AGE-OLD PUBLIC HOSPITAL SYSTEM CALLED INTO QUESTION
Hospitals can drastically reduce waiting times in emergency departments by treating the less urgent cases first. A controversial trial at Sir Charles Gairdner Hospital in Perth resulted in a 20 per cent drop in waiting times for all emergency department patients and an 18 per cent reduction in the average length of stay. Triage nurses usually prioritise patients by the seriousness of their injury or illness, with the most critically ill treated first.
In the trial, nurses triaged patients as soon as they arrived, separating those who were likely to be admitted from those with minor ailments who could be discharged after a quick consultation. The less critical patients were moved to a "fast-track" area, where they were immediately treated by a medical team specifically employed to treat only the minor cases. Waiting times dropped 20per cent over the 12-week trial compared to the same period the previous year, despite a 7 per cent increase in the number of people showing up in emergency.
George Jelinek, professor of emergency medicine at the hospital, said the system required staff to rethink the way emergency departments were run. "All of our training has focused on prioritising patients in the order of how urgent their condition is, and this system seemed to be against the spirit of this," he said. "We had to overcome the philosophical objections we had to treating less urgent patients out of order."
Professor Jelinek said the hospital was initially worried about the impact on sicker patients. "However, it seemed to unclog the rest of the department so they worked more efficiently as well," he said. He said the fast-track system, which has become standard procedure at the hospital, should be implemented elsewhere.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Pages are here or here or here.
***************************
Tuesday, October 31, 2006
Monday, October 30, 2006
NHS CUTS TRAINING
If they keep cutting back at their present rate there will soon be only bureaucrats left in the NHS...
Universities are being forced to cut staff and medical training programmes as strategic health authorities trim their budgets to reduce the NHS deficit, The Times has learnt. Nursing, midwifery, physiotherapy and radiography courses have all been severely depleted, as have community-care programmes. Vice-chancellors have given warning that the cuts are likely to cause a boom-and-bust cycle in healthcare provision that may later result in the closure of university departments.
In Central, South West and the East of England, student numbers have dropped this year by as much as a quarter. Overall they have dropped 13 per cent, as health authorities pull contracts.
England’s nursing and allied-health students are paid for via contracts between the strategic health authorities (SHAs) and the universities. Last year 97,000 students were taking such degrees. At the University of the West of England (UWE), a loss of 900,000 pounds in contracts has resulted in 114 fewer students this year, and the end of all conversion courses for nurses wanting to retrain either as midwives and health visitors or to work in the community. Avon, Gloucestershire and Wiltshire SHA made savings of 7.8 million pounds in training programmes in 2005-06 and is continuing to do so. The fear, says Steve West, UWE’s deputy vice-chancellor, is that the cuts will continue. “Our health-visiting, district-nursing and midwifery conversion courses have all been cut, gone, closed,” he said. “It’s becoming very difficult to sustain our commitment to the NHS when our budgets keep being cut.”
England’s SHAs made savings or “underspent” last year by 524 million, but they are now being asked to set aside a further minimum of 350 million for a contingency fund. Much of this money, argues the Council of Deans for Nursing and Health Professions, is coming out of their education and training budgets. This is resulting in the loss of academics and contracts for nurses and and other health professionals.
More here
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Pages are here or here or here.
***************************
If they keep cutting back at their present rate there will soon be only bureaucrats left in the NHS...
Universities are being forced to cut staff and medical training programmes as strategic health authorities trim their budgets to reduce the NHS deficit, The Times has learnt. Nursing, midwifery, physiotherapy and radiography courses have all been severely depleted, as have community-care programmes. Vice-chancellors have given warning that the cuts are likely to cause a boom-and-bust cycle in healthcare provision that may later result in the closure of university departments.
In Central, South West and the East of England, student numbers have dropped this year by as much as a quarter. Overall they have dropped 13 per cent, as health authorities pull contracts.
England’s nursing and allied-health students are paid for via contracts between the strategic health authorities (SHAs) and the universities. Last year 97,000 students were taking such degrees. At the University of the West of England (UWE), a loss of 900,000 pounds in contracts has resulted in 114 fewer students this year, and the end of all conversion courses for nurses wanting to retrain either as midwives and health visitors or to work in the community. Avon, Gloucestershire and Wiltshire SHA made savings of 7.8 million pounds in training programmes in 2005-06 and is continuing to do so. The fear, says Steve West, UWE’s deputy vice-chancellor, is that the cuts will continue. “Our health-visiting, district-nursing and midwifery conversion courses have all been cut, gone, closed,” he said. “It’s becoming very difficult to sustain our commitment to the NHS when our budgets keep being cut.”
England’s SHAs made savings or “underspent” last year by 524 million, but they are now being asked to set aside a further minimum of 350 million for a contingency fund. Much of this money, argues the Council of Deans for Nursing and Health Professions, is coming out of their education and training budgets. This is resulting in the loss of academics and contracts for nurses and and other health professionals.
More here
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Pages are here or here or here.
***************************
Sunday, October 29, 2006
SOME COMMENTS FROM AN ER PHYSICIAN:
Right or Privilege:
If health care was a right of every person, every patient, US citizen or not, would have access to medical care - whether they could pay or not. Actually, this system is already in place at every state-funded university or teaching hospital in the nation. Due to EMTALA (Emergency Medical Treatment and Active Labor Act), emergency physicians and hospitals are FORCED to see and treat people who can't pay. EMTALA defined- any patient who "comes to the emergency department" requesting "examination or treatment for a medical condition" must be provided with "an appropriate medical screening examination" to determine if he is suffering from an "emergency medical condition". If he is, then the hospital is obligated to either provide him with treatment until he is stable or to transfer him to another hospital in conformance with the statute's directives. So, we as ED physicians and the hospitals that house us, are forced by law to see and treat patients who can't pay for services, and then are still liable for litigation by those patients when there is a bad outcome. I'm sorry, but if I am to be forced by the government to see and treat you, than the government should be liable, not me. Better yet, don't sue, be thankful you're even getting care, and stop being a drain on society.
What is supposed to happen in this system is that people get their medical care and the government picks up the bill; however, in our current system, this doesn't happen. So, people get their free care and who pays? Nobody. The physicians and hospitals supply all their services (nursing time, equipment, supplies) free of charge. Basically, the hospital and physicians are giving charity care, which should not happen. The end result, hospitals have to overcharge patients who CAN pay for medications and supplies in order to partially offset the enormous costs of giving away care to the millions that can't afford it.
In the last decade, over 400 emergency departments have closed while the number of patients seeking emergency care has jumped over 10 million - leading to problems with waits for beds and boarding of patients in EDs. Now, in a monetary economy such as ours, you would think that with such a demand for emergency care, emergency departments would be springing up like weeds. Simply put, medical care, in selected areas throughout the country is socialized and free. It is the non-paying American public (citizen or not) who is driving American health care into the ground.
Health care is a privilege, not a right. Every person deserves care for actual medical problems, but with so many people actively abusing the system (getting free care for non-life-threatening problems and wasting our time) my sympathy on the matter is gone.
SMOKING
Patients who need to walk outside in a hospital gown trailing IV poles to smoke cigarettes are extremely frustrating. They waste everybody's time. The nurses sometimes have to wheel them outside, plus, I stop by in the 2-3 minutes I have to see them during the day, and they aren't even there. I understand that smoking is quite possibly the hardest addiction to kick, but it is just bizarre to see a patient outside with IV pole in hand, gown on, no shoes, sick as hell, and smoking. Kind of defeats the purpose of what we're trying to do at the hospital, don't you think?
On a different note, smoking should be absolutely banned from any public building, including the outdoors part of a restaurant. Sorry, just because you made the extremely bad decision to start smoking doesn't mean that I shouldn't be able to enjoy a meal outside. First of all, you smokers stink (how can you not tell?), and secondly, your smoke always seems to blow right in my face. But, when you come into the emergency room for your chest pain, shortness of breath, and massive heart attack, you won't be smoking then...there's no smoking in the hospital.
I think the whole concept of natural selection is completely wrong. People who become highly educated, acquire good careers, and actually have something to contribute to society usually have to wait to have children. By the time they do have children they have an increased risk of birth defects or problems with pregnancy. On the other hand, it seems like any teen with half a brain, but able to screw, is able to get pregnant on the first try and have a completely normal baby. Unfortunately, these teens will have their babies, never go far in school, will take the lowest jobs in the world and be total drains on society, while all the highly educated people who can't have kids end up paying high taxes to cover the medical care, food, etc. of these young societal black-holes. Natural selection is failing miserably.
BROKEN HEART
Informing a family that a loved one is very sick or died used to be the toughest part of the job. The absolute worst is informing of a child's death. Obviously those times are terrible and nothing can prepare one for dealing with the emotions, which is probably why doctors have a high rate of alcohol and drug abuse. Thankfully, I have neither. My saddest moment thus far...
An elderly woman was brought into the ER from home due to dehydration. She had a long-standing history of Alzheimer's dementia and received care from her elderly husband. They lived alone and it became quickly apparent that the woman was not dehydrated, but perfectly normal (in a demented way). The husband had a look on his face of fatigue. He had spent the last 5-7 years watching his wife deteriorate into an abusive shell of a woman. Apparently, the years had finally taken their toll and his call to 911 for dehydration was actually a cry for help. He had been trying to arrange for both of them to go to some assisted care facility in Penn. or South Carolina, where their daughters lived. Basically, he was trying to do this on his own, with no money, no family close by, and with a wife that needed constant care. I was amazed at how strong his love for her was. He was keeping his vow to take care of her in sickness and in health, and was being destroyed for it. Truly tragic.
SOCIALIZED MEDICINE
This is for those who dream of socialized medicine where all people have access to medical care. Wake up! It already exists in the U.S. Any poor, homeless, or uninsured person is able to walk into any university or teaching hospital and receive FREE care. They can't be turned away, it's the law. They will walk though those big expensive doors of a state-of-the-art facility, see world-class physicians, receive the same top-quality meds that any CEO would get, and are placed into hospitals where the most cutting-edge research is taking place. When these patients leave the hospital, they still have no money, and they will never pay their bill. So, what happens. The hospital and I eat the costs.
Now, if you are complaining about the system, you are probably a well-educated and working individual with enough income that you actually do pay your medical bills. Unfortunately, the real people being screwed in this whole ordeal are the working middle-class. American medical care is expensive (due to litigation, the price of malpractice insurance, expensive medications, research, etc.), and those working enough to pay their bills bear the brunt of the problem; however, you are still terribly naive to think socialized medicine is the answer. Before you cry any longer about the system do this. Travel down to Latin America or another country with socialized medicine and try it out. Acquiring health care and treatment is quite different with such a system. You may soon change you mind and come to appreciate what you already have a bit more. Stop thinking you're politically informed and start thinking more realistically.
If you really want to make a change in the system, here is my advice. Advocate for caps on malpractice claims and consequences for inappropriate lawsuits. The price of physicians' malpractice insurance will decrease, the price of physician costs will decrease, and hospitals and doctors wouldn't have to charge so much for care. As for the extremely high cost for medications, we're all screwed. Lastly, if you still want socialized health care that bad, leave.
ACCESS TO EMERGENCY SERVICES ACT
Here's the problem: Physicians that work at free clinics or urgent care centers, where patients can come in for emergent free care, are at no risk of being sued. They are protected under the law from litigation. Emergency physicians anywhere else are under legal force to see any patient that walks through the door, insured or not. Hence, uninsured patients who come into the ER, 1) end up receiving free care (usually the hospital eats the cost) and 2) can still sue the doctors forced to take care of them. Basically, we are forced to treat patients for free and then have no protection from litigation. If you think about it, some patients get free care and then get a large settlement because insurance companies would rather settle out of court than defend the doctor, even when that doctor didn't screw up in the first place. And you wonder why your medical bills suck.
LAWYERS AND MEDICAL COSTS
In regards to personal injury and/or malpractice lawyers, I think that anyone who makes a living in such a way must find it difficult to look at themselves in the mirror. I'm sure at some point during thier path to "greatness", they felt a flicker of humanity; however, it seems that such a flicker is momentary. Yes, I make a living off sick people...some may say that I am exploiting the sick just like those lawyers I speak of. If this is what helps you sleep at night, so be it. But I take comfort in the concept that, while mistakes will be made, I am trying to actually help the patient. These blood-suckers swoop in after mistakes are made and exploit not only the patient, but the physicians, hospitals, and insurance companies - all the while filling their pockets with no risk of being sued themselves.
For all you patients out there complaining about the rise in health care costs, look no further. I have your answer right here. As long as there are naive patients, with imperfect doctors and heartless lawyers, the amount I have to spend on malpractice insurance will increase, the amount of your insurance will increase, the cost of health care and medical bills will increase, and you will find yourself screwed. You, the patients, will ultimately be left behind in the end because lawyers will earn more, doctors will still earn a decent living, insurance companies will do just fine, and drug companies will run rampant over us all.
ANNOYANCE
Last night I was working another shift in the ED (emergency dept) and was once again annoyed by the absolute abuses taking place. It was the night shift lasting from 9 PM till 7 AM, and I was having a relatively good shift. I was working though patients quickly, solving problems, diagnosing, and getting them out the door or to the floor efficiently. Unfortunately, around 3-4 AM the usual folks walked through the door. This is the "It's 3 AM and I have a cold" crew of which I speak. OK, for those of you out there who can relate to these people, you're idiots. These people, who come in all ages and ethnicities, come into the ED in the middle of the night with nothing more than a cold or flu. What's even worse is that these same knobs, if I don't get to them right away because I'm off trying to help someone who actually is sick or dying, get upset and give me attitude because they have to wait for so long. Screw you. First of all, it's an ER, not a restaurant. It is not first come, first serve. If you think so, don't come in the first place because you'll just end up disappointed. And for those of you who do come to see me in the middle of the night with some benign and pathetic complaint, I will still treat you with the same care and professionalism you don't deserve.
Even though many of the concepts presented here may seem politically one-sided, I am strongly against party politics and will support whatever I deem fit to support. I have a very jaded view of society given the profession I work in; therefore, if you don't agree with me, it is simply because you have not seen what I have seen
Source
FEDS "LOOKING INTO" MEDICARE TRANSPORT ABUSE
Federal auditors are examining the skyrocketing costs of providing transportation to Medicaid patients across the country, a problem that D.C. officials are struggling to control. The Office of Inspector General for the U.S. Department of Health and Human Services said it "will determine whether state Medicaid agencies make erroneous payments for transportation services," according to its recently released 2007 work plan.
Medicaid transportation costs across the nation rose by 48 percent from 1999 to 2003, reaching $1.5 billion, according to the work plan. The District has seen its Medicaid transportation costs rise to more than $20 million overall last year. More than $16 million was spent on van rides alone, according to a report last month by the D.C. Office of the Inspector General. But the city's Medicaid transportation program, which also pays for public transit and taxis, cost taxpayers $14.3 million in fiscal 2004, according to the D.C. inspector general's 2006 work plan.
The program was also the subject of recent reports by the city's inspector general and the D.C. Council Committee on Health. The Washington Times on Monday reported that the District last year spent $22.3 million for nonemergency transportation of Medicaid patients -- slightly more than what the city paid for patients to see individual doctors, according to city records.
In the federal work plan, the inspector general does not single out the District or any state in outlining a review of Medicaid transportation services. Medicaid, which provides health insurance for the poor, is funded by the federal government and the states, which also manage their programs. Reimbursement rates and rules for Medicaid transportation vary by state.
"Since so much money is involved here, the federal government certainly has a very keen interest in how it is spent," Donald White, spokesman for the HHS inspector general, said yesterday of the nationwide look at Medicaid transportation costs. Health care consultant Robin Mathias said that it's not uncommon for Medicaid programs to lose 30 percent to 50 percent of nonemergency transportation spending to fraud and abuse.
More here
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Pages are here or here or here.
***************************
Right or Privilege:
If health care was a right of every person, every patient, US citizen or not, would have access to medical care - whether they could pay or not. Actually, this system is already in place at every state-funded university or teaching hospital in the nation. Due to EMTALA (Emergency Medical Treatment and Active Labor Act), emergency physicians and hospitals are FORCED to see and treat people who can't pay. EMTALA defined- any patient who "comes to the emergency department" requesting "examination or treatment for a medical condition" must be provided with "an appropriate medical screening examination" to determine if he is suffering from an "emergency medical condition". If he is, then the hospital is obligated to either provide him with treatment until he is stable or to transfer him to another hospital in conformance with the statute's directives. So, we as ED physicians and the hospitals that house us, are forced by law to see and treat patients who can't pay for services, and then are still liable for litigation by those patients when there is a bad outcome. I'm sorry, but if I am to be forced by the government to see and treat you, than the government should be liable, not me. Better yet, don't sue, be thankful you're even getting care, and stop being a drain on society.
What is supposed to happen in this system is that people get their medical care and the government picks up the bill; however, in our current system, this doesn't happen. So, people get their free care and who pays? Nobody. The physicians and hospitals supply all their services (nursing time, equipment, supplies) free of charge. Basically, the hospital and physicians are giving charity care, which should not happen. The end result, hospitals have to overcharge patients who CAN pay for medications and supplies in order to partially offset the enormous costs of giving away care to the millions that can't afford it.
In the last decade, over 400 emergency departments have closed while the number of patients seeking emergency care has jumped over 10 million - leading to problems with waits for beds and boarding of patients in EDs. Now, in a monetary economy such as ours, you would think that with such a demand for emergency care, emergency departments would be springing up like weeds. Simply put, medical care, in selected areas throughout the country is socialized and free. It is the non-paying American public (citizen or not) who is driving American health care into the ground.
Health care is a privilege, not a right. Every person deserves care for actual medical problems, but with so many people actively abusing the system (getting free care for non-life-threatening problems and wasting our time) my sympathy on the matter is gone.
SMOKING
Patients who need to walk outside in a hospital gown trailing IV poles to smoke cigarettes are extremely frustrating. They waste everybody's time. The nurses sometimes have to wheel them outside, plus, I stop by in the 2-3 minutes I have to see them during the day, and they aren't even there. I understand that smoking is quite possibly the hardest addiction to kick, but it is just bizarre to see a patient outside with IV pole in hand, gown on, no shoes, sick as hell, and smoking. Kind of defeats the purpose of what we're trying to do at the hospital, don't you think?
On a different note, smoking should be absolutely banned from any public building, including the outdoors part of a restaurant. Sorry, just because you made the extremely bad decision to start smoking doesn't mean that I shouldn't be able to enjoy a meal outside. First of all, you smokers stink (how can you not tell?), and secondly, your smoke always seems to blow right in my face. But, when you come into the emergency room for your chest pain, shortness of breath, and massive heart attack, you won't be smoking then...there's no smoking in the hospital.
I think the whole concept of natural selection is completely wrong. People who become highly educated, acquire good careers, and actually have something to contribute to society usually have to wait to have children. By the time they do have children they have an increased risk of birth defects or problems with pregnancy. On the other hand, it seems like any teen with half a brain, but able to screw, is able to get pregnant on the first try and have a completely normal baby. Unfortunately, these teens will have their babies, never go far in school, will take the lowest jobs in the world and be total drains on society, while all the highly educated people who can't have kids end up paying high taxes to cover the medical care, food, etc. of these young societal black-holes. Natural selection is failing miserably.
BROKEN HEART
Informing a family that a loved one is very sick or died used to be the toughest part of the job. The absolute worst is informing of a child's death. Obviously those times are terrible and nothing can prepare one for dealing with the emotions, which is probably why doctors have a high rate of alcohol and drug abuse. Thankfully, I have neither. My saddest moment thus far...
An elderly woman was brought into the ER from home due to dehydration. She had a long-standing history of Alzheimer's dementia and received care from her elderly husband. They lived alone and it became quickly apparent that the woman was not dehydrated, but perfectly normal (in a demented way). The husband had a look on his face of fatigue. He had spent the last 5-7 years watching his wife deteriorate into an abusive shell of a woman. Apparently, the years had finally taken their toll and his call to 911 for dehydration was actually a cry for help. He had been trying to arrange for both of them to go to some assisted care facility in Penn. or South Carolina, where their daughters lived. Basically, he was trying to do this on his own, with no money, no family close by, and with a wife that needed constant care. I was amazed at how strong his love for her was. He was keeping his vow to take care of her in sickness and in health, and was being destroyed for it. Truly tragic.
SOCIALIZED MEDICINE
This is for those who dream of socialized medicine where all people have access to medical care. Wake up! It already exists in the U.S. Any poor, homeless, or uninsured person is able to walk into any university or teaching hospital and receive FREE care. They can't be turned away, it's the law. They will walk though those big expensive doors of a state-of-the-art facility, see world-class physicians, receive the same top-quality meds that any CEO would get, and are placed into hospitals where the most cutting-edge research is taking place. When these patients leave the hospital, they still have no money, and they will never pay their bill. So, what happens. The hospital and I eat the costs.
Now, if you are complaining about the system, you are probably a well-educated and working individual with enough income that you actually do pay your medical bills. Unfortunately, the real people being screwed in this whole ordeal are the working middle-class. American medical care is expensive (due to litigation, the price of malpractice insurance, expensive medications, research, etc.), and those working enough to pay their bills bear the brunt of the problem; however, you are still terribly naive to think socialized medicine is the answer. Before you cry any longer about the system do this. Travel down to Latin America or another country with socialized medicine and try it out. Acquiring health care and treatment is quite different with such a system. You may soon change you mind and come to appreciate what you already have a bit more. Stop thinking you're politically informed and start thinking more realistically.
If you really want to make a change in the system, here is my advice. Advocate for caps on malpractice claims and consequences for inappropriate lawsuits. The price of physicians' malpractice insurance will decrease, the price of physician costs will decrease, and hospitals and doctors wouldn't have to charge so much for care. As for the extremely high cost for medications, we're all screwed. Lastly, if you still want socialized health care that bad, leave.
ACCESS TO EMERGENCY SERVICES ACT
Here's the problem: Physicians that work at free clinics or urgent care centers, where patients can come in for emergent free care, are at no risk of being sued. They are protected under the law from litigation. Emergency physicians anywhere else are under legal force to see any patient that walks through the door, insured or not. Hence, uninsured patients who come into the ER, 1) end up receiving free care (usually the hospital eats the cost) and 2) can still sue the doctors forced to take care of them. Basically, we are forced to treat patients for free and then have no protection from litigation. If you think about it, some patients get free care and then get a large settlement because insurance companies would rather settle out of court than defend the doctor, even when that doctor didn't screw up in the first place. And you wonder why your medical bills suck.
LAWYERS AND MEDICAL COSTS
In regards to personal injury and/or malpractice lawyers, I think that anyone who makes a living in such a way must find it difficult to look at themselves in the mirror. I'm sure at some point during thier path to "greatness", they felt a flicker of humanity; however, it seems that such a flicker is momentary. Yes, I make a living off sick people...some may say that I am exploiting the sick just like those lawyers I speak of. If this is what helps you sleep at night, so be it. But I take comfort in the concept that, while mistakes will be made, I am trying to actually help the patient. These blood-suckers swoop in after mistakes are made and exploit not only the patient, but the physicians, hospitals, and insurance companies - all the while filling their pockets with no risk of being sued themselves.
For all you patients out there complaining about the rise in health care costs, look no further. I have your answer right here. As long as there are naive patients, with imperfect doctors and heartless lawyers, the amount I have to spend on malpractice insurance will increase, the amount of your insurance will increase, the cost of health care and medical bills will increase, and you will find yourself screwed. You, the patients, will ultimately be left behind in the end because lawyers will earn more, doctors will still earn a decent living, insurance companies will do just fine, and drug companies will run rampant over us all.
ANNOYANCE
Last night I was working another shift in the ED (emergency dept) and was once again annoyed by the absolute abuses taking place. It was the night shift lasting from 9 PM till 7 AM, and I was having a relatively good shift. I was working though patients quickly, solving problems, diagnosing, and getting them out the door or to the floor efficiently. Unfortunately, around 3-4 AM the usual folks walked through the door. This is the "It's 3 AM and I have a cold" crew of which I speak. OK, for those of you out there who can relate to these people, you're idiots. These people, who come in all ages and ethnicities, come into the ED in the middle of the night with nothing more than a cold or flu. What's even worse is that these same knobs, if I don't get to them right away because I'm off trying to help someone who actually is sick or dying, get upset and give me attitude because they have to wait for so long. Screw you. First of all, it's an ER, not a restaurant. It is not first come, first serve. If you think so, don't come in the first place because you'll just end up disappointed. And for those of you who do come to see me in the middle of the night with some benign and pathetic complaint, I will still treat you with the same care and professionalism you don't deserve.
Even though many of the concepts presented here may seem politically one-sided, I am strongly against party politics and will support whatever I deem fit to support. I have a very jaded view of society given the profession I work in; therefore, if you don't agree with me, it is simply because you have not seen what I have seen
Source
FEDS "LOOKING INTO" MEDICARE TRANSPORT ABUSE
Federal auditors are examining the skyrocketing costs of providing transportation to Medicaid patients across the country, a problem that D.C. officials are struggling to control. The Office of Inspector General for the U.S. Department of Health and Human Services said it "will determine whether state Medicaid agencies make erroneous payments for transportation services," according to its recently released 2007 work plan.
Medicaid transportation costs across the nation rose by 48 percent from 1999 to 2003, reaching $1.5 billion, according to the work plan. The District has seen its Medicaid transportation costs rise to more than $20 million overall last year. More than $16 million was spent on van rides alone, according to a report last month by the D.C. Office of the Inspector General. But the city's Medicaid transportation program, which also pays for public transit and taxis, cost taxpayers $14.3 million in fiscal 2004, according to the D.C. inspector general's 2006 work plan.
The program was also the subject of recent reports by the city's inspector general and the D.C. Council Committee on Health. The Washington Times on Monday reported that the District last year spent $22.3 million for nonemergency transportation of Medicaid patients -- slightly more than what the city paid for patients to see individual doctors, according to city records.
In the federal work plan, the inspector general does not single out the District or any state in outlining a review of Medicaid transportation services. Medicaid, which provides health insurance for the poor, is funded by the federal government and the states, which also manage their programs. Reimbursement rates and rules for Medicaid transportation vary by state.
"Since so much money is involved here, the federal government certainly has a very keen interest in how it is spent," Donald White, spokesman for the HHS inspector general, said yesterday of the nationwide look at Medicaid transportation costs. Health care consultant Robin Mathias said that it's not uncommon for Medicaid programs to lose 30 percent to 50 percent of nonemergency transportation spending to fraud and abuse.
More here
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Pages are here or here or here.
***************************
Saturday, October 28, 2006
For better, cheaper healthcare
Everyone complains about the rising cost of healthcare. And now is the season when politicians and pundits propose solutions. Unfortunately, too many of these proposals spring from the wrongheaded notion that healthcare is, as a recent New York Times letter-writer asserted, "a human right and a universal entitlement."
Sounds noble. But not everything that is highly desirable is a right. Most rights simply oblige us to respect one another's freedoms; they do not oblige us to pay for others to exercise these freedoms. Respecting rights such as freedom of speech and of worship does not impose huge demands upon taxpayers. Healthcare, although highly desirable, differs fundamentally from these rights. Because providing healthcare takes scarce resources, offering it free at the point of delivery would raise its cost and reduce its availability. To see why, imagine if government tried to supply food as a universally available "right."
To satisfy this right, government would raise taxes to meet all anticipated food needs. Store shelves across the land would then be stocked. Citizens would have the right to enter these storehouses to get "free" food. Does anyone believe that such a system would effectively supply food? It's clear that with free access to food, too many people would take too much food, leaving many others with no food at all. Government would soon realize that food storehouses are emptying faster than expected. In response, it might hike taxes even higher to produce more food - raising the price that society pays for nutrition.
Stocking stores with more food, though, won't solve the problem. With food free at the point of delivery, consumers would take all that they can carry. People would quickly learn that if they don't grab as much food as possible today, the store might run out of the foods that their families need tomorrow. This creates a vicious cycle of moral hazard that unwittingly pits neighbor against neighbor. Eventually, to avoid spending impossibly large chunks of society's resources producing food, government would start restricting access to it. Bureaucrats would enforce rations, such as "two gallons of milk per family per week." There might be exceptions for those with special needs, but most of us would be allowed to take only those foods that officials decide we need. Food would be a universal entitlement in name only. In practice, it would be strictly limited by government rules.
Of course, by keeping what food it does supply "free," government might ensure that at least basic foodstuffs are available to everyone as a right. And maybe this is the sort of outcome that universal healthcare advocates have in mind: Only essential care is a right to be enjoyed by everyone free of charge. The problem is that notions of "essential care" are vague. Is medical care essential if doctors say it might improve by 50 percent an 80-year-old's chances of living an additional year? What about care that improves by 10 percent a 25-year-old's chances of living an additional 50 years? Such questions are wickedly difficult to answer.
Despite these difficulties, many Americans demand that government do more to guarantee access to healthcare. Although their concern is understandable, those who make such demands forget that government intervention itself is a major cause of today's high and rising healthcare costs. Indeed, this intervention has created a situation akin to what would happen if government supplied our food for "free."
Medicare, Medicaid, and tax-deductibility of employer-provided health insurance created a system in which patients at the point of delivery now pay only a small fraction of their medical bills out of pocket. This situation leads to monstrously inefficient consumption of healthcare. Some people consume too much, while many others with more pressing needs do without. Because the wasteful consumption caused by heavily subsidized access drives up healthcare costs, taxpayers must pay more and more to fund Medicare and Medicaid, while private insurers must continually raise premiums. The sad and perverse result is that increasing numbers of people go without health insurance.
The solution is less, not more, government involvement in healthcare. Market forces have consistently lowered the cost and improved the quality and accessibility of food - which is at least as important to human survival as is healthcare. There's no reason markets can't do the same for healthcare. It's ironic but true: Only by abandoning attempts to provide healthcare as a "right" that's paid for largely by others will we enjoy surer access to it.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Everyone complains about the rising cost of healthcare. And now is the season when politicians and pundits propose solutions. Unfortunately, too many of these proposals spring from the wrongheaded notion that healthcare is, as a recent New York Times letter-writer asserted, "a human right and a universal entitlement."
Sounds noble. But not everything that is highly desirable is a right. Most rights simply oblige us to respect one another's freedoms; they do not oblige us to pay for others to exercise these freedoms. Respecting rights such as freedom of speech and of worship does not impose huge demands upon taxpayers. Healthcare, although highly desirable, differs fundamentally from these rights. Because providing healthcare takes scarce resources, offering it free at the point of delivery would raise its cost and reduce its availability. To see why, imagine if government tried to supply food as a universally available "right."
To satisfy this right, government would raise taxes to meet all anticipated food needs. Store shelves across the land would then be stocked. Citizens would have the right to enter these storehouses to get "free" food. Does anyone believe that such a system would effectively supply food? It's clear that with free access to food, too many people would take too much food, leaving many others with no food at all. Government would soon realize that food storehouses are emptying faster than expected. In response, it might hike taxes even higher to produce more food - raising the price that society pays for nutrition.
Stocking stores with more food, though, won't solve the problem. With food free at the point of delivery, consumers would take all that they can carry. People would quickly learn that if they don't grab as much food as possible today, the store might run out of the foods that their families need tomorrow. This creates a vicious cycle of moral hazard that unwittingly pits neighbor against neighbor. Eventually, to avoid spending impossibly large chunks of society's resources producing food, government would start restricting access to it. Bureaucrats would enforce rations, such as "two gallons of milk per family per week." There might be exceptions for those with special needs, but most of us would be allowed to take only those foods that officials decide we need. Food would be a universal entitlement in name only. In practice, it would be strictly limited by government rules.
Of course, by keeping what food it does supply "free," government might ensure that at least basic foodstuffs are available to everyone as a right. And maybe this is the sort of outcome that universal healthcare advocates have in mind: Only essential care is a right to be enjoyed by everyone free of charge. The problem is that notions of "essential care" are vague. Is medical care essential if doctors say it might improve by 50 percent an 80-year-old's chances of living an additional year? What about care that improves by 10 percent a 25-year-old's chances of living an additional 50 years? Such questions are wickedly difficult to answer.
Despite these difficulties, many Americans demand that government do more to guarantee access to healthcare. Although their concern is understandable, those who make such demands forget that government intervention itself is a major cause of today's high and rising healthcare costs. Indeed, this intervention has created a situation akin to what would happen if government supplied our food for "free."
Medicare, Medicaid, and tax-deductibility of employer-provided health insurance created a system in which patients at the point of delivery now pay only a small fraction of their medical bills out of pocket. This situation leads to monstrously inefficient consumption of healthcare. Some people consume too much, while many others with more pressing needs do without. Because the wasteful consumption caused by heavily subsidized access drives up healthcare costs, taxpayers must pay more and more to fund Medicare and Medicaid, while private insurers must continually raise premiums. The sad and perverse result is that increasing numbers of people go without health insurance.
The solution is less, not more, government involvement in healthcare. Market forces have consistently lowered the cost and improved the quality and accessibility of food - which is at least as important to human survival as is healthcare. There's no reason markets can't do the same for healthcare. It's ironic but true: Only by abandoning attempts to provide healthcare as a "right" that's paid for largely by others will we enjoy surer access to it.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Friday, October 27, 2006
"Posts unfilled are not jobs lost"??
Good old British "fudging"
The one certainty is that jobs have been lost. But in the publicity fog surrounding the NHS, it is unclear how many. Take the Mid Yorkshire Hospitals NHS Trust. Health Service Journal (Oct 19) quotes its chief executive: "We thought we would have to place just over 200 staff at risk of redundancy." In fact, just ten have taken voluntary redundancy and only four have been made redundant. But 200 is more likely to make headlines than four.
Another trust, in Worcestershire, identified more than 750 jobs at risk. In fact, says a trust spokesperson, only 11 have actually been lost. But pessimists can be forgiven for having expected worse. NHS Employers estimated that 20,000 posts were threatened. HSJ says that the reality is just 766 redundancies so far.
The important distinction is, it seems, between jobs lost and posts unfilled. Kevin Barron, the chair of the Commons Health Select Committee, says that he is "hoarse" from talking to organisations such as the Royal College of Nursing (RCN) which he says tell the media that thousands of jobs are being lost. "In my view, posts unfilled are not jobs lost," Barron says.
But that's little comfort to those who have been made redundant or who have completed their healthcare training and then found that they cannot get work. Commenting on a survey which found that barely half of student nurses expect to have jobs on qualifying, Susan Watts, the RCN's student adviser, says that new staff should be guaranteed a one-year contract. Failure to do so risks nursing shortages in a few years' time, she predicts.
Therapy Weekly (Oct 19) suggests that newly qualified physiotherapists are in a similar position. It says that a "staggering" 93 per cent of this year's graduates have still not found an NHS post.
Source
Australia: Working hours for young doctors still insane
Young doctors are still being compelled to work far more hours than are good for either them or patients, the Australian Medical Association said today. Despite the best efforts of the AMA over recent years, the latest safety audit of doctors found some still worked more than 100 hours a week, AMA president Dr Mukesh Haikerwal said. In one case, a doctor reported working 63 hours continuously.
The audit covered more than 15,000 doctors from hospitals around the country. Details will be released today. Dr Haikerwal said it showed 62 per cent of hospital doctors still were working unsafe hours and were classified as working at high or significant risk. "It used to be part of the folklore and it continues to be part of the myth and the myth is that you need to work long hours non-stop continuously to gain the experience," he told ABC radio. "At the end of the day, you can't actually learn anything if you are dead beat on your feet. "People who are seeing a doctor would expect them to be sharp and aware and alert when they are being treated and they certainly wouldn't want to be seeing them on their 80th or 39th or so hour on the trot."
Dr Haikerwal said he had been working in this issues since his days as a student and as a young doctor. The situation had improved, "but it is still not acceptable for people to be working 39 hours non-stop and it's not acceptable for people to be working up to 100 hours on average a week," he said.
Dr Alex Markwell, from the AMA council of doctors in training, said there was still an element of older doctors who trained under the old regime who felt their junior colleagues should undergo similar experience. "We need to start putting in place strict guidelines that actually enable safe rostering, enable doctors to say 'hold on, it's 16 hours, I am tired, someone else needs to come on and take over'," she told ABC radio. "We just need to stop expecting our doctors to keep going until something tragic happens which we have unfortunately seen in some states."
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Good old British "fudging"
The one certainty is that jobs have been lost. But in the publicity fog surrounding the NHS, it is unclear how many. Take the Mid Yorkshire Hospitals NHS Trust. Health Service Journal (Oct 19) quotes its chief executive: "We thought we would have to place just over 200 staff at risk of redundancy." In fact, just ten have taken voluntary redundancy and only four have been made redundant. But 200 is more likely to make headlines than four.
Another trust, in Worcestershire, identified more than 750 jobs at risk. In fact, says a trust spokesperson, only 11 have actually been lost. But pessimists can be forgiven for having expected worse. NHS Employers estimated that 20,000 posts were threatened. HSJ says that the reality is just 766 redundancies so far.
The important distinction is, it seems, between jobs lost and posts unfilled. Kevin Barron, the chair of the Commons Health Select Committee, says that he is "hoarse" from talking to organisations such as the Royal College of Nursing (RCN) which he says tell the media that thousands of jobs are being lost. "In my view, posts unfilled are not jobs lost," Barron says.
But that's little comfort to those who have been made redundant or who have completed their healthcare training and then found that they cannot get work. Commenting on a survey which found that barely half of student nurses expect to have jobs on qualifying, Susan Watts, the RCN's student adviser, says that new staff should be guaranteed a one-year contract. Failure to do so risks nursing shortages in a few years' time, she predicts.
Therapy Weekly (Oct 19) suggests that newly qualified physiotherapists are in a similar position. It says that a "staggering" 93 per cent of this year's graduates have still not found an NHS post.
Source
Australia: Working hours for young doctors still insane
Young doctors are still being compelled to work far more hours than are good for either them or patients, the Australian Medical Association said today. Despite the best efforts of the AMA over recent years, the latest safety audit of doctors found some still worked more than 100 hours a week, AMA president Dr Mukesh Haikerwal said. In one case, a doctor reported working 63 hours continuously.
The audit covered more than 15,000 doctors from hospitals around the country. Details will be released today. Dr Haikerwal said it showed 62 per cent of hospital doctors still were working unsafe hours and were classified as working at high or significant risk. "It used to be part of the folklore and it continues to be part of the myth and the myth is that you need to work long hours non-stop continuously to gain the experience," he told ABC radio. "At the end of the day, you can't actually learn anything if you are dead beat on your feet. "People who are seeing a doctor would expect them to be sharp and aware and alert when they are being treated and they certainly wouldn't want to be seeing them on their 80th or 39th or so hour on the trot."
Dr Haikerwal said he had been working in this issues since his days as a student and as a young doctor. The situation had improved, "but it is still not acceptable for people to be working 39 hours non-stop and it's not acceptable for people to be working up to 100 hours on average a week," he said.
Dr Alex Markwell, from the AMA council of doctors in training, said there was still an element of older doctors who trained under the old regime who felt their junior colleagues should undergo similar experience. "We need to start putting in place strict guidelines that actually enable safe rostering, enable doctors to say 'hold on, it's 16 hours, I am tired, someone else needs to come on and take over'," she told ABC radio. "We just need to stop expecting our doctors to keep going until something tragic happens which we have unfortunately seen in some states."
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Thursday, October 26, 2006
MORE MEDICAID CORRUPTION
Kayode Y. Abrams had nearly a dozen traffic citations and a criminal record when the District's Medicaid agency hired his company to drive the city's neediest to medical appointments. And when Abrams' company wasn't transporting Medicaid patients, the 33-year-old businessman had a side job: He was an organizer in a Northern Virginia crack-cocaine ring, according to court records.
Despite his criminal record, Abrams won certification as a Medicaid provider in the District. It was no fluke. Gaining entry into the lucrative but little-known industry has required little more than a driver's license, an inspected van, auto insurance and valid rates on file. Neither the D.C. Department of Health, which oversees Medicaid, nor the Washington Metropolitan Area Transit Commission, which licenses motor carriers, has conducted background checks of company officials in recent years.
City officials recently have pledged to reform the troubled program, but the lack of oversight raises questions about the overall management of the city's more than $1 billion Medicaid program. Last year, the District spent $22.3 million for nonemergency transportation of Medicaid patients -- slightly more than what the city paid for patients to see individual doctors, according to city records. "There's more paid for transportation trips than doctor visits, and anybody can tell you that smells," says D.C. Council member David A. Catania, at-large independent.
Kayo LLC, founded in 2002, was one of about 200 Medicaid transporters operating in the city before it collapsed in the wake of Abrams' arrest and 10-year prison sentence last year. Even with its owner in prison, Kayo LLC remains on a directory of Medicaid providers posted by the Department of Health on its Web site. Medicaid, which provides health insurance for the poor, is funded by the federal government and the states, which also manage their programs.
Much more here
Australia: Long wait for a little girl in pain
A 10-Year-old girl with chronic tonsilitis has been told she has to wait more than a year for surgery to relieve her constant pain. Bindy Fuller, of Warren in central western NSW, is in pain and requires constant medication. Her mother, Karon Fuller, said today that when she heard the NSW government claim there were only 50 people waiting longer than a year for surgery, she was hopeful her daughter would not have to wait long for her tonsils to be removed.
But after contacting Dubbo Base Hospital in May, Mrs Fuller said she had since been told Bindy would have to wait until November 2007.
Opposition health spokeswoman Jillian Skinner said the operation would only take 30 minutes. "Here's a little girl who has suffered tonsilitis all her life and has now been told she has to wait to November 2007 to have treatment," Ms Skinner said. "I can only imagine how difficult it is for a mum, hearing a premier boasting about few people waiting for surgery, to be told that you now have to wait longer than ever."
A spokesman for NSW Health Minister John Hatzistergos said it was unlikely Bindy would have to wait until November next year for surgery. He said she had been assessed as a category three patient and would therefore be scheduled for surgery within 12 months. This meant she was not due to receive surgery until May 2007 and it was unlikely the hospital would contact her before January.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Kayode Y. Abrams had nearly a dozen traffic citations and a criminal record when the District's Medicaid agency hired his company to drive the city's neediest to medical appointments. And when Abrams' company wasn't transporting Medicaid patients, the 33-year-old businessman had a side job: He was an organizer in a Northern Virginia crack-cocaine ring, according to court records.
Despite his criminal record, Abrams won certification as a Medicaid provider in the District. It was no fluke. Gaining entry into the lucrative but little-known industry has required little more than a driver's license, an inspected van, auto insurance and valid rates on file. Neither the D.C. Department of Health, which oversees Medicaid, nor the Washington Metropolitan Area Transit Commission, which licenses motor carriers, has conducted background checks of company officials in recent years.
City officials recently have pledged to reform the troubled program, but the lack of oversight raises questions about the overall management of the city's more than $1 billion Medicaid program. Last year, the District spent $22.3 million for nonemergency transportation of Medicaid patients -- slightly more than what the city paid for patients to see individual doctors, according to city records. "There's more paid for transportation trips than doctor visits, and anybody can tell you that smells," says D.C. Council member David A. Catania, at-large independent.
Kayo LLC, founded in 2002, was one of about 200 Medicaid transporters operating in the city before it collapsed in the wake of Abrams' arrest and 10-year prison sentence last year. Even with its owner in prison, Kayo LLC remains on a directory of Medicaid providers posted by the Department of Health on its Web site. Medicaid, which provides health insurance for the poor, is funded by the federal government and the states, which also manage their programs.
Much more here
Australia: Long wait for a little girl in pain
A 10-Year-old girl with chronic tonsilitis has been told she has to wait more than a year for surgery to relieve her constant pain. Bindy Fuller, of Warren in central western NSW, is in pain and requires constant medication. Her mother, Karon Fuller, said today that when she heard the NSW government claim there were only 50 people waiting longer than a year for surgery, she was hopeful her daughter would not have to wait long for her tonsils to be removed.
But after contacting Dubbo Base Hospital in May, Mrs Fuller said she had since been told Bindy would have to wait until November 2007.
Opposition health spokeswoman Jillian Skinner said the operation would only take 30 minutes. "Here's a little girl who has suffered tonsilitis all her life and has now been told she has to wait to November 2007 to have treatment," Ms Skinner said. "I can only imagine how difficult it is for a mum, hearing a premier boasting about few people waiting for surgery, to be told that you now have to wait longer than ever."
A spokesman for NSW Health Minister John Hatzistergos said it was unlikely Bindy would have to wait until November next year for surgery. He said she had been assessed as a category three patient and would therefore be scheduled for surgery within 12 months. This meant she was not due to receive surgery until May 2007 and it was unlikely the hospital would contact her before January.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Wednesday, October 25, 2006
MORE NHS NEGLIGENCE
What happens when erring doctors get little more than a slap on the wrist
Patients got a record 1 million pounds in payouts last year after docs operated on the WRONG body part. The NHS compensation went to 40 people.
Healthy ears, legs and hips were operated on - and in 35 cases wrong teeth were removed. One patient got 327,076 pounds - the biggest payout by the NHS Litigation Authority. Experts believe it is likely a good lung was removed.
In 2004 there were 27 claims for "wrong site surgery" - costing the NHS 447,000 pounds. But the figure has jumped 100 per cent in two years to 1,098,000. The authority was forced to disclose the payouts under the Freedom of Information Act.
A separate study found the wrong set of lungs were transplanted into a patient, another had a healthy testicle removed and a hysterectomy was carried out on the wrong woman. A Patients Association spokesman said: "Doctors must take care."
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
What happens when erring doctors get little more than a slap on the wrist
Patients got a record 1 million pounds in payouts last year after docs operated on the WRONG body part. The NHS compensation went to 40 people.
Healthy ears, legs and hips were operated on - and in 35 cases wrong teeth were removed. One patient got 327,076 pounds - the biggest payout by the NHS Litigation Authority. Experts believe it is likely a good lung was removed.
In 2004 there were 27 claims for "wrong site surgery" - costing the NHS 447,000 pounds. But the figure has jumped 100 per cent in two years to 1,098,000. The authority was forced to disclose the payouts under the Freedom of Information Act.
A separate study found the wrong set of lungs were transplanted into a patient, another had a healthy testicle removed and a hysterectomy was carried out on the wrong woman. A Patients Association spokesman said: "Doctors must take care."
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Tuesday, October 24, 2006
SOMETHING HOPEFUL BEING DONE ABOUT KING/DREW AT LAST
The black hospital in Los Angeles that kills blacks
A federal report detailed the reasons why a troubled inner-city hospital failed a critical inspection, including sloppy nursing care, medication mistakes, expired baby formula and blood-stained equipment. Martin Luther King Jr./Drew Medical Center came up short in nine of 23 health care categories, according to the 204-page final report released Friday by the U.S. Centers for Medicare and Medicaid Services. The troubled Willowbrook hospital had its $200 million in annual federal funding yanked after failing last summer's inspection.
As a result, county supervisors unanimously approved a plan to turn over the hospital's management to the Harbor-UCLA Medical Center. The hospital will be renamed Harbor-MLK Community Hospital on March 1. All of its staff will have to reapply for jobs, and it would be stripped of specialty services.
The document cited shortcomings in nearly all departments including management, the pharmacy, nursing and infection control. It focused on three areas in particular: the administration of medicine, errors by staff and the hospital's general lack of upkeep. County health department chief Dr. Bruce Chernof declined to comment on the final report.
Source
Australia: Foreign doctors bypass skills tests as shortages grow
Thousands of overseas-trained doctors are working in Australia without undergoing standard competency checks despite pledges of a shake-up in the wake of the Jayant Patel case in Queensland, new research has found. The number of unchecked doctors from non-Western countries is likely to rise because shortages are increasing dependence on foreign recruits, but there is no immediate prospect of a nationally agreed check on their skills, the research concludes. More than 3000 overseas doctors are granted work visas each year, but many are not required to have their knowledge and clinical skills formally assessed because of pressure to fill vacancies in many hospitals and country towns, the researchers Bob Birrell and Andrew Schwartz say.
Promises by health authorities of a tougher regime for overseas recruits have had "little effect on levels of recruitment of overseas-trained doctors, or on the way in which they were assessed", say Professor Birrell, a leading medical workforce analyst, and Mr Schwartz, president of the Australian Doctors Trained Overseas Association. Their research appears in Monash University's People and Place journal, published today.
In a separate development, the Australian Medical Association has asked the Federal Government to tighten assessment requirements for overseas doctors if states and territories are not able to agree on a national scheme.
The research finds that not only do many imported doctors bypass Australian assessment authorities because of provisional postings and acceptance by state medical boards of their employers' assurances, but also that many who do sit exams fail. The proportion of overseas general practitioner candidates initially deemed eligible to practice who passed their Australian exams had dropped from 61 per cent in 1999 to 40 per cent in 2004, figures supplied by the Royal Australian College of General Practitioners to the researchers said.
Professor Birrell and Mr Schwartz say the scale of the dependence on overseas doctors is shown by the number of occupational trainee doctors granted work visas. In 2004-05, there were 1400 registered in NSW alone, about a third from Britain and another third from Asian countries. The researchers say a national assessment scheme for overseas doctors has been proposed since the early 1990s but has foundered on the states' insistence on being able to bypass requirements to fill vacancies "in the public interest". In the wake of the Patel scandal, the state and federal governments had agreed to establish a national scheme by December, but there was "no immediate prospect" of a scheme coming into effect.
A spokeswoman for the federal Health Minister, Tony Abbott, said a "fully developed proposal" on national accreditation was expected by December and this would be "ready for further discussion and endorsement between the states and Commonwealth".
The researchers say there has been no outcry from Australia's medical profession, even though many medical authorities "care deeply about the situation". "Their silence partly reflects worries about doctor shortages and partly a reluctance to comment for fear that they will be regarded as feathering their own nest." But the scale of the shortage and the limited supply of British doctors "means that there will be increasing dependence on overseas-trained doctors drawn from non-Western medical settings", the researchers say.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
The black hospital in Los Angeles that kills blacks
A federal report detailed the reasons why a troubled inner-city hospital failed a critical inspection, including sloppy nursing care, medication mistakes, expired baby formula and blood-stained equipment. Martin Luther King Jr./Drew Medical Center came up short in nine of 23 health care categories, according to the 204-page final report released Friday by the U.S. Centers for Medicare and Medicaid Services. The troubled Willowbrook hospital had its $200 million in annual federal funding yanked after failing last summer's inspection.
As a result, county supervisors unanimously approved a plan to turn over the hospital's management to the Harbor-UCLA Medical Center. The hospital will be renamed Harbor-MLK Community Hospital on March 1. All of its staff will have to reapply for jobs, and it would be stripped of specialty services.
The document cited shortcomings in nearly all departments including management, the pharmacy, nursing and infection control. It focused on three areas in particular: the administration of medicine, errors by staff and the hospital's general lack of upkeep. County health department chief Dr. Bruce Chernof declined to comment on the final report.
Source
Australia: Foreign doctors bypass skills tests as shortages grow
Thousands of overseas-trained doctors are working in Australia without undergoing standard competency checks despite pledges of a shake-up in the wake of the Jayant Patel case in Queensland, new research has found. The number of unchecked doctors from non-Western countries is likely to rise because shortages are increasing dependence on foreign recruits, but there is no immediate prospect of a nationally agreed check on their skills, the research concludes. More than 3000 overseas doctors are granted work visas each year, but many are not required to have their knowledge and clinical skills formally assessed because of pressure to fill vacancies in many hospitals and country towns, the researchers Bob Birrell and Andrew Schwartz say.
Promises by health authorities of a tougher regime for overseas recruits have had "little effect on levels of recruitment of overseas-trained doctors, or on the way in which they were assessed", say Professor Birrell, a leading medical workforce analyst, and Mr Schwartz, president of the Australian Doctors Trained Overseas Association. Their research appears in Monash University's People and Place journal, published today.
In a separate development, the Australian Medical Association has asked the Federal Government to tighten assessment requirements for overseas doctors if states and territories are not able to agree on a national scheme.
The research finds that not only do many imported doctors bypass Australian assessment authorities because of provisional postings and acceptance by state medical boards of their employers' assurances, but also that many who do sit exams fail. The proportion of overseas general practitioner candidates initially deemed eligible to practice who passed their Australian exams had dropped from 61 per cent in 1999 to 40 per cent in 2004, figures supplied by the Royal Australian College of General Practitioners to the researchers said.
Professor Birrell and Mr Schwartz say the scale of the dependence on overseas doctors is shown by the number of occupational trainee doctors granted work visas. In 2004-05, there were 1400 registered in NSW alone, about a third from Britain and another third from Asian countries. The researchers say a national assessment scheme for overseas doctors has been proposed since the early 1990s but has foundered on the states' insistence on being able to bypass requirements to fill vacancies "in the public interest". In the wake of the Patel scandal, the state and federal governments had agreed to establish a national scheme by December, but there was "no immediate prospect" of a scheme coming into effect.
A spokeswoman for the federal Health Minister, Tony Abbott, said a "fully developed proposal" on national accreditation was expected by December and this would be "ready for further discussion and endorsement between the states and Commonwealth".
The researchers say there has been no outcry from Australia's medical profession, even though many medical authorities "care deeply about the situation". "Their silence partly reflects worries about doctor shortages and partly a reluctance to comment for fear that they will be regarded as feathering their own nest." But the scale of the shortage and the limited supply of British doctors "means that there will be increasing dependence on overseas-trained doctors drawn from non-Western medical settings", the researchers say.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Monday, October 23, 2006
STRANGE NHS PRIORITIES
The National Health Service spent tens of millions of pounds removing nearly 200,000 tattoos last year, according to figures released by the Department of Health last week. Rosie Winterton, the health minister, said in a Commons written answer that doctors had carried out the procedure, involving either skin grafts or lasers, on 187,063 tattoos. The figure has astonished MPs and consultants who fear NHS funds are being spent on trivial surgery while patients are denied potentially life-saving drugs and staff are laid off.
Even conservative estimates of the cost of removing a small tattoo under anaesthetic on the NHS put the bill for 2004-05 at 37 million pounds, but some consultants suggested a figure of 300m.
Steve Webb, the Liberal Democrat health spokesman, said: “In a week when we’ve seen the NHS turning down Velcade (a cancer drug) it seems incredible that so much is being spent on tattoo removal.” Tattoos were once seen as a rebellious statement and the preserve of criminals, bikers and sailors, but they have become increasingly mainstream adornments. According to research carried out by the Discovery Channel earlier this year, 29% of Britons aged 25-34 have tattoos. They are popular among celebrities. David Beckham, the former England football captain, has tattoos bearing the names of his three children, while Robbie Williams, the pop singer, has a Maori pattern on his left arm, a Celtic cross on his right hip, a lion on his shoulder and his grandfather’s name on his arm. Eight years ago there were 300 tattoo parlours in Britain; today there are more than 1,500.
Because tattoos penetrate under the skin, removing them is expensive. The tattooed area must be cut out and skin grafted over the gap. Removing tattoos with skin grafts in the private sector can cost 1,000-2,500 pounds. Laser surgery costs from a minimum 200 to more than 2,500.
While having tattoos removed for “beautification” on the NHS is banned, surgery may be undertaken to “secure mental health wellbeing”. Earlier this year a health trust in Manchester agreed to spend 2,500 removing the tattoos of Tanya Bainbridge, a 57-year-old transsexual. The former merchant seaman, previously called Brian, claimed the large tattoos on her forearms were “not ladylike” and made her depressed.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
The National Health Service spent tens of millions of pounds removing nearly 200,000 tattoos last year, according to figures released by the Department of Health last week. Rosie Winterton, the health minister, said in a Commons written answer that doctors had carried out the procedure, involving either skin grafts or lasers, on 187,063 tattoos. The figure has astonished MPs and consultants who fear NHS funds are being spent on trivial surgery while patients are denied potentially life-saving drugs and staff are laid off.
Even conservative estimates of the cost of removing a small tattoo under anaesthetic on the NHS put the bill for 2004-05 at 37 million pounds, but some consultants suggested a figure of 300m.
Steve Webb, the Liberal Democrat health spokesman, said: “In a week when we’ve seen the NHS turning down Velcade (a cancer drug) it seems incredible that so much is being spent on tattoo removal.” Tattoos were once seen as a rebellious statement and the preserve of criminals, bikers and sailors, but they have become increasingly mainstream adornments. According to research carried out by the Discovery Channel earlier this year, 29% of Britons aged 25-34 have tattoos. They are popular among celebrities. David Beckham, the former England football captain, has tattoos bearing the names of his three children, while Robbie Williams, the pop singer, has a Maori pattern on his left arm, a Celtic cross on his right hip, a lion on his shoulder and his grandfather’s name on his arm. Eight years ago there were 300 tattoo parlours in Britain; today there are more than 1,500.
Because tattoos penetrate under the skin, removing them is expensive. The tattooed area must be cut out and skin grafted over the gap. Removing tattoos with skin grafts in the private sector can cost 1,000-2,500 pounds. Laser surgery costs from a minimum 200 to more than 2,500.
While having tattoos removed for “beautification” on the NHS is banned, surgery may be undertaken to “secure mental health wellbeing”. Earlier this year a health trust in Manchester agreed to spend 2,500 removing the tattoos of Tanya Bainbridge, a 57-year-old transsexual. The former merchant seaman, previously called Brian, claimed the large tattoos on her forearms were “not ladylike” and made her depressed.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Sunday, October 22, 2006
PAY CUT FOR NHS MEDICAL STAFF
No cuts to the pay of bureaucrats, though; THEY are essential
Doctors and nurses are facing pay cuts as the Government struggles to resolve the hospital deficit crisis that has led to thousands of job losses. Nurses' unions accused the Department of Health of bullying after it insisted that medical staff should have a below-inflation pay rise to plug the hole in budgets, saying that patients would suffer otherwise.
The department said that doctors, nurses, midwives and dentists should get basic pay rises of 1.5 per cent next year, despite the NHS budget rising by 9 per cent. The 1.5 per cent offer is less than half the rate of inflation, so in real terms pay rates would be cut.
In its evidence to the independent pay review boards, the department gave warning that without pay restraint the NHS would not be able to tackle its deficits, jobs would be cut and patient care would suffer. It said: "The NHS is facing a challenging financial period with the need to change a 512 million pound deficit in 2005-06 into lasting financial balance." The department added: "All NHS pay is met from the general NHS allocation; there is no separate funding for pay. Therefore, pay uplifts must be affordable, otherwise funding for patient services will suffer. If pay levels are too high, NHS employers may well need to reduce staff posts."
Unions, which will present their claims on Tuesday, said that the Government was bullying them into accepting an offer that amounted to just 2p an hour for a newly qualified nurse. Karen Jennings, Unison's head of health, said: "It is outrageous to suggest that unless staff take what is effectively a pay cut, jobs will go and patients will suffer." Josie Irwin, head of employment at the Royal College of Nursing, said that the offer was derisory. "It is a slap in the face for the staff who have worked so hard under such intense pressure to deliver the Government's health reforms."
The Government faces the prospect of industrial action from Amicus, the union for health workers. Kevin Coyne, its national health officer, said: "Unless an improved [offer] is put on the table we will not hesitate to proceed to ballot for industrial action." The British Medical Association has already demanded a 4 per cent pay rise for doctors.
The Government dismissed claims that 1.5 per cent amounted to a pay cut because staff also got a rise for each year worked. Pay for some staff would be cut but the offer delivered a 4 per cent increase in average earnings "which compares with the average across the whole economy".
Andrew Lansley, the Shadow Health Secretary, said that Ms Hewitt was trying "to make NHS staff pay for the consequences of the Government's financial mismanagement and the 1.3 billion deficit from last year".
Source
NHS: "DIE OF CANCER. SEE IF WE CARE!"
Cancer sufferers in England are to be denied a life-extending drug because the Government's drugs rationing watchdog has refused to fund treatment, it was claimed last night. The National Institute for Health and Clinical Excellence will announce next week that Velcade should not be offered on the NHS to treat multiple myeloma, a cancer of the bone marrow. A course of Velcade costs between 9,000 and 18,000 pounds and was approved for use in Scotland in 1994.
Cancer charities and victims of the disease criticised the decision by NICE, saying that it was the latest example of the watchdog trying to save the Government money by rejecting drugs that increase life expectancy. Since June, NICE has refused to endorse five treatments that would extend the lives of people with bowel cancer, leukaemia and breast cancer, as well as Alzheimer's disease.
