Tuesday, July 24, 2007

NHS negligence kills little boy

A hospital has apologised to the parents of a baby who died when doctors failed to spot a serious heart condition after mixing up his X-rays. Staff at the Royal Cornwall Hospital in Truro thought that one-year-old Jack Garland was teething and sent him home with painkillers. After a second X-ray two weeks later, they realised that he had mitochondrial respiratory complex, a rare genetic complaint. He was taken immediately to Great Ormond Street Hospital, but died 16 days later of heart failure and a brain haemorrhage.

Jack’s father, Ben Garland, 31, from Truro, said: “Those two weeks when he was first sent home were crucial. The hospital’s mistake cost my son his fighting chance. To hold him while they turned the machines off is something I will never forget. All we want is someone to be honest and say they will take responsibility.”

John Watkins, chief executive of the Royal Cornwall Hospitals Trust, said in a letter to Jack’s parents that a senior doctor had reviewed the first X-ray and could “clearly” see that the child had an enlarged heart. Mr Watkins wrote: “The doctor is at a loss to explain how this happened and can only deduce that the person who reported Jack’s X-ray reported on the wrong film. The conclusion is that it was a failure of the system that caused Jack’s X-ray to be overlooked and not attributable to one individual.” The trust said that a thorough review was under way. The hospital had a 31million pound deficit at the time and had cut 300 staff, although the trust said that no jobs had been cut that would have compromised clinical care.


Hospital rankings coming in Australia

HOSPITALS face closer scrutiny of their performance in areas such as patient safety and infection rates under a scheme the federal Health Minister, Tony Abbott, will put to state governments. Mr Abbott told the Herald he was planning to propose hospital "league tables" on safety, and quality measures be included as part of the hospital funding agreement between the federal and state governments. The transparency measures would enable patients to compare the record of different hospitals in such areas as surgical infection rates, unplanned readmissions and waiting times for elective surgery.

Citing new research showing that Australia has fallen behind other countries in the release of individual hospital performance data, Mr Abbott said such information was readily available elsewhere. "Why should we not have it here?". The research says that, by some estimates, adverse events and infections in Australian hospitals generate $2.5 billion in expenditure every year, but improvements are impeded by the lack of comparative data on hospital performance. Besides letting patients know how hospitals rated on different indicators, it would also help hospitals to identify strengths and weaknesses and spur improvements, Mr Abbott said.

A frequent argument against publishing such information was that it was hard to compare hospital outcomes. But Mr Abbott said the public would be able to factor in differences such as some hospitals having a higher rate of problems because they took on more difficult cases. The Federal Government wanted to see such information included in the next Australian Health Care Agreements, which provide for federal funding of public hospitals and are scheduled for renegotiation with the states after the federal election.

A study undertaken for the Australian Centre for Health Research says "very little" analysis has been published in Australia to assess the hospital system and even less undertaken to determine whether hospitals are working in concert with other parts of the system, such as general practitioners. "This raises the risk of wasted funds, poor health outcomes and reduced access for patients," it says. The report recommends the Government take the lead in defining what standard care information should be collected.

The publication of hospital performance indicators had triggered the establishment of "infomediaries" - companies which analysed the performance figures and could help patients make decisions about their health and how to manage it, in addition to providing a guide to quality care. The research was headed by David Charles, who said that the health system had avoided the trend towards greater transparency that had been accepted in many other sectors of government and business in the past 20 years.



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

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