Friday, August 28, 2009

'Cruel and neglectful' care of one million British public hospital patients exposed

One million NHS patients have been the victims of appalling care in hospitals across Britain, according to a major report released today. In the last six years, the Patients Association claims hundreds of thousands have suffered from poor standards of nursing, often with 'neglectful, demeaning, painful and sometimes downright cruel' treatment.

The charity has disclosed a horrifying catalogue of elderly people left in pain, in soiled bed clothes, denied adequate food and drink, and suffering from repeatedly cancelled operations, missed diagnoses and dismissive staff. The Patients Association said the dossier proves that while the scale of the scandal at Mid-Staffordshire NHS Foundation Trust - where up to 1,200 people died through failings in urgent care - was a one off, there are repeated examples they have uncovered of the same appalling standards throughout the NHS.

While the criticisms cover all aspects of hospital care, the treatment and attitude of nurses stands out as a repeated theme across almost all of the cases. They have called on Government and the Care Quality Commission to conduct an urgent review of standards of basic hospital care and to enforce stricter supervision and regulation.

Claire Rayner, President of the Patients Association and a former nurse, said:“For far too long now, the Patients Association has been receiving calls on our helpline from people wanting to talk about the dreadful, neglectful, demeaning, painful and sometimes downright cruel treatment their elderly relatives had experienced at the hands of NHS nurses. “I am sickened by what has happened to some part of my profession of which I was so proud. "These bad, cruel nurses may be - probably are - a tiny proportion of the nursing work force, but even if they are only one or two percent of the whole they should be identified and struck off the Register.”

The charity has published a selection of personal accounts from hundreds of relatives of patients, most of whom died, following their care in NHS hospitals. They cite patient surveys which show the vast majority of patients highly rate their NHS care - but, with some ten million treated a year, even a small percentage means hundreds of thousands have suffered.

Ms Rayner said it was by "sad coincidence" that she trained as a nurse with one of the patients who had "suffered so much". She went on: "I know that she, like me, was horrified by the appalling care she had before she died. "We both came from a generation of nurses who were trained at the bedside and in whom the core values of nursing were deeply inculcated."

Katherine Murphy, Director of the Patients Association, said “Whilst Mid Staffordshire may have been an anomaly in terms of scale the PA knew the kinds of appalling treatment given there could be found across the NHS. This report removes any doubt and makes this clear to all. Two of the accounts come from Stafford, and they sadly fail to stand out from the others. “These accounts tell the story of the two percent of patients that consistently rate their care as poor (in NHS patient surveys). "If this was extrapolated to the whole of the NHS from 2002 to 2008 it would equate to over one million patients. Very often these are the most vulnerable elderly and terminally ill patients. It’s a sad indictment of the care they receive.”

The Patients Association said one hospital had threatened it with legal action if it chose to publish the material.

Pamela Goddard, a piano teacher from Bletchingley, in Surrey, was 82 and suffering with cancer but was left in her own excrement and her condition deteriorated due to her bed sores. Florence Weston, from Sedgley in the West Midlands, died aged 85 and had to remain without food or water for several days as her hip operation was repeated cancelled.

The charity released the dossier to highlight the poor care which a minority of patients in the NHS are subjected to. Ms Murphy said the numbers rating care as poor came despite investment in the NHS doubling and the number of frontline nurses increasing by more than a quarter since 1996.

The personal stories were revealed to prevent their cases being ignored as only representing a small portion of patients. The report said: "These are patients, not numbers. These are people, not statistics."

Dr Peter Carter, Chief Executive of the Royal College of Nursing, said he was concerned that public confidence in the NHS could be undermined by the examples cited and it would affect morale in hardworking staff. He said: “The level of care described by these families is completely unacceptable, and we will not condone nurses who behave in ways that are contrary to the principles and ethics of the profession. "However we believe that the vast majority of nurses are decent, highly skilled individuals. “This report is based on the two per cent of patients who feel that their care was unacceptable. Two per cent is too many but we are concerned that this might undermine the public’s confidence in the world-class care they can expect to receive from the NHS."

Barbara Young, Chairman of the Care Quality Commission, the super-regulator, said: “It is absolutely right to highlight that standards of hospital care can vary from very good to poor. “Many people are happy with the care they receive, but we also know that there are problems. “I am in no doubt that many hospitals need to raise their game in this area. “Where NHS trusts fail to meet the mark, we have tough new enforcement powers, ranging from warnings and fines to closure in extreme cases. We will not hesitate to use these powers when necessary to bring improvement. "We will be asking NHS trusts and primary care trusts how they are ensuring that the needs of patients and their safety and dignity are kept at the heart of care.” [Blah, blah, blah!]

Chris Beasley, Chief Nursing Officer at the Department of Health said the care in the cases highlighted by the PA was “simply unacceptable”. She added: "It is important to note this is not representative of the picture across the NHS. "The NHS treats millions of people every day and the vast majority of patients experience good quality, safe and effective care - the Care Quality Commission's recent patient experience survey shows that 93 percent of patients rate their overall care as good or excellent.

"We will shortly be publishing complaints data on the NHS Choices website and expect trusts to publish the number of complaints they receive, setting out how these are successfully resolved."


Australia: More revelations about a rotten government-run ambulance service

Paramedics operate in 'culture of fear' because management behavior in unaccountable

THE State Government will establish a panel [A "panel" three bureaucrats! Three dedicated coverup artists, no doubt. How about a judicial enquiry?] to investigate bullying and harassment amid concerns paramedics and emergency workers operate in a "culture of fear".

The Courier-Mail can reveal an internal investigation found an Emergency Management Queensland boss guilty of victimisation, harassment and inappropriate comments, which included very harsh, sexist and intimidatory language. Documents obtained under Right