Monday, May 14, 2007

NHS 'failing on mixed-sex wards'

The NHS is failing to ensure all non-emergency hospital patients are kept in single-sex accommodation, the government has admitted. Campaigners say mixed-sex accommodation denies patients the chance of treatment with "privacy, respect and dignity".

Ministers were insisting as recently as November that 99% of patients were being seen in single-sex wards. But the government has now announced that 28 NHS trusts - 15% of the total - need more help achieving this. The promise to end mixed-sex accommodation was first made in the 1997 general election manifesto after Tony Blair attacked the Conservatives for failing to have "the wit" to end the practice. A target was introduced in 2000 that within two years 95% of patients would be in single-sex accommodation.

The government's definition includes separate wards or bays divided by fixed partitions, which campaigners say is not enough. Patients also needed access to single-sex toilet facilities. Departments such as intensive care and A&E do not have to fully comply for practical reasons, although they are expected to make an effort.

Last year, ministers said NHS managers had reported just 1% of patients were seen in mixed wards. But the government launched an inquiry after reports from patients and a survey by the Healthcare Commission cast doubt on the claim.

Chief nursing officer Christine Beasley, who conducted the inquiry, has now concluded the NHS had to do more to keep male and female patients separate. Her report called on all hospitals to review their practices and said 28 trusts were receiving support to change their practices because they were falling a long-way short. It did not identify how many patients were staying in mixed accommodation, although campaigners said it ran into many thousands. The report also failed to explain why NHS managers had given ministers what turned out to be incorrect information.

Professor Beasley said: "I am asking the NHS to do more to ensure that when there is no choice but to mix patients, that more safeguards are taken to ensure that privacy is maintained."

Health Secretary Patricia Hewitt said: "The NHS overall has an excellent record of treating people with dignity and respect. "However, this report shows there is clearly still more work for the NHS to do to meet our commitment to eliminate mixed-sex accommodation wherever possible."

Katherine Murphy, of the Patients Association, said: "Patients have a right to be treated in a safe environment with privacy, respect and dignity. "Patients continue to complain and for years politicians have promised to rectify this problem. "After more than 10 years of promises broken by a succession of ministers, it is time for action."

The Patient Forums organisation said a survey it carried out of 2,500 patients in March this year found 25% had shared a ward or bay with members of the opposite sex. Chair Jacquie Pearce-Gervis said: "We would like to see an eradication of mixed sex wards in order for all patients to spend their time in hospital recovering and not worrying that their dignity or privacy could be compromised."

Shadow health secretary Andrew Lansley accused the government of trying to bury bad news by publishing the report on the day Tony Blair was expected to announce his resignation. "Labour will never learn that the public are fed up with their style of government instead of dealing with the problems being faced by patients."

Source




Cancer, and good and bad arguments against socialized medicine

Post lifted from Tiger Hawk . See the original for links

Captain Ed declared today that "US healthcare saves more lives than socialized medicine." Maybe it does, and maybe it doesn't. I'm quite sure, though, that Ed's evidence -- a recent study that shows a correlation between the availability of certain anti-cancer drugs and survival rates in more than 60 countries -- does not necessarily support the proposition in the title of Ed's post. The Anchoress, bless her soul, is no closer to the target with her headline: "US Cancer Care 10X better than socialized UK."

There are a number of obvious objections to these post titles and the underlying claims made for them, but the most devestating one is this: It hardly matters if cancer cure rates are higher in the United States if we also have higher rates of advanced stage cancer because of other aspects in our health care system, such as infrequent or non-existent screening for an unfortunately large proportion of the population. Sure, we may cure more cancers than those parlor pinks in Europe, but perhaps we have more cancers to cure because we do a poorer job of detecting precancerous changes when they can be treated without drugs. Now, I don't know that any of the foregoing is true -- although I suspect it is -- but one cannot determine from Ed's post or the underlying links whether it isn't true. The conclusion in the post heading is therefore a leap of faith rather than a bankable conclusion.

That said, there are versions of socialized medicine that raise troubling questions that are quite independent from "collective" public health outcomes. First, better collective results do not necessarily make for a more just system. A socialized single-payer system might, for example, decide that it was wasting money on too-frequent screening of women for cervical cancer at the cost of, say, insufficient "well baby" care. A bureaucratic decision to shift resources from the first to the second might save the lives of more children than the lives lost to undetected cervical cancer, and so result in a "better" public health outcome. That collective victory, however, would be cold comfort to the dying woman who would have elected more frequent Pap smears but was not allowed even to pay for them out of her own pocket (for fear of creating an alternative private system for "the rich"). A rigid single-payer system does not allow for different appetites for risk -- those judgments become "social," rather than individual. That forced substitution of bureaucratic decision for individual choice is itself dehumanizing, whether socialists admit it or not.

Second, the supporters of hard single-payer systems completely ignore the rights -- yes, I mean the rights -- of physicians and other healthcare providers. Extra: TigerHawk points to the first reader who identifies the author and context of this quotation:

"I quit when medicine was placed under State control, some years ago," said Dr. Hendricks. "Do you know what it takes to perform a brain operation? Do you know the kind of skill it demands, and the years of passionate, merciless, excruciating devotion that go to acquire that skill? That was what I would not place at the disposal of men whose sole qualification to rule me was their capacity to spout the fraudulent generalities that got them elected tot he privilege of enforcing their wishes at the point of a gun. I would not let them dictate the purpose for which my years of study had been spent, or the conditions of my work, or my choice of patients, or the amount of my reward. I observed that in all the discussions that preceded the enslavement of medicine, men discussed everything -- except the desires of the doctors. Men considered only the 'welfare' of the patients, with no thought for those who were to provide it. That a doctor should have any right, desire or choice in the matter, was regarded as irrelevant selfishness; his is not to choose, they said, only 'to serve.' That a man who's willing to work under compulsion is too dangerous a brute to entrust with a job in the stockyards -- never occurred to those who proposed to help the sick by making life impossible for the healthy. I have often wondered at the smugness with which people assert their right to enslave me, to control my work, to force my will, to violate my conscience, to stifle my mind -- yet what is it that they expect to depend on, when they lie on an operating table under my hands? Their moral code has taught them to believe that it is safe to rely on the virtue of their victims. Well, that is the virtue I have withdrawn. Let them discover the kind of doctors that their system will now produce. Let them discover, in their operating rooms and hospital wards, that it is not safe to place their lives in the hands of a man whose life they have throttled. It is not safe, if he is the sort of man who resents it -- and still less safe, if he is the sort who doesn't."

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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?

For more postings from me, see TONGUE-TIED, GREENIE WATCH, POLITICAL CORRECTNESS WATCH, FOOD & HEALTH SKEPTIC, GUN WATCH, EDUCATION WATCH, AUSTRALIAN POLITICS, DISSECTING LEFTISM, IMMIGRATION WATCH and EYE ON BRITAIN. My Home Pages are here or here or here. Email me (John Ray) here. For times when blogger.com is playing up, there are mirrors of this site here and here.

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