Janice Wrigglesworth, 59, from Keighley, in West Yorkshire, has multiple myeloma. She condemend the decision as insanity. She said: "Are they saying a Scottish life is worth more than an English life? "They are effectively saying to people with incurable diseases, `sit down in a darkened room and die'."
NICE refused to comment on next week's announcement. However, a spokesman said: "NICE's expert advisers review all the evidence on cancer treatments to determine whether they add benefits for patients when compared to other treatments that are already available. "The benefits that we assess include whether a drug extends life, and whether a drug improves patients' quality of life." A Department of Health spokesman said that it could not comment until the guidance was published.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
No cuts to the pay of bureaucrats, though; THEY are essential
Doctors and nurses are facing pay cuts as the Government struggles to resolve the hospital deficit crisis that has led to thousands of job losses. Nurses' unions accused the Department of Health of bullying after it insisted that medical staff should have a below-inflation pay rise to plug the hole in budgets, saying that patients would suffer otherwise.
The department said that doctors, nurses, midwives and dentists should get basic pay rises of 1.5 per cent next year, despite the NHS budget rising by 9 per cent. The 1.5 per cent offer is less than half the rate of inflation, so in real terms pay rates would be cut.
In its evidence to the independent pay review boards, the department gave warning that without pay restraint the NHS would not be able to tackle its deficits, jobs would be cut and patient care would suffer. It said: "The NHS is facing a challenging financial period with the need to change a 512 million pound deficit in 2005-06 into lasting financial balance." The department added: "All NHS pay is met from the general NHS allocation; there is no separate funding for pay. Therefore, pay uplifts must be affordable, otherwise funding for patient services will suffer. If pay levels are too high, NHS employers may well need to reduce staff posts."
Unions, which will present their claims on Tuesday, said that the Government was bullying them into accepting an offer that amounted to just 2p an hour for a newly qualified nurse. Karen Jennings, Unison's head of health, said: "It is outrageous to suggest that unless staff take what is effectively a pay cut, jobs will go and patients will suffer." Josie Irwin, head of employment at the Royal College of Nursing, said that the offer was derisory. "It is a slap in the face for the staff who have worked so hard under such intense pressure to deliver the Government's health reforms."
The Government faces the prospect of industrial action from Amicus, the union for health workers. Kevin Coyne, its national health officer, said: "Unless an improved [offer] is put on the table we will not hesitate to proceed to ballot for industrial action." The British Medical Association has already demanded a 4 per cent pay rise for doctors.
The Government dismissed claims that 1.5 per cent amounted to a pay cut because staff also got a rise for each year worked. Pay for some staff would be cut but the offer delivered a 4 per cent increase in average earnings "which compares with the average across the whole economy".
Andrew Lansley, the Shadow Health Secretary, said that Ms Hewitt was trying "to make NHS staff pay for the consequences of the Government's financial mismanagement and the 1.3 billion deficit from last year".
Source
NHS: "DIE OF CANCER. SEE IF WE CARE!"
Cancer sufferers in England are to be denied a life-extending drug because the Government's drugs rationing watchdog has refused to fund treatment, it was claimed last night. The National Institute for Health and Clinical Excellence will announce next week that Velcade should not be offered on the NHS to treat multiple myeloma, a cancer of the bone marrow. A course of Velcade costs between 9,000 and 18,000 pounds and was approved for use in Scotland in 1994.
Cancer charities and victims of the disease criticised the decision by NICE, saying that it was the latest example of the watchdog trying to save the Government money by rejecting drugs that increase life expectancy. Since June, NICE has refused to endorse five treatments that would extend the lives of people with bowel cancer, leukaemia and breast cancer, as well as Alzheimer's disease.
Janice Wrigglesworth, 59, from Keighley, in West Yorkshire, has multiple myeloma. She condemend the decision as insanity. She said: "Are they saying a Scottish life is worth more than an English life? "They are effectively saying to people with incurable diseases, `sit down in a darkened room and die'."
NICE refused to comment on next week's announcement. However, a spokesman said: "NICE's expert advisers review all the evidence on cancer treatments to determine whether they add benefits for patients when compared to other treatments that are already available. "The benefits that we assess include whether a drug extends life, and whether a drug improves patients' quality of life." A Department of Health spokesman said that it could not comment until the guidance was published.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Saturday, October 21, 2006
NEGLIGENT NHS KILLS AGAIN
THE family of a teenager who was exposed to massive overdoses of radiation during treatment for cancer blamed her death on hospital chiefs yesterday. Lisa Norris, 16, died at home on Wednesday, after receiving at least 17 overdoses of radiation during treatment for a brain tumour at the Beatson Oncology Centre in Glasgow. Her father, Ken Norris, said that she died after the cancer returned, but believed that it was a direct result of the hospital blunder and not a natural recurrence of the disease.
Eight months ago, Lisa and her family were celebrating after doctors said that a course of radiotherapy had destroyed a tumour in her brain. However, days later, consultants from the centre visited Lisa at her home in Girvan, Ayrshire, and told her that on every visit she had been exposed to a level of radiation 65 per cent higher than prescribed. Recalling the visit, Lisa said: "I asked them if I was going to die, but they ignored me. When I asked a second time if I would be here in five years, they said they could not answer."
NHS Greater Glasgow admitted at the time that the overdoses, which were administered by three different physicians and went unnoticed by two hospital administrators, were simply human error. It is now bracing itself for legal action from Lisa's parents, and the possibility of further legal actions from dozens of other patients. It has disclosed that there have been 46 incidents over the past 20 years during radiotherapy treatment, including 14 cases in which patients were given overdoses.
Mr Norris described Lisa as an inspiration. He said: "She kept us going in many ways. She was so positive and strong." He added: "We knew things were not looking good but we never expected Lisa to pass away so soon. We had hoped to see Christmas."
Professor Sir John Arbuthnott, the chairman of NHS Greater Glasgow, said that staff were "extremely upset" to hear of Lisa's death. He said: "I have passed on my condolences to the family on behalf of the whole organisation."
The overdoses left Lisa with bright red sores and blisters on her ears, head and neck. She also had difficulty sleeping because of a constant burning sensation inside her. She needed to take cold showers in an attempt to cool down but maintained her good humour, even as the symptoms grew worse. After trying on a blonde wig, Lisa, who had ginger hair until it fell out, said: "I always hated my hair colour. Anyway, I have such a red face and head now that it would have clashed."
Lisa became ill again last month and returned to hospital for emergency surgery for fluid on the brain. Doctors told her that the tumour had returned and offered her chemotherapy, but by then the cancer had spread to her spine and other parts of her body. Mr Norris said: "When she was in hospital recently, a doctor told us the overdose might have been to blame for the problems she developed. "One of the hardest things is that Lisa has died when there are still so many unanswered questions. But we will continue the fight for truth and for justice in her name."
The Scottish Executive has begun an independent investigation, which a spokesman said was in its final stages.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
THE family of a teenager who was exposed to massive overdoses of radiation during treatment for cancer blamed her death on hospital chiefs yesterday. Lisa Norris, 16, died at home on Wednesday, after receiving at least 17 overdoses of radiation during treatment for a brain tumour at the Beatson Oncology Centre in Glasgow. Her father, Ken Norris, said that she died after the cancer returned, but believed that it was a direct result of the hospital blunder and not a natural recurrence of the disease.
Eight months ago, Lisa and her family were celebrating after doctors said that a course of radiotherapy had destroyed a tumour in her brain. However, days later, consultants from the centre visited Lisa at her home in Girvan, Ayrshire, and told her that on every visit she had been exposed to a level of radiation 65 per cent higher than prescribed. Recalling the visit, Lisa said: "I asked them if I was going to die, but they ignored me. When I asked a second time if I would be here in five years, they said they could not answer."
NHS Greater Glasgow admitted at the time that the overdoses, which were administered by three different physicians and went unnoticed by two hospital administrators, were simply human error. It is now bracing itself for legal action from Lisa's parents, and the possibility of further legal actions from dozens of other patients. It has disclosed that there have been 46 incidents over the past 20 years during radiotherapy treatment, including 14 cases in which patients were given overdoses.
Mr Norris described Lisa as an inspiration. He said: "She kept us going in many ways. She was so positive and strong." He added: "We knew things were not looking good but we never expected Lisa to pass away so soon. We had hoped to see Christmas."
Professor Sir John Arbuthnott, the chairman of NHS Greater Glasgow, said that staff were "extremely upset" to hear of Lisa's death. He said: "I have passed on my condolences to the family on behalf of the whole organisation."
The overdoses left Lisa with bright red sores and blisters on her ears, head and neck. She also had difficulty sleeping because of a constant burning sensation inside her. She needed to take cold showers in an attempt to cool down but maintained her good humour, even as the symptoms grew worse. After trying on a blonde wig, Lisa, who had ginger hair until it fell out, said: "I always hated my hair colour. Anyway, I have such a red face and head now that it would have clashed."
Lisa became ill again last month and returned to hospital for emergency surgery for fluid on the brain. Doctors told her that the tumour had returned and offered her chemotherapy, but by then the cancer had spread to her spine and other parts of her body. Mr Norris said: "When she was in hospital recently, a doctor told us the overdose might have been to blame for the problems she developed. "One of the hardest things is that Lisa has died when there are still so many unanswered questions. But we will continue the fight for truth and for justice in her name."
The Scottish Executive has begun an independent investigation, which a spokesman said was in its final stages.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Friday, October 20, 2006
ONLY 15 MINUTES HELP FOR THE FRAIL ELDERLY IN BRITAIN
Privatization called for
Social workers have set a 15-minute limit on the amount of home help they will allow frail and vulnerable elderly people, a shocking watchdog report revealed. Care workers are under strict orders to take no more than a quarter of an hour to dress and bathe someone who needs help looking after themselves. Then they must abandon the job and move on to the next one, a report by the Government's social services inspectors said.
Their inquiry into the treatment of more than 350,000 vulnerable older people who need help to stay in their own homes found the system is riddled with shortages, failure and indifference. Most hurtful of the miseries inflicted on the elderly who get home help is the "15 minute slot", which is "undignified and unsafe", the Commission for Social Care Inspection said. It called for radical reforms to strip local council social workers of the right to organise home help for the elderly, and instead give older people their own buying power to get help from outside or pay the relatives who already care for them.
Inspectorate chief Dame Denise Platt said: "Failure to listen to what people really need, and respond to this, results in missed opportunities to promote independence. "At worst, it can also result in services that do not respect people’s rights and dignity."
The condemnation of the way elderly people are treated in their own homes by social workers and contractors hired by local councils is the latest in a series of scathing reports into the way frail and sick old people are cared for. The Daily Mail's Dignity for the Elderly campaign has highlighted the ill-treatment suffered by older people in care homes and hospitals, and the way the controversial means-testing scheme covering care home places forces 70,000 people a year to sell their homes to meet the bills.
The new report by inspectors backed the findings of an independent inquiry into care of the elderly carried out earlier this year by former Treasury troubleshooter Sir Derek Wanless. His findings - which were instantly dismissed by Chancellor Gordon Brown - said the Government should put greatly increased public spending into caring for people in their own homes in order to help them stay independent and out of care homes. The CSCI report said that far from increasing numbers who are helped at home, the total of those given assistance in dressing, washing, cleaning and preparing meals has dropped by a third over the past 13 years to just over 350,000. The inspectors found "widespread problems in relation to the shortness of visits, the timing of visits, and reliability, associated with care workers rushing between visits and turning up late."
Social work chiefs, it said, "restrict the help they will offer to a list of prescribed activities." "Care managers draw up individual care plans that tightly specify both the tasks to be undertaken and the time to be evoted to thise tasks. "People using services, their families and their care workers told us that it could be difficult to carry out the required tasks in the time available." The report called for a shake-up to strip social workers of their powers to organise care and give older people and their families more say. Pressure groups for the elderly endorsed the inspectors' findings.
Gordon Lishman of Age Concern said: "Too many frail and vulnerable older people are being let down by under-pressure staff and over-stretched councils who are not providing the care they need." A survey by the charity Counsel and Care last month found that one in three town halls have cut back the level of services they offer to elderly people getting help at home.
The Government has launched a 'Dignity in Care' campaign under which care workers and hospital staff will be told not to call old people "poppet" or "love" as part of an effort to cut maltreatment. But ministers have offered no new money to help improve the care system. Councils blamed the Government for giving them too little cash to provide home help. David Rogers of the Local Government Association said: "Councils want to provide more personalised services to give elderly people the care they both need and deserve. "An increasingly ageing population and issues around central government funding means there is not enough money in the system."
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Privatization called for
Social workers have set a 15-minute limit on the amount of home help they will allow frail and vulnerable elderly people, a shocking watchdog report revealed. Care workers are under strict orders to take no more than a quarter of an hour to dress and bathe someone who needs help looking after themselves. Then they must abandon the job and move on to the next one, a report by the Government's social services inspectors said.
Their inquiry into the treatment of more than 350,000 vulnerable older people who need help to stay in their own homes found the system is riddled with shortages, failure and indifference. Most hurtful of the miseries inflicted on the elderly who get home help is the "15 minute slot", which is "undignified and unsafe", the Commission for Social Care Inspection said. It called for radical reforms to strip local council social workers of the right to organise home help for the elderly, and instead give older people their own buying power to get help from outside or pay the relatives who already care for them.
Inspectorate chief Dame Denise Platt said: "Failure to listen to what people really need, and respond to this, results in missed opportunities to promote independence. "At worst, it can also result in services that do not respect people’s rights and dignity."
The condemnation of the way elderly people are treated in their own homes by social workers and contractors hired by local councils is the latest in a series of scathing reports into the way frail and sick old people are cared for. The Daily Mail's Dignity for the Elderly campaign has highlighted the ill-treatment suffered by older people in care homes and hospitals, and the way the controversial means-testing scheme covering care home places forces 70,000 people a year to sell their homes to meet the bills.
The new report by inspectors backed the findings of an independent inquiry into care of the elderly carried out earlier this year by former Treasury troubleshooter Sir Derek Wanless. His findings - which were instantly dismissed by Chancellor Gordon Brown - said the Government should put greatly increased public spending into caring for people in their own homes in order to help them stay independent and out of care homes. The CSCI report said that far from increasing numbers who are helped at home, the total of those given assistance in dressing, washing, cleaning and preparing meals has dropped by a third over the past 13 years to just over 350,000. The inspectors found "widespread problems in relation to the shortness of visits, the timing of visits, and reliability, associated with care workers rushing between visits and turning up late."
Social work chiefs, it said, "restrict the help they will offer to a list of prescribed activities." "Care managers draw up individual care plans that tightly specify both the tasks to be undertaken and the time to be evoted to thise tasks. "People using services, their families and their care workers told us that it could be difficult to carry out the required tasks in the time available." The report called for a shake-up to strip social workers of their powers to organise care and give older people and their families more say. Pressure groups for the elderly endorsed the inspectors' findings.
Gordon Lishman of Age Concern said: "Too many frail and vulnerable older people are being let down by under-pressure staff and over-stretched councils who are not providing the care they need." A survey by the charity Counsel and Care last month found that one in three town halls have cut back the level of services they offer to elderly people getting help at home.
