Tuesday, February 17, 2009

NHS criticised in half of complaints reviewed

One in five NHS complaints sent for independent review relates to poor treatment or a wrong diagnosis.

The Healthcare Commission said that trusts were at fault or could have done more in almost half of the 8,939 complaints it investigated last year. Eleven per cent concerned treatment, 9 per cent delayed or wrong diagnosis and 8 per cent waiting or problems having treatment. Nearly half of complaints were upheld or referred back to trusts. The NHS receives about 135,000 complaints annually. It provides about 380 million treatments. In April unresolved complaints will be passed to the Parliamentary and Health Service Ombudsman, as the Healthcare Commission is replaced by the Care Quality Commission, covering health and social care.

The new system relies on more complaints being resolved locally but the Healthcare Commission said some trusts were still not responding to complaints effectively enough for the new arrangement to work.


Australian public hospitals have triple the baby deaths of private

Poor people tend to have worse health but the gap here seems too large for that to be the main factor. And the grave problems often reported with public hospital obstetric services leave little room for doubt about where the main fault lies

For every baby that dies soon after birth in an Australian private hospital, three die in the public system, alarming new figures reveal. Women who give birth in public hospitals are also more than twice as likely to suffer tearing, or that their babies will need resuscitation, according to the alarming findings of a new study. Associate Professor Steve Robson and colleagues examined the outcomes of almost 790,000 births which took place over four years, and about a third were in the nation's private hospitals.

Dr Robson said he was shocked not only by the "striking difference" between the two systems, but also by the results that contradict a common criticism of births in private hospitals. "There is often a lot of criticism in the medical press of rates of caesarean birth and rates of the induction of labour - everybody says 'Wow they're so much higher in private hospitals,"' says Dr Robson, of the Australian National University Medical School. "And if you take the literature at face value ... all of those things ought to up the complication rate, (but) it was lower. "We found that quite staggering."

Dr Robson says the study raises questions about the view that some in the medical fraternity hold that "increased rates of obstetric intervention are bad for women and their babies". "Our study suggests these things could be beneficial because the rate of babies dying is about half in the private hospital, and the rate of serious maternal injury is less than half," he said. Dr Robson said differences in the health and socio-economic status of the mothers alone could not explain the performance gap between public and private hospitals, and that further research was needed. "And it's not as though we've taken a small sample, we basically looked at every birth in the country (over four years)," he says.

The study, to be published in the Medical Journal of Australia, reported women giving birth in public hospitals had more than twice the rate of "severe perineal tearing", and their babies were more than twice as likely to require "high-level resuscitation" at birth. The neonatal death rate was one for every 1,000 babies born in private hospitals, compared to three in 1,000 in public hospitals.

The study was also undertaken by Elizabeth Sullivan and Paula Laws from the Perinatal and Reproductive Epidemiology Research Unit, at the University of NSW. Australia's rate of caesarean sections has risen from a single digit per cent in the 1980s to now account for more than 30 per cent of all births.


No comments: