Monday, January 19, 2009

New EU working laws will be disaster for NHS

Changes to hospital working hours which come into force this summer under European law will be "disastrous" for patient care and result in "major service failure", Britain's top surgeon has warned.

John Black, president of the Royal College of Surgeons, has issued a dramatic warning that the National Health Service will not be able to cope with the effects of the controversial European Working Time Directive. From August, hospitals face heavy fines if they allow any health care staff, including surgeons, to work more than 48 hours a week, despite warnings from hospitals that they are not able to make the change. In his February newsletter, Mr Black said the new rules were "an impending disaster" which will "devastate" medical training because no surgeon will be able to work a shift long enough to gain proper experience.

The multiple handovers of staff needed to comply with the rules will mean that patients do not see the same doctor for more than a few hours, he said. And he warned there could be "dangerous" lapses in patient care, especially at night. "With nobody able to work more than 48 hours a week from August, the effects on patient care in the NHS are potentially disastrous," Mr Black said. "Out-of-hours cover will be so thin, on occasions non-existent, that major service failure with unplanned reconfiguration of services appears inevitable. "It is well known that dangerous incidents are far more likely to happen at night and weekends, and this will get worse with even fewer doctors available. "This is not to mention the dangers of multiple handovers or the frustration and alarm felt by patients who rarely see the same doctor for more than a few hours. This is all being done under social chapter legislation, supposed to make people's lives better."

Mr Black is meeting Alan Johnson, the Health Secretary, in February to propose a "speciality opt-out" and an upper limit on surgeons' hours of 65 to 70 hours a week. "I have no doubt we will be told that it is impossible to alter or bypass the European law. I do not believe this. All manner of EC law must have been bent or ignored in nationalising a bank in 24 hours. The Government can do it if it has the political will," Mr Black said.

The European Working Time Directive has proved a massive challenge for the NHS since it was introduced in 1998. At first, certain staff were exempt, but a 58-hour limit was introduced in 2004, falling to 56 in 2007 with the final drop to 48 required by August 2009. With time running out to make the changes to rotas needed, a survey of hospital trusts in November last year found that only 18% were hitting the 48 hour limit.

A Department of Health spokesperson said: "A few hospitals have implemented the maximum 48 hour week across all rotas. We are monitoring the situation as some smaller specialities and isolated hospitals may find meeting the deadline more challenging."


Australia: The "caring" Leftist mania for closing down public hospitals continues

Yesterday it was Queensland. Today it is South Australia. And once again the bureaucrats think they know better than the doctors. They didn't even bother talking to the doctors! My suspicion is that some Leftist hater just didn't like the "Royal" in the name of the existing hospital. They are small-minded enough for that. Witness all their whining about politically correct words

Eminent medical specialists have launched a campaign to save the Royal Adelaide Hospital, saying the city does not need the planned $1.7 billion Marjorie Jackson-Nelson Hospital. A group of respected senior doctors who have spent the past year "brooding and alarmed" have decided to go public with their opposition and have formed a committee dedicated to saving the RAH from being bulldozed. "We want genuine discussion about whether the RAH really needs to be closed," spokesman Dr James Katsaros said yesterday. "We have a responsibility to look at whether we are making a terrible mistake in spending $1.7 billion on something that is not needed while erasing an iconic institution. ". . . as senior members of the medical community we came to the view that if we did not stand up against this lunancy, no one would. "We have been brooding on this for a long time, whispering in corridors and over coffees about the madness of the plan, which was announced without consultation with the medical community."

The "Save the RAH Medical Committee" says the state does not need a new hospital and the RAH's patient accommodation could be upgraded for far less than the Marj's ballooning $1.7bn cost - and the work completed far earlier than the Marj's 12-year time frame. The Save the RAH group includes leading and retired orthopaedic surgeons, cardiologists, plastic surgeons, oncologists and pathologists, as well as people who have held representative positions such as Australian Medical Association office holders. Members so far include Dr Peter Hetzel, Dr John Sangster, Dr Daryl Teague, Dr Francis Ghan, Dr Randall Sach, Dr Peter Malycha, Dr Philip Harding and Dr Katsaros.