The Government has launched a 'Dignity in Care' campaign under which care workers and hospital staff will be told not to call old people "poppet" or "love" as part of an effort to cut maltreatment. But ministers have offered no new money to help improve the care system. Councils blamed the Government for giving them too little cash to provide home help. David Rogers of the Local Government Association said: "Councils want to provide more personalised services to give elderly people the care they both need and deserve. "An increasingly ageing population and issues around central government funding means there is not enough money in the system."
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Thursday, October 19, 2006
TRANSPLANTS STUMP THE NHS
The NHS cannot cope with the huge increase in the number of organ transplants for which the Government has legislated, campaigners say. The National Kidney Federation and the All Party Parliamentary Kidney Group will call today for changes to the organ transplant system to take advantage of the Human Tissue Act, which came into effect last month. Reforms could double the number of kidney patients receiving transplants each year and abolish the waiting list of 6,000, campaigners say. But a shortage of surgeons and nurses means that the effects of the Act are limited.
Britain has 24 transplant centres, which should each have five surgeons - 120 in total. The actual number of specialist transplant surgeons is 86, the federation says. There are 12 full-time transplant co-ordinators - specialist nurses who give advice to patients and relatives; there should be at least 40.
About half of organs are unused as a result of relatives refusing permission. The Act, which states that relatives do not have a right to veto the expressed wishes of a donor, and should not be invited to do so, was intended at least to double Britain's rate of organ donation, currently the lowest in Western Europe. Doctors will still be expected to respect the preferences and religious wishes of families, experts said. Tim Statham, chief executive of the federation, said: "Despite the provisions of the Act, we do not expect surgeons to now ignore the strongly held wishes of relatives."
However, an increase in the availability of organs, and in the time for testing, identification and monitoring of suitable donors and transplant patients, would put stresses on the capacity of surgeons and transplant centres, he said. According to the federation, about 800 potential donor organs are lost each year from donors in whom the heart has stopped. In other cases, donors are "brain-dead". Until recently non-heartbeating donors had not been considered an appropriate source of organs.
The report, published today, calls on the Government to monitor the effect of legislation on transplant success. Anthony Warrens, of the Royal Society of Medicine, said: "At a time of deep emotional stress, when relatives have lost a loved one, it is understandable that a person may refuse permission to donate a much needed organ from their relative. This is often a decision they come to regret."
The NHS is cancelling more than 620 operations a day because of administrative errors, it was claimed last night. Mistakes such as failing to book operating theatres or to inform patients of the date resulted in about 162,500 procedures being abandoned last year. The Conservative MP Grant Shapps has used Freedom of Information laws to request data from trusts in England and Wales
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
The NHS cannot cope with the huge increase in the number of organ transplants for which the Government has legislated, campaigners say. The National Kidney Federation and the All Party Parliamentary Kidney Group will call today for changes to the organ transplant system to take advantage of the Human Tissue Act, which came into effect last month. Reforms could double the number of kidney patients receiving transplants each year and abolish the waiting list of 6,000, campaigners say. But a shortage of surgeons and nurses means that the effects of the Act are limited.
Britain has 24 transplant centres, which should each have five surgeons - 120 in total. The actual number of specialist transplant surgeons is 86, the federation says. There are 12 full-time transplant co-ordinators - specialist nurses who give advice to patients and relatives; there should be at least 40.
About half of organs are unused as a result of relatives refusing permission. The Act, which states that relatives do not have a right to veto the expressed wishes of a donor, and should not be invited to do so, was intended at least to double Britain's rate of organ donation, currently the lowest in Western Europe. Doctors will still be expected to respect the preferences and religious wishes of families, experts said. Tim Statham, chief executive of the federation, said: "Despite the provisions of the Act, we do not expect surgeons to now ignore the strongly held wishes of relatives."
However, an increase in the availability of organs, and in the time for testing, identification and monitoring of suitable donors and transplant patients, would put stresses on the capacity of surgeons and transplant centres, he said. According to the federation, about 800 potential donor organs are lost each year from donors in whom the heart has stopped. In other cases, donors are "brain-dead". Until recently non-heartbeating donors had not been considered an appropriate source of organs.
The report, published today, calls on the Government to monitor the effect of legislation on transplant success. Anthony Warrens, of the Royal Society of Medicine, said: "At a time of deep emotional stress, when relatives have lost a loved one, it is understandable that a person may refuse permission to donate a much needed organ from their relative. This is often a decision they come to regret."
The NHS is cancelling more than 620 operations a day because of administrative errors, it was claimed last night. Mistakes such as failing to book operating theatres or to inform patients of the date resulted in about 162,500 procedures being abandoned last year. The Conservative MP Grant Shapps has used Freedom of Information laws to request data from trusts in England and Wales
Source
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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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Wednesday, October 18, 2006
NHS centres 'rationing consultant visits'
New centres that "screen" patient referrals from GPs to hospital consultants are being used by the NHS to ration health care by stealth, say medical professionals. More than a third of primary care trusts (PCTs) have established "referral management centres" that, critics say, are preventing patients from seeing the doctor of their choice and in some cases are prolonging waiting times in order to save cash. In one case, GPs found thousands of referral letters stashed in a cupboard for weeks.
Patients' groups and doctors' leaders say the referral schemes, which are sanctioned by the Department of Health, are creating another tier of NHS bureaucracy and could actually harm people's health. GPs say some centres are refusing to let patients see consultants sooner than the Government's outpatient target of 13 weeks. This limits the number of appointments in any one year - saving the PCT money. In some trusts, people are being sent back to their GPs by doctors employed by referral centres, who decide they are not sick enough to warrant a hospital consultation. In a survey carried out by the medical magazine Pulse, 10 per cent of all PCTs admitted they had a specific target to cut GP referrals.
When patients in Milton Keynes started complaining of long delays, their GPs investigated. Milton Keynes PCT had set up a referral management centre, which was meant to scrutinise all referrals in order to speed access and ensure patients got the right treatment. But Dr Peter Berkin and colleagues discovered a backlog of more than 2,000 letters locked in a cupboard by the centre's secretaries until just short of the 13-week waiting-time target. "It got really scary," said Dr Berkin. "There were cases that could have been very serious and needed to see a consultant quickly. We were horrified. The decisions were taken by secretarial staff, not doctors." A spokesman for Milton Keynes PCT admitted there was a backlog, but said it had mostly been dealt with.
Katherine Murphy, of the Patients' Association, said: "These centres are springing up all over the place, but who's monitoring what they're up to? It seems to be another way of rationing patient care by stealth." Dr Hamish Meldrum, chairman of the British Medical Association's GPs' committee, said: "There is considerable concern among doctors. Where clinicians have been involved, things may be working well, but in other places there has been no effective consultation and it seems the main intention is to cut costs. This is potentially harmful to patients' health."
A Department of Health official said referral centres were a "local initiative" by PCTs, but national guidance had been issued on running them. "They must only be set up where they will have clinical benefits and should add value to patient services. They should not conflict with giving patients more choice [and] must not lengthen the patient journey or create 'hidden' waiting times."
Source
Australia: Public hospital cancer patients shafted
Secret waiting list figures have exposed the deadly delays Queensland cancer sufferers are forced to endure. Damning internal Queensland Health statistics have revealed cancer patients are waiting more than four times longer than recommended for life-saving treatment. According to the latest figures, priority-two patients, who have been diagnosed with aggressive cancers and internal bleeding, are now waiting up to 48 days for radiation treatment. Queensland Health's recommended maximum waiting time is 14 days to avoid "a significant adverse effect on outcomes". Patients with priority-three conditions, who predominantly suffer breast and prostate cancers, are waiting up to 89 days for treatment. The recommended maximum waiting time is 28 days.
The figures have changed little in the month since Health Minister Stephen Robertson downplayed radiation waiting times as a week-to-week prospect when they were initially obtained by The Courier-Mail. Mr Robertson, who yesterday could not be contacted, has repeatedly insisted the Government is tackling waiting times with a $9.7 billion injection into Queensland's health system. However, a spokesman for the Medical Radiation Professionals Group, a collective of Queensland Health workers, said waiting times would worsen.
Only the Royal Brisbane and Women's Hospital manages to treat patients within recommended waiting times. High-level hospital sources believe the RBWH's short waiting times were being caused by a chronic shortage of specialists able to recommend radiation. The Princess Alexandra Hospital in Brisbane has the longest wait times for category-two patients at 48 days. Townsville hospital has maintained the longest wait for priority-three patients at 89 days.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
New centres that "screen" patient referrals from GPs to hospital consultants are being used by the NHS to ration health care by stealth, say medical professionals. More than a third of primary care trusts (PCTs) have established "referral management centres" that, critics say, are preventing patients from seeing the doctor of their choice and in some cases are prolonging waiting times in order to save cash. In one case, GPs found thousands of referral letters stashed in a cupboard for weeks.
Patients' groups and doctors' leaders say the referral schemes, which are sanctioned by the Department of Health, are creating another tier of NHS bureaucracy and could actually harm people's health. GPs say some centres are refusing to let patients see consultants sooner than the Government's outpatient target of 13 weeks. This limits the number of appointments in any one year - saving the PCT money. In some trusts, people are being sent back to their GPs by doctors employed by referral centres, who decide they are not sick enough to warrant a hospital consultation. In a survey carried out by the medical magazine Pulse, 10 per cent of all PCTs admitted they had a specific target to cut GP referrals.
When patients in Milton Keynes started complaining of long delays, their GPs investigated. Milton Keynes PCT had set up a referral management centre, which was meant to scrutinise all referrals in order to speed access and ensure patients got the right treatment. But Dr Peter Berkin and colleagues discovered a backlog of more than 2,000 letters locked in a cupboard by the centre's secretaries until just short of the 13-week waiting-time target. "It got really scary," said Dr Berkin. "There were cases that could have been very serious and needed to see a consultant quickly. We were horrified. The decisions were taken by secretarial staff, not doctors." A spokesman for Milton Keynes PCT admitted there was a backlog, but said it had mostly been dealt with.
Katherine Murphy, of the Patients' Association, said: "These centres are springing up all over the place, but who's monitoring what they're up to? It seems to be another way of rationing patient care by stealth." Dr Hamish Meldrum, chairman of the British Medical Association's GPs' committee, said: "There is considerable concern among doctors. Where clinicians have been involved, things may be working well, but in other places there has been no effective consultation and it seems the main intention is to cut costs. This is potentially harmful to patients' health."
A Department of Health official said referral centres were a "local initiative" by PCTs, but national guidance had been issued on running them. "They must only be set up where they will have clinical benefits and should add value to patient services. They should not conflict with giving patients more choice [and] must not lengthen the patient journey or create 'hidden' waiting times."
Source
Australia: Public hospital cancer patients shafted
Secret waiting list figures have exposed the deadly delays Queensland cancer sufferers are forced to endure. Damning internal Queensland Health statistics have revealed cancer patients are waiting more than four times longer than recommended for life-saving treatment. According to the latest figures, priority-two patients, who have been diagnosed with aggressive cancers and internal bleeding, are now waiting up to 48 days for radiation treatment. Queensland Health's recommended maximum waiting time is 14 days to avoid "a significant adverse effect on outcomes". Patients with priority-three conditions, who predominantly suffer breast and prostate cancers, are waiting up to 89 days for treatment. The recommended maximum waiting time is 28 days.
The figures have changed little in the month since Health Minister Stephen Robertson downplayed radiation waiting times as a week-to-week prospect when they were initially obtained by The Courier-Mail. Mr Robertson, who yesterday could not be contacted, has repeatedly insisted the Government is tackling waiting times with a $9.7 billion injection into Queensland's health system. However, a spokesman for the Medical Radiation Professionals Group, a collective of Queensland Health workers, said waiting times would worsen.
Only the Royal Brisbane and Women's Hospital manages to treat patients within recommended waiting times. High-level hospital sources believe the RBWH's short waiting times were being caused by a chronic shortage of specialists able to recommend radiation. The Princess Alexandra Hospital in Brisbane has the longest wait times for category-two patients at 48 days. Townsville hospital has maintained the longest wait for priority-three patients at 89 days.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Tuesday, October 17, 2006
NHS to punish conservatives
Community hospitals that lie in Conservative or Liberal Democrat constituencies will bear the brunt of the Government's closure programme, re-igniting accusations of political interference in the NHS. The Times has learnt that seven times as many community hospitals have closed or are under threat in constituencies held by opposition MPs. There are 62 closed or at-risk hospitals in Conservative constituencies and 8 in Liberal Democrats seats, with 11 in Labour areas. This has prompted opposition MPs to accuse the Government of "playing politics" and undermining the hospital closure programme.
The revelation comes a month after The Times disclosed that ministers and Labour Party officials held meetings to work out ways of closing hospitals without jeopardising key marginal seats. Leaked e-mails showed that Patricia Hewitt, the Health Secretary, called for those at the meeting to be provided with "heat maps", showing marginal Labour seats where closures or reconfigurations of health services could cost votes. The Department of Health has consistently denied that political considerations reflect policy-making.
But research carried out by the Community Hospitals Association reveals that of the ten community hospitals that have already closed this year five fall in Conservative-held seats while four are in Liberal Democrat areas. The Department for Health said that it was committed to community hospitals, which are often found in more rural areas. Ms Hewitt recently promised a 750 million pound cash injection to community health services declaring: "Community hospitals have for too long been viewed as the poor relation of larger hospitals. This stops today."
Lord Warner, the Health Minister, has said that the Government is committed to spending 100 million on building or refurbishing at least 50 community hospitals which provide diagnostics, day surgery and outpatient facilities closer to where people live and work. However, a spokesman for the department said that some community hospitals could not cope with the challenge of the modern NHS and would close. The spokesman insisted that ministers had no ability to chose directly which hospitals closed and which stayed open. A statement from the department in February said that "hit squads" of inspectors would be dispatched to meet the heads of strategic health authorities, and reject any plans for community hospital closures from primary care trusts if they could not show that they had considered all other options, including other companies taking over the hospitals.
However, opposition MPs are suspicious of the move. Andrew Lansley, the Conservative health spokesman, said: "Last month we discovered that ministers are more concerned with saving the political skins of Labour MPs than they are with pursuing the long-term interests of the health service." Steve Webb, the Liberal Democrat health spokesman, said: "There are too many times for coincidence that the process is favouring Labour seats and Labour MPs. That undermines the whole process. If you go through consultations with a sneaking suspicion that the Labour seat is going to get the hospital anyway, it destroys your faith in these consultations. "Nobody would argue that a particular set of buildings should be set in stone for ever. Health needs change, population change, so buildings and services should change. The key is that the decision should be clinically based; what delivers the best care."
Sources close to Ms Hewitt said: "The reality is that a lot of these hospitals are not particularly strong on state-of-the-art healthcare. "We want the best healthcare, which is not the same as wanting to maintain the same buildings."
Source
Australia: Victoria's public hospitals are in deep doo doo also
Emergency ambulances are waiting up to three hours to unload patients because of overcrowded hospitals. The Herald Sun has been told patients' lives are at risk as the system struggles to cope. Some hospitals are accused of putting money before patients by refusing to send ambulances on. A Herald Sun Insight investigation has found:
HOSPITALS are going on ambulance bypass or partial diversion at near-record levels.
SOME are forcing ambulances to wait rather than miss financial bonuses by going on bypass.
A CASE when eight ambulances were queued outside an emergency department.
PARAMEDICS are no longer warned when hospitals shut their doors to emergency ambulances.
NEW mobile computers to record patient details are delaying patient delivery.
