qualify for "foundation status".
There may have been a lack of front line staff, made worse by the EU working time directive, but there certainly has been no lack of money. Administrators have been multiplying like rabbits.
Totally confirm the point about meals put down and taken away without any attempt to help elderly patients to eat them. If ONE patient dies of malnutrition the ward manager should be sacked; but it is commonplace in all NHS hospitals and has been for many years. I don't buy the "just obeying orders" defence - if you are ordered to do something morally repugnant and do not refuse to do it, you are an accomplice.
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