Wednesday, September 20, 2006

NHS patients left waiting on operating tables by computer failures

Hospital operations and consultations are being delayed across England because the new NHS computer system suffers almost one “major incident” failure every day. Patients have been left waiting on operating tables and others have had appointments cancelled because of problems with the £12.4 billion system. The scale of the failures has prompted calls for the Government to rethink the future of the world’s largest non-military computer system amid fears about the impact on patient safety.

More than 110 major incidents have been reported by hospitals and GPs over the past four months, Computer Weekly magazine reports today. The scale of the problems at such an early stage will come as a blow to the National Programme for IT, which is at the heart of Tony Blair’s efforts to modernise the NHS. Over the next ten years the system is due to link more than 30,000 GPs in England to almost 300 hospitals. Connecting for Health, the body that oversees the programme, said, however, that the new computer system was much more reliable than those that it is replacing.

Reported problems include failures of the system used by surgeons to see X-ray pictures on a computer screen in wards and operating theatres. On some occasions the system has crashed during an operation, forcing the surgeon to suspend the procedure while a hard copy of the X-ray is found. Hospitals have also lost access to their patient administration systems, which hold records on appointments and planned treatments, so that they do not know who is due to have consultations or treatments.

Experts are concerned at the level of failures so early in the use of the system. Patients will be at even greater risk if the failures continue when the system is expanded across the country to prescribe drugs, order test results and store 50 million medical records. More than 20 of the major incidents reported over the past four months have affected multiple NHS sites. In July a data centre in Maidstone, Kent, crashed, causing the loss of central services and systems to 80 NHS trusts.

The Nuffield Orthopaedic Centre NHS Trust in Oxford said this year that it had identified “major issues of patient safety” when patients were lost in the system after being dropped from waiting lists or were not being called for important treatment.

Richard Bacon, a Tory member of the Commons Public Accounts Committee, said that the Government needed to reconsider the scheme. “This is the latest evidence that there are serious and growing problems with the whole National Programme for IT in the health service,” he said. “In many respects the NHS IT programme is making things worse, not better, while sowing distrust and disillusionment across the health service.”

Richard Vautrey, a member of the GPs’ joint IT committee of the British Medial Association and the Royal College of General Practitioners, said: “Any system in healthcare has to be available to clinicians and any downtime, however short, can have significant implications. If it is not possible to access the information during the consultation that can make the consultation particularly difficult.”

A Connecting for Health spokesman said that what constituted a major incident was open to interpretation and often problems were reported when systems were simply running slowly. “Connecting for Health is operating systems 24 hours a day, seven days a week in hundreds of locations across England,” he said. “In that context, what is being quoted represents a very small service interruption and we expect performance to compare favourably with any large-scale organisation that uses IT, especially in the first year of operations.”


The good old generous taxpayer again

The Queensland Government will subsidise the travel of public-sector doctors to attend an extravagant medical conference in Beijing later this month, despite running a cash-starved health system that has lurched from crisis to crisis. The annual conference of the Queensland branch of the Australian Medical Association, the lobby group that was particularly vocal during the recent election campaign in which health was a key issue, will be held over five days in the Chinese capital. But delegates will have to attend only four morning sessions over the week and will hear from two keynote speakers - both of whom are based in Brisbane. All afternoons are taken up with leisure activities or sightseeing, with the only evening commitment the "conference farewell dinner".

Senior public health professionals who choose to attend can pay for it from the $20,000 they receive each year for professional development, an allowance secured by the AMAQ during salary negotiations held earlier this year. The Australian understands that senior government officials are disappointed by the AMAQ's choice of location, particularly when the enterprise bargaining agreement requires the allowance to be paid without restrictions.

The middle day of the conference, which will be held from September 25 to 29, begins with a breakfast on the Great Wall followed by a visit to the Summer Palace and Lake Kunming. "Comfortable rubber-soled hiking boots are strongly recommended," the conference itinerary states. Lunch is included. On the other four days, delegates will only have to attend programs on medical issues for a few hours each morning. Queensland AMA president Zelle Hodge said while she would not be attending the conference, it was a chance for doctors and other health professionals to network and share information. "This is an opportunity for people to develop some continuing professional development and it's not going to make any difference to the crumbling health system," Dr Hodge said. "It is not uncommon to share speakers across countries and understanding the complexities of healthcare across different countries."

A spokeswoman for Queensland Health said yesterday it was unclear how many public-system officials would attend the conference because it was organised on a "district by district" basis. The AMAQ was also unable to provide information about how many health professionals would be attending. State Health Minister Stephen Robertson could not be reached for comment. The AMAQ held its conference last year in St Petersburg, Russia.

While most health professionals attending the conference would be working in Queensland's private health sector, senior medical officers and superintendents working in the public system receive $20,000 each year to spend on continuing education programs. Dr Hodge said it was a matter of personal choice how public-sector officials chose to spend their salaries. "That money is part of their salary package which they utilise however they see fit and any travel they do for professional development is part of that package," she said. "This is part of their salary package, and it's not as if that money would not come out of that salary package and patients in Queensland are actually going to be adversely affected."



For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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