Friday, January 16, 2009

NHS patients face indignity of mixed-sex hospital wards

Men and women in hospital are still being treated on mixed-sex wards with little or no segregation, despite government promises to improve privacy for patients, the Conservative Party says. In April ministers claimed that they were close to abolishing mixed-sex accommodation in the National Health Service. Figures obtained by the Conservatives suggest that 15 per cent of hospitals in England still use mixed, open-plan "Nightingale" wards, while a similar proportion (16 per cent) have wards where patients are segregated only by curtains. The party said that nearly a third of trusts did not have separate bathrooms for men and women.

There were 997 complaints about lack of privacy and dignity in hospital trusts and 135 complaints in mental health trusts in the past year, a poll of 132 acute trusts and 55 mental health trusts showed.

Andrew Lansley, the Shadow Health Secretary, accused the Government of breaking its promises on the issue. "Patients have enough to worry about when they go into hospital without having to suffer the indignity of being placed in accommodation that affords them too little privacy at such a sensitive time," he said.

Alan Johnson, the Health Secretary, told a nurses' conference last year that there was a "bit of a political distinction" between the terms mixed-sex accommodation - where men and women are in separate rooms or bays and have their own bathrooms and lavatories - and the larger, mixed-sex wards.

The Department of Health responded: "We are reducing mixed-sex accommodation to an absolute minimum and have made significant progress. Some hospitals and local NHS areas still have more to do and they are now required to publish and implement ambitious plans to improve." A spokesman added that only 2 per cent of patients complained about lack of privacy in the latest official audit.


Midwives' workload surges under Labour - putting mothers and babies at risk

The decline of maternity care under Labour was highlighted last night by figures showing that midwives are more overworked than they have been for at least a decade. NHS midwives are delivering far more babies per year than stipulated by safety guidelines - putting mothers and babies at risk. For the sixth year running, the number of births each midwife handles has risen, and it is now higher than at any time since records began in 1997.

The workload being heaped on maternity wards was blamed for the recent doubling in the number of payouts for medical blunders - and for the fact that rising numbers of women are being left alone and terrified during labour. Experts believe up to 1,000 babies a year die needlessly because doctors and midwives are too overstretched or poorly-trained to detect warning signs.

Safety guidelines, laid down by the Royal College of Midwives, say that midwives should deliver an average of 27.5 babies a year - one every 13 days or so - to ensure mother and child have the best quality of care. But figures obtained by the Liberal Democrats from a parliamentary question show that in 2007, the average midwife in England delivered 34.0 babies - one every ten or 11 days, and almost 25 per cent more than they should under the safety standard. This was up on 2006, when the midwife to baby ratio was 33.7, despite the launch of a major maternity strategy designed to turn things round and even offer all women onetoone care with a midwife. The number of babies delivered is 10 per cent higher than in 2001, and is higher than at any time since records began in 1997, when the ratio was 33.7.

Critics blame a continuing shortage of midwives and ministers' failure to anticipate a soaring birthrate. More babies are now born in England than at any time in the past 26 years; largely the result of immigration. They say the figures prove the Government has no chance of honouring its pledge that all women should have one to one care from a named midwife during the entire pregnancy by the end of this year. The number of babies a midwife is expected to deliver is less than one a week because the job is much wider than dealing with the birth: they look after women over the whole pregnancy and afterwards.

Liberal Democrat health spokesman Norman Lamb said: 'After 12 years of empty promises the Labour party will have left maternity care in a state of near crisis. 'Last year it was revealed that hundreds of thousands of women are being left alone during their labour causing worry and distress to many. We also know that the number of safety incidents is on the rise and that millions are being paid out in compensation for medical blunders. 'To find now that midwives are at their most over-stretched since records began, adds to the shameful failure of the Government. 'We must increase the number of midwives and cut back on managers so the health service can cope, especially with a birth rate set to rise.'

Last year, the Healthcare Commission watchdog found that more than a quarter of women were left worried and alone during labour or shortly after birth. Other figures showed that the numbers of medical blunders on NHS maternity wards has doubled in two years. In 2007, 70,108 cases of blunders or abuse of mothers on neonatal units were passed to the National Patient Safety Agency, compared with 35,428 in 2005.

A spokesman for the Department of Health said: 'The UK is one of the safest countries in the world to have a baby. 'There is no evidence to suggest a lower ratio of births to midwives is needed. The number of midwives is actually increasing.'


Maggots in Australian public hospital ICU

This must be about as charming as it gets. Maggots breed in garbage or dead bodies. But the NHS got there before us, of course

Maggots have been found falling from the ceiling of the Royal Hobart Hospital's intensive care unit. The maggots were discovered on Tuesday in a male staff toilet not accessible to the general public. The hospital attempted to play down the grubby find yesterday, saying only a small number of larvae were found by a staff member, who reported them immediately.

Spokeswoman Pene Snashall said patient hygiene was never at risk. "The Environmental Services Team and the Infection and Prevention Control Team responded immediately with a thorough clean-up and investigation," Ms Snashall said. "Patient safety and care was always our top priority." But even after virtually gutting the toilet block, the source of the infestation remains a mystery. The hygiene team ripped out ceiling tiles looking for possible sources of the maggots, including dead rodents in the air-conditioning vents, but found nothing. "There have not been any further discoveries [of maggots] as of today and we are confident we have eliminated the problem," Ms Snashall said.

Maggots are sometimes used in medicine to eat dead flesh and speed up the healing of wounds -- but not in this case. Ms Snashall said the hospital had a year-round pest control program to control spiders, ants and cockroaches.

Australian Nursing Federation Neroli Ellis said the incident showed the ageing hospital was virtually rotting. "I do think it is a one-off -- the cleaning staff are vigilant," she said. "But it is reflective of the state of the building and the age of the building that these issues are occurring and there needs to be strong monitoring and a review of maintenance to ensure this situation doesn't happen again." Ms Ellis said building a new hospital would not fix the problems at the old facility in the short term. "Whatever is decided politically about building a new hospital, there must be an ongoing upgrade of the current building in the meantime because it is falling down around them," she said.


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