The committee is holding a meeting for the medical fraternity at the RAH on March 16 to discuss the issues and see if there is genuine support for the new hospital. If the meeting shows a lack of support for the Marj, the committee will widen the debate to public meetings. The key concerns of the Save the RAH group include:

A LACK of consultation by the State Government with the medical community or the AMA before the plan was announced;

A LACK of convincing arguments in favour of building the Marj;

MISINFORMATION about the state of the RAH, which they say has been substantially upgraded in recent years;

DESTRUCTION of the close working relationship between the RAH, Adelaide University Medical School, Hanson Institute and Institute of Medical and Veterinary Science, which are all on the one city campus;

ABOLITION of the brand name "Royal Adelaide Hospital" - world famous within medical circles.

Dr Katsaros, committee chairman and director of the plastic and reconstructive surgery at the RAH, said the group represented conservative people who otherwise would not want to be caught in a political row. "There was no review to see if it was actually needed, no public debate, just an announcement," he said. "We have been alarmed ever since the announcement was suddenly made and the discussions among doctors have been ones of alarm and incredulity. "Being conservative, it has taken a while to band together and go public, but we have to show leadership and generate genuine discussion about whether we need a new hospital. "While we as senior doctors feel we must stand up, we also have the support of many junior staff as well as nurses and allied health workers who believe the RAH should be retained. "I believe we do not need a new hospital at all; but if the overwhelming view of the medical community after we have discussions is that we do need one, then we will say `so be it' and move on."

Dr Katsaros noted the RAH was world respected, both in facilities and in name that also promoted the city. "The RAH has a brand new emergency (department), which is state-of-the-art, an intensive care area the envy of most hospitals, a world-class burns unit, modern dialysis unit and so on," he said. "Every hospital has to start planning upgrades virtually as soon as they are built, but the RAH right now is at a point where the most urgent thing is a new patient accommodation wing. "That could be built for around $300 million, rather than $1.7 billion, and could be completed in a couple of years rather than waiting 12 years."

The committee will meet AMA officials this week with a request it notify members of the March 16 meeting in the hope of having the largest possible number of the medical fraternity on hand to voice their opinions about whether a new hospital is needed.

Dr Katsaros said the Marj announcement came without any review into whether it was needed. "The existing institution can be refurbished and rejuvenated, as was done in the 1960s when a larger RAH was rebuilt on site without major problems," he said. Dr Katsaros emphasised the RAH name was a respected and valuable brand name for SA. "Can you imagine the folk in Minnesota bulldozing the Mayo Clinic and building the Michael Jordan Hospital 1km away?" he said. "They'd be a laughing stock."


Australia: And a corrupt hospital system in Victoria too

A SENIOR Victorian doctor will this week use a parliamentary inquiry to blow the whistle on alleged corruption, negligence and bureaucratic bungling in our public health-care system. Peter Lazzari is to release a report that says a "deepening crisis in our hospitals" is costing hundreds of Victorian lives every year. Dr Lazzari, head of an acute unit of medicine at Angliss Hospital and deputy chair of the Victorian State Committee of the Royal Australian College of Physicians, says a deteriorating standard of care and training is responsible for more than 500 deaths each year. In a submission to the Upper House Parliamentary Inquiry Into Public Hospital Performance Data, Dr Lazzari is to:

ACCUSE the Brumby Government and health executives of incompetence and intimidation of doctors, calling medical service directors "doctors of death".

CLAIM nurses are frequently violently and sometimes sexually assaulted by patients and that hospital administrators leave them without protection, "terrified" and "alone" at the bedside.

ACCUSE hospital boards and bosses of deliberate and "widespread cruelty to patients, doctors and nurses".

REVEAL several hospital buildings are putting patients' lives at risk because they are riddled with asbestos, have "crumbling internal walls" and have operating theatres that shake when trucks pass.

In a separate submission, Dr Lazzari will tackle "fraudulent waiting list reporting", claiming many hospitals "fudge" waiting list figures, to avoid penalties and claim government bonuses. He says hospitals tweak elected surgery waiting lists for up to a year, then claim it was the patients' choices. Others keep a second set of waiting lists and only enter them into the system when beds are available. He says it is "sentencing patients to pain, suffering and death". Both reports, expected to be released within days, call for major reforms.


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