The Herald Sun revealed in May that the lives of hundreds of critically ill and injured patients were being put at risk by long delays in ambulance black spots. A Department of Human Services source this week told Insight some hospitals were ignoring a system designed to ensure ambulances bypassed overcrowded emergency departments. "They get penalised if they go on bypass so they don't, which in turn affects ambulance services quite badly," the DHS source said. "They can wait two to three hours at some hospitals before a patient is taken off the stretcher."
A Langwarrin ambulance crew was sent to relieve a Rosebud crew left waiting at Frankston Hospital for two hours last Wednesday night. The source said ambulances had been forced to wait three hours on several occasions at Frankston last month. "It's not just a Frankston problem. It's widespread," the source said. On one day in June, eight ambulances were banked up outside Dandenong Hospital waiting for patients to be assessed. Three were eventually treated at the hospital, but beds couldn't be found for the other five.
Leaked documents reveal city hospitals refused all but the most critical cases while on bypass on 65 occasions totalling 130 hours in May. These don't include diversions under the Hospital Early Warning System, introduced in 2002 to cut bypasses. In May, hospitals used HEWS 287 times, 80 more than in May last year. That puts total bypasses and diversions in 2005-06 as high as 4200. City hospitals went on bypass 2021 times in 1999-2000. The Government stopped releasing bypass numbers four years ago and does not publish HEWS figures.
Operational changes introduced last month mean paramedics are no longer told by dispatchers when a hospital goes on bypass or HEWS diversion. They are notified only when they enter a hospital name into an onboard data terminal when loading a patient. Ambulance employees union boss Steve McGhie accused the Government of keeping paramedics in the dark on bypasses ahead of the election. "It's a way of avoiding access to any data regarding hospital bypass by ourselves and ambulance employees," he said.
Paramedics said it took 20-40 minutes longer to enter cases on new handheld computers. "You actually take your mind off what you're doing with the patient at times to type things in," one said.
Opposition health spokeswoman Helen Shardey blamed Government pressure to reduce elective surgery waiting lists. "For the Government to tell us that everything is working well is clearly a distortion of the truth and these horrific stories are evidence of that," she said. Health Minister Bronwyn Pike rejected suggestions hospitals would endanger patients for financial reasons. "But our emergency departments are busy places and if they get an influx of people at the same time then the system has to deal with it," her spokesman said. He said the ambulance bypass rate of 1.3 per cent was a third of what it was in 1999.
MAS emergency operations manager Andre Coia said computerised bypass alerts were part of a new tracking system. He said average "at hospital times" had risen four minutes to 29 because of it, but changes were being made to speed up the process and cut times. The leaked figures show Royal Melbourne Hospital was worst hit, going on bypass for 50 hours and HEWS for 52 hours in May.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Community hospitals that lie in Conservative or Liberal Democrat constituencies will bear the brunt of the Government's closure programme, re-igniting accusations of political interference in the NHS. The Times has learnt that seven times as many community hospitals have closed or are under threat in constituencies held by opposition MPs. There are 62 closed or at-risk hospitals in Conservative constituencies and 8 in Liberal Democrats seats, with 11 in Labour areas. This has prompted opposition MPs to accuse the Government of "playing politics" and undermining the hospital closure programme.
The revelation comes a month after The Times disclosed that ministers and Labour Party officials held meetings to work out ways of closing hospitals without jeopardising key marginal seats. Leaked e-mails showed that Patricia Hewitt, the Health Secretary, called for those at the meeting to be provided with "heat maps", showing marginal Labour seats where closures or reconfigurations of health services could cost votes. The Department of Health has consistently denied that political considerations reflect policy-making.
But research carried out by the Community Hospitals Association reveals that of the ten community hospitals that have already closed this year five fall in Conservative-held seats while four are in Liberal Democrat areas. The Department for Health said that it was committed to community hospitals, which are often found in more rural areas. Ms Hewitt recently promised a 750 million pound cash injection to community health services declaring: "Community hospitals have for too long been viewed as the poor relation of larger hospitals. This stops today."
Lord Warner, the Health Minister, has said that the Government is committed to spending 100 million on building or refurbishing at least 50 community hospitals which provide diagnostics, day surgery and outpatient facilities closer to where people live and work. However, a spokesman for the department said that some community hospitals could not cope with the challenge of the modern NHS and would close. The spokesman insisted that ministers had no ability to chose directly which hospitals closed and which stayed open. A statement from the department in February said that "hit squads" of inspectors would be dispatched to meet the heads of strategic health authorities, and reject any plans for community hospital closures from primary care trusts if they could not show that they had considered all other options, including other companies taking over the hospitals.
However, opposition MPs are suspicious of the move. Andrew Lansley, the Conservative health spokesman, said: "Last month we discovered that ministers are more concerned with saving the political skins of Labour MPs than they are with pursuing the long-term interests of the health service." Steve Webb, the Liberal Democrat health spokesman, said: "There are too many times for coincidence that the process is favouring Labour seats and Labour MPs. That undermines the whole process. If you go through consultations with a sneaking suspicion that the Labour seat is going to get the hospital anyway, it destroys your faith in these consultations. "Nobody would argue that a particular set of buildings should be set in stone for ever. Health needs change, population change, so buildings and services should change. The key is that the decision should be clinically based; what delivers the best care."
Sources close to Ms Hewitt said: "The reality is that a lot of these hospitals are not particularly strong on state-of-the-art healthcare. "We want the best healthcare, which is not the same as wanting to maintain the same buildings."
Source
Australia: Victoria's public hospitals are in deep doo doo also
Emergency ambulances are waiting up to three hours to unload patients because of overcrowded hospitals. The Herald Sun has been told patients' lives are at risk as the system struggles to cope. Some hospitals are accused of putting money before patients by refusing to send ambulances on. A Herald Sun Insight investigation has found:
HOSPITALS are going on ambulance bypass or partial diversion at near-record levels.
SOME are forcing ambulances to wait rather than miss financial bonuses by going on bypass.
A CASE when eight ambulances were queued outside an emergency department.
PARAMEDICS are no longer warned when hospitals shut their doors to emergency ambulances.
NEW mobile computers to record patient details are delaying patient delivery.
The Herald Sun revealed in May that the lives of hundreds of critically ill and injured patients were being put at risk by long delays in ambulance black spots. A Department of Human Services source this week told Insight some hospitals were ignoring a system designed to ensure ambulances bypassed overcrowded emergency departments. "They get penalised if they go on bypass so they don't, which in turn affects ambulance services quite badly," the DHS source said. "They can wait two to three hours at some hospitals before a patient is taken off the stretcher."
A Langwarrin ambulance crew was sent to relieve a Rosebud crew left waiting at Frankston Hospital for two hours last Wednesday night. The source said ambulances had been forced to wait three hours on several occasions at Frankston last month. "It's not just a Frankston problem. It's widespread," the source said. On one day in June, eight ambulances were banked up outside Dandenong Hospital waiting for patients to be assessed. Three were eventually treated at the hospital, but beds couldn't be found for the other five.
Leaked documents reveal city hospitals refused all but the most critical cases while on bypass on 65 occasions totalling 130 hours in May. These don't include diversions under the Hospital Early Warning System, introduced in 2002 to cut bypasses. In May, hospitals used HEWS 287 times, 80 more than in May last year. That puts total bypasses and diversions in 2005-06 as high as 4200. City hospitals went on bypass 2021 times in 1999-2000. The Government stopped releasing bypass numbers four years ago and does not publish HEWS figures.
Operational changes introduced last month mean paramedics are no longer told by dispatchers when a hospital goes on bypass or HEWS diversion. They are notified only when they enter a hospital name into an onboard data terminal when loading a patient. Ambulance employees union boss Steve McGhie accused the Government of keeping paramedics in the dark on bypasses ahead of the election. "It's a way of avoiding access to any data regarding hospital bypass by ourselves and ambulance employees," he said.
Paramedics said it took 20-40 minutes longer to enter cases on new handheld computers. "You actually take your mind off what you're doing with the patient at times to type things in," one said.
Opposition health spokeswoman Helen Shardey blamed Government pressure to reduce elective surgery waiting lists. "For the Government to tell us that everything is working well is clearly a distortion of the truth and these horrific stories are evidence of that," she said. Health Minister Bronwyn Pike rejected suggestions hospitals would endanger patients for financial reasons. "But our emergency departments are busy places and if they get an influx of people at the same time then the system has to deal with it," her spokesman said. He said the ambulance bypass rate of 1.3 per cent was a third of what it was in 1999.
MAS emergency operations manager Andre Coia said computerised bypass alerts were part of a new tracking system. He said average "at hospital times" had risen four minutes to 29 because of it, but changes were being made to speed up the process and cut times. The leaked figures show Royal Melbourne Hospital was worst hit, going on bypass for 50 hours and HEWS for 52 hours in May.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Monday, October 16, 2006
THE DE-SKILLING OF THE NHS
Closing hospitals and shoving their work onto GPs
Minor surgery such as hernia repairs and varicose vein removal will be carried out in family doctors’ surgeries instead of in hospitals under plans to be announced by Patricia Hewitt, the health secretary, this week. Ministers believe that up to half of the 45m hospital outpatient appointments can be dealt with by GPs and nurses in local health centres. It will save the National Health Service money by freeing up hospital beds which cost about 300 pounds a day. Ministers say surgery in local health centres will make better use of highly trained GPs and be more convenient for patients.
Lord Warner, the minister for NHS reform, said: “The rationale behind providing care closer to home is to make better use of highly specialist skills . . . this will involve (having) GPs who are as skilled with the scalpel as they are with the stethoscope.”
Hewitt will also announce plans to free up hospital beds by discharging patients early with a telephone number for a nurse in case they have a relapse. The health secretary will say patients are likely to make a speedier recovery in the comfort of their own homes. A trial of the dial-a-nurse plan has already been carried out at the Royal Hampshire county hospital in Winchester. Bowel cancer patients have been discharged from hospital early and told to call if their condition deteriorates.
Cancer patients will be given chemotherapy in their own homes as part of the drive to reduce the amount of treatment carried out in hospitals, which are expensive to run. The changes will also reduce the risk of patients catching hospital-acquired infections such as MRSA. Hewitt pledged to move treatment out of hospitals in the government white paper Health Outside Hospitals, published in January. The plans may prove controversial when some hospitals are either downgraded or closed.
David Nicholson, chief executive of the NHS, warned that some hospitals will need to close. Last month he said that there would be up to 60 “reconfigurations” of NHS services, affecting every region in England.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Closing hospitals and shoving their work onto GPs
Minor surgery such as hernia repairs and varicose vein removal will be carried out in family doctors’ surgeries instead of in hospitals under plans to be announced by Patricia Hewitt, the health secretary, this week. Ministers believe that up to half of the 45m hospital outpatient appointments can be dealt with by GPs and nurses in local health centres. It will save the National Health Service money by freeing up hospital beds which cost about 300 pounds a day. Ministers say surgery in local health centres will make better use of highly trained GPs and be more convenient for patients.
Lord Warner, the minister for NHS reform, said: “The rationale behind providing care closer to home is to make better use of highly specialist skills . . . this will involve (having) GPs who are as skilled with the scalpel as they are with the stethoscope.”
Hewitt will also announce plans to free up hospital beds by discharging patients early with a telephone number for a nurse in case they have a relapse. The health secretary will say patients are likely to make a speedier recovery in the comfort of their own homes. A trial of the dial-a-nurse plan has already been carried out at the Royal Hampshire county hospital in Winchester. Bowel cancer patients have been discharged from hospital early and told to call if their condition deteriorates.
Cancer patients will be given chemotherapy in their own homes as part of the drive to reduce the amount of treatment carried out in hospitals, which are expensive to run. The changes will also reduce the risk of patients catching hospital-acquired infections such as MRSA. Hewitt pledged to move treatment out of hospitals in the government white paper Health Outside Hospitals, published in January. The plans may prove controversial when some hospitals are either downgraded or closed.
David Nicholson, chief executive of the NHS, warned that some hospitals will need to close. Last month he said that there would be up to 60 “reconfigurations” of NHS services, affecting every region in England.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Sunday, October 15, 2006
Why can't British patients pay for their own drugs?
The NHS often will not
The developers of a groundbreaking new breast cancer drug are expected to file for a licence to sell it in this country within the next few days. Trials suggest Lapatinib (brand name Tykerb) is effective on some women with advanced breast cancer who no longer get benefits from taking the drug Herceptin, and on women who are unable to take Herceptin because of side effects. Like Herceptin, it targets the HER2 protein, which can fuel the growth of breast tumours. About one in five beast cancers carry an excess of HER2 proteins. Unlike Herceptin, it also targets the HER1 receptor, and it may also act on secondary tumours in the brain. It is not a cure for cancer, but it appears to give patients an average of a few months longer to live.
Anni Matthews has advanced breast cancer which has spread to her lungs, and in 2002 she was told she only had two years to live. She took Herceptin for two and a half years, and began taking Lapatinib in March when Herceptin stopped being effective. She had seven tumours in her lungs, and she says all but one seems to have disappeared since she began her new treatment. She has experienced side effects, including stomach upsets and bleeding from her eyes, nose and fingernails, but she feels so well she is still able to lead a normal life including playing tennis twice a week.
Anni is lucky, though. She is getting Lapatinib because she is taking part in a medical trial. If the drug is licensed in Europe, other patients will have to pay for it, unless the NHS decides to fund it. Cancer experts estimate it will cost about 25,000 pounds a year. And patients would also have to pay for the rest of their cancer treatment privately, which would cost at least another 25,000 pounds, because they are not allowed to "top up" their NHS treatment by paying privately for new drugs.
Anni believes Lapatinib should be available on the NHS. "I can't see how this country can spend millions of pounds on drug research - encouraging companies to seek a cure for cancer - and then turn round and say, I'm terribly sorry we can't afford it," she said.
A leading oncologist, Professor Karol Sikora, says the time has come for the NHS to rethink the way expensive cancer drugs are funded. He believes patients should be allowed to "top up" their NHS treatment and pay for drugs themselves if their Primary Care Trusts won't fund them. "I think there's no alternative," he said. "In the next five years there are about 40 new cancer drugs coming along. They will all cost about 40,000 or 50,000 pounds a year. "The NHS simply can't afford them unless it gets an even bigger increase than it's had in the last ten years."
But the medical think tank, the King's Fund, is fundamentally opposed. "The NHS is based on equal treatment for equal need," says Tony Harrison, a senior fellow in health policy. "This could mean you'd get a patient in one NHS bed who can't have the drug next to a patient in the next bed who can, and that would be so obviously inequitable."
The Department of Health said it's not an option being considered at the moment. A spokesperson said it would risk creating a two-tier health service and be in direct contravention with the principles and values of the NHS.
Research is ongoing into whether Lapatinib might be effective against other forms of cancer. And while that continues, so will the debate about how this and other new cancer drugs might be funded in the future.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
The NHS often will not
The developers of a groundbreaking new breast cancer drug are expected to file for a licence to sell it in this country within the next few days. Trials suggest Lapatinib (brand name Tykerb) is effective on some women with advanced breast cancer who no longer get benefits from taking the drug Herceptin, and on women who are unable to take Herceptin because of side effects. Like Herceptin, it targets the HER2 protein, which can fuel the growth of breast tumours. About one in five beast cancers carry an excess of HER2 proteins. Unlike Herceptin, it also targets the HER1 receptor, and it may also act on secondary tumours in the brain. It is not a cure for cancer, but it appears to give patients an average of a few months longer to live.
Anni Matthews has advanced breast cancer which has spread to her lungs, and in 2002 she was told she only had two years to live. She took Herceptin for two and a half years, and began taking Lapatinib in March when Herceptin stopped being effective. She had seven tumours in her lungs, and she says all but one seems to have disappeared since she began her new treatment. She has experienced side effects, including stomach upsets and bleeding from her eyes, nose and fingernails, but she feels so well she is still able to lead a normal life including playing tennis twice a week.
Anni is lucky, though. She is getting Lapatinib because she is taking part in a medical trial. If the drug is licensed in Europe, other patients will have to pay for it, unless the NHS decides to fund it. Cancer experts estimate it will cost about 25,000 pounds a year. And patients would also have to pay for the rest of their cancer treatment privately, which would cost at least another 25,000 pounds, because they are not allowed to "top up" their NHS treatment by paying privately for new drugs.
Anni believes Lapatinib should be available on the NHS. "I can't see how this country can spend millions of pounds on drug research - encouraging companies to seek a cure for cancer - and then turn round and say, I'm terribly sorry we can't afford it," she said.
A leading oncologist, Professor Karol Sikora, says the time has come for the NHS to rethink the way expensive cancer drugs are funded. He believes patients should be allowed to "top up" their NHS treatment and pay for drugs themselves if their Primary Care Trusts won't fund them. "I think there's no alternative," he said. "In the next five years there are about 40 new cancer drugs coming along. They will all cost about 40,000 or 50,000 pounds a year. "The NHS simply can't afford them unless it gets an even bigger increase than it's had in the last ten years."
But the medical think tank, the King's Fund, is fundamentally opposed. "The NHS is based on equal treatment for equal need," says Tony Harrison, a senior fellow in health policy. "This could mean you'd get a patient in one NHS bed who can't have the drug next to a patient in the next bed who can, and that would be so obviously inequitable."
The Department of Health said it's not an option being considered at the moment. A spokesperson said it would risk creating a two-tier health service and be in direct contravention with the principles and values of the NHS.
Research is ongoing into whether Lapatinib might be effective against other forms of cancer. And while that continues, so will the debate about how this and other new cancer drugs might be funded in the future.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Saturday, October 14, 2006
Alzheimer's drugs appeal refused
Two pounds and fifty pence per day per patient is too expensive for the NHS!
Alzheimer's disease groups have condemned a decision by the NHS drugs watchdog to reject their appeal for greater access to certain drugs. The National Institute for Health and Clinical Excellence said donepezil, rivastigmine and galantamine could be used to treat moderate stage disease. Campaigners had argued patients in the early stages of Alzheimer's should also have access to the 2.50 pounds-per-day drugs. But NICE said studies showed the drugs "did not make enough of a difference". NICE guidelines cover England and Wales, but the health bodies in Scotland often follow suit.
The body has also ruled another drug, memantine, should be used only in clinical studies for people with moderately severe to severe Alzheimer's disease. Eisai and Pfizer, who produce donepezil, also known as Aricept, said they were considering whether to seek a judicial review of the decision.
About 750,000 people in the UK are estimated to have dementia, but only 78,000 patients take donepezil, rivastigmine and galantamine, with two thirds of those taking donepezil. Galantamine is also known as Reminyl, rivastigmine as Exelon and memantine as Ebixa.
NICE guidance in 2001 recommended the drugs - which can make it easier to carry out everyday tasks - should be used as standard. However, in July 2005 it said access to the drugs should be restricted because they were not good value for money. It has now issued its final guidance, which will apply only to newly-diagnosed patients. Those already taking the drugs will continue to do so.
Andrew Dillon, chief executive of NICE, said: "Alzheimer's is a cruel and devastating illness and we realise that today's announcement will be disappointing to people with Alzheimer's and those who treat and care for them. "But we have to be honest and say that, based on all the evidence, including data presented by the drug companies themselves, our experts have concluded that these drugs do not make enough of a difference for us to recommend their use for treating all stages of Alzheimer's disease. "We have recommended the use of these drugs where they have the potential to make a real difference, which is at the moderate stage of the illness." He told the BBC the appeal was "not designed to re-run the whole evaluation", but that "the appeal panel is to make sure the process has been followed properly".
Action on Alzheimer's, an alliance of more than 30 professional and patient organisations, reacted angrily to the ruling. "The decision will force patients to wait until their condition deteriorates into a state of fear and confusion before receiving drugs that work," it said. Speaking on the BBC's Today programme, Professor Clive Ballard, from the Alzheimer's Society, claimed there were "a number of clear errors during the [Nice] appeal process" that did not appear to have been "addressed". He said: "I think that is a very serious allegation but I believe that to be true."
Help the Aged said one in five people over 80 were affected by dementia and the number of people living with the disease was set to double in a decade. Jonathan Ellis, senior policy manager at the charity, said: "It cannot be right to allow the health of thousands of older people to deteriorate on the altar of cost." A Department of Health spokesman said it would be "entirely inappropriate" to overrule NICE's decision.
Source
FEW GOOD HOSPITALS IN THE NHS
Quality standards and financial management in the NHS still need improvement, according to a hard-hitting report into the service. More than half of all NHS trusts in England provide services that are only weak or fair, and four fifths fall into the same category for their use of resources.
The ratings are the first produced by the Healthcare Commission under a system that has replaced star ratings. The criteria are broader and tougher, which is reflected in the results. Among hospitals, 11 qualify as excellent and 12 are described as weak in quality of service. Primary care trusts (PCTs) come out even worse: only six deliver excellent services and 24 are weak.
The new scales offer four rungs, roughly corresponding to the old three, two, one or zero stars. Services are assessed as excellent, good, fair or weak, and a similar scale is used to measure financial management, described as "use of resources". Not a single PCT wins the accolade of excellent for financial management and 124 are described as weak. Among ambulance trusts, not one is deemed excellent in either category.
The report will make unhappy reading for ministers, who have argued that the extra money going into the NHS is having real effects. The Healthcare Commission agrees: it sees a lot of positives in the findings and says that more demanding criteria, rather than declining performance, are behind the gloomy ratings.
The commission ranked 570 trusts in England, including PCTs, acute hospital trusts, mental health trusts and ambulance trusts. It concluded that 60 per cent were weak or needed to improve. Only two hospitals - Harrogate and District NHS Foundation Trust and the Royal Marsden Hospital in London - gained excellent ratings for services and use of resources. Eight scored weak in both categories. Overall, 24 trusts were ranked as weak for both quality of services and use of resources. For these - eight hospital trusts, 11 PCTs, four ambulance trusts and one mental health trust - the strategic health authorities would be demanding an action plan to put things right within 30 days.
Anna Walker, the chief executive of the commission, said that there were examples of good work, but added: "The NHS does need to raise its game to ensure a universal guarantee that general standards on both quality of services and use of resources are being met. What this assessment is about is systematically looking at each of these trusts to see how they are performing. What we are saying about the weak ones is not that they are unsafe but that they do have issues that they need to address quickly."
All trusts that ran a deficit in 2005-06 were automatically rated as weak in use of resources. But many, especially among the PCTs, would have scored the same even if they had not run a deficit, because their financial management was poor, Gary Needle, head of the annual health check at the commission, said. Ms Walker said: "This is a worrying picture of an NHS where financial management is not good enough. There are too many weak trusts, which failed to manage finances properly and too many fair trusts, which means that there is room for improvement. "It is no secret that the NHS has struggled with finances over the past year, but this assessment shows it is not only deficits that are the problem. It shows that many organisations do not have adequate financial systems in place. "Patients' care will suffer in the end if this is not put right."
The commission examined quality of services in a variety of ways. They included 24 core standards, looking at areas such as safety, clinical effectiveness and patient focus. Also incorporated were the old targets, mostly concerned with waiting times, where trusts did relatively well, and new targets, such as promoting good health, reducing obesity and helping people to give up smoking, where they did less well.
Patricia Hewitt, the Health Secretary, urged the NHS to redouble its efforts to meet patients' expectations. "The best of the NHS is among the best in the world and we should all be proud of its achievements," she said. "But I want to see the best everywhere. "This is the toughest and most comprehensive assessment of the NHS and it takes forward the commitment we made to patients and the public to provide them with detailed and easily understandable information about the performance of their local health services."
Nigel Edwards, director of policy at the NHS Confederation, said that the spread of results was proof that the latest round of reorganisations had adversely affected services. "Foundation trusts, who have not been reorganised and have extra freedoms to manage their own affairs, have been able to get on with the job and improve services, as the health check shows," he said.
Niall Dickson, chief executive of the King's Fund health think-tank, said: "There is clearly a mountain to climb here, especially in financial management: in part a legacy of the health service not grappling with underlying deficits early enough."
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Two pounds and fifty pence per day per patient is too expensive for the NHS!
Alzheimer's disease groups have condemned a decision by the NHS drugs watchdog to reject their appeal for greater access to certain drugs. The National Institute for Health and Clinical Excellence said donepezil, rivastigmine and galantamine could be used to treat moderate stage disease. Campaigners had argued patients in the early stages of Alzheimer's should also have access to the 2.50 pounds-per-day drugs. But NICE said studies showed the drugs "did not make enough of a difference". NICE guidelines cover England and Wales, but the health bodies in Scotland often follow suit.
The body has also ruled another drug, memantine, should be used only in clinical studies for people with moderately severe to severe Alzheimer's disease. Eisai and Pfizer, who produce donepezil, also known as Aricept, said they were considering whether to seek a judicial review of the decision.
About 750,000 people in the UK are estimated to have dementia, but only 78,000 patients take donepezil, rivastigmine and galantamine, with two thirds of those taking donepezil. Galantamine is also known as Reminyl, rivastigmine as Exelon and memantine as Ebixa.
NICE guidance in 2001 recommended the drugs - which can make it easier to carry out everyday tasks - should be used as standard. However, in July 2005 it said access to the drugs should be restricted because they were not good value for money. It has now issued its final guidance, which will apply only to newly-diagnosed patients. Those already taking the drugs will continue to do so.
Andrew Dillon, chief executive of NICE, said: "Alzheimer's is a cruel and devastating illness and we realise that today's announcement will be disappointing to people with Alzheimer's and those who treat and care for them. "But we have to be honest and say that, based on all the evidence, including data presented by the drug companies themselves, our experts have concluded that these drugs do not make enough of a difference for us to recommend their use for treating all stages of Alzheimer's disease. "We have recommended the use of these drugs where they have the potential to make a real difference, which is at the moderate stage of the illness." He told the BBC the appeal was "not designed to re-run the whole evaluation", but that "the appeal panel is to make sure the process has been followed properly".
Action on Alzheimer's, an alliance of more than 30 professional and patient organisations, reacted angrily to the ruling. "The decision will force patients to wait until their condition deteriorates into a state of fear and confusion before receiving drugs that work," it said. Speaking on the BBC's Today programme, Professor Clive Ballard, from the Alzheimer's Society, claimed there were "a number of clear errors during the [Nice] appeal process" that did not appear to have been "addressed". He said: "I think that is a very serious allegation but I believe that to be true."
Help the Aged said one in five people over 80 were affected by dementia and the number of people living with the disease was set to double in a decade. Jonathan Ellis, senior policy manager at the charity, said: "It cannot be right to allow the health of thousands of older people to deteriorate on the altar of cost." A Department of Health spokesman said it would be "entirely inappropriate" to overrule NICE's decision.
Source
FEW GOOD HOSPITALS IN THE NHS
Quality standards and financial management in the NHS still need improvement, according to a hard-hitting report into the service. More than half of all NHS trusts in England provide services that are only weak or fair, and four fifths fall into the same category for their use of resources.
The ratings are the first produced by the Healthcare Commission under a system that has replaced star ratings. The criteria are broader and tougher, which is reflected in the results. Among hospitals, 11 qualify as excellent and 12 are described as weak in quality of service. Primary care trusts (PCTs) come out even worse: only six deliver excellent services and 24 are weak.
The new scales offer four rungs, roughly corresponding to the old three, two, one or zero stars. Services are assessed as excellent, good, fair or weak, and a similar scale is used to measure financial management, described as "use of resources". Not a single PCT wins the accolade of excellent for financial management and 124 are described as weak. Among ambulance trusts, not one is deemed excellent in either category.
The report will make unhappy reading for ministers, who have argued that the extra money going into the NHS is having real effects. The Healthcare Commission agrees: it sees a lot of positives in the findings and says that more demanding criteria, rather than declining performance, are behind the gloomy ratings.
The commission ranked 570 trusts in England, including PCTs, acute hospital trusts, mental health trusts and ambulance trusts. It concluded that 60 per cent were weak or needed to improve. Only two hospitals - Harrogate and District NHS Foundation Trust and the Royal Marsden Hospital in London - gained excellent ratings for services and use of resources. Eight scored weak in both categories. Overall, 24 trusts were ranked as weak for both quality of services and use of resources. For these - eight hospital trusts, 11 PCTs, four ambulance trusts and one mental health trust - the strategic health authorities would be demanding an action plan to put things right within 30 days.
Anna Walker, the chief executive of the commission, said that there were examples of good work, but added: "The NHS does need to raise its game to ensure a universal guarantee that general standards on both quality of services and use of resources are being met. What this assessment is about is systematically looking at each of these trusts to see how they are performing. What we are saying about the weak ones is not that they are unsafe but that they do have issues that they need to address quickly."
All trusts that ran a deficit in 2005-06 were automatically rated as weak in use of resources. But many, especially among the PCTs, would have scored the same even if they had not run a deficit, because their financial management was poor, Gary Needle, head of the annual health check at the commission, said. Ms Walker said: "This is a worrying picture of an NHS where financial management is not good enough. There are too many weak trusts, which failed to manage finances properly and too many fair trusts, which means that there is room for improvement. "It is no secret that the NHS has struggled with finances over the past year, but this assessment shows it is not only deficits that are the problem. It shows that many organisations do not have adequate financial systems in place. "Patients' care will suffer in the end if this is not put right."
The commission examined quality of services in a variety of ways. They included 24 core standards, looking at areas such as safety, clinical effectiveness and patient focus. Also incorporated were the old targets, mostly concerned with waiting times, where trusts did relatively well, and new targets, such as promoting good health, reducing obesity and helping people to give up smoking, where they did less well.
Patricia Hewitt, the Health Secretary, urged the NHS to redouble its efforts to meet patients' expectations. "The best of the NHS is among the best in the world and we should all be proud of its achievements," she said. "But I want to see the best everywhere. "This is the toughest and most comprehensive assessment of the NHS and it takes forward the commitment we made to patients and the public to provide them with detailed and easily understandable information about the performance of their local health services."
Nigel Edwards, director of policy at the NHS Confederation, said that the spread of results was proof that the latest round of reorganisations had adversely affected services. "Foundation trusts, who have not been reorganised and have extra freedoms to manage their own affairs, have been able to get on with the job and improve services, as the health check shows," he said.
Niall Dickson, chief executive of the King's Fund health think-tank, said: "There is clearly a mountain to climb here, especially in financial management: in part a legacy of the health service not grappling with underlying deficits early enough."
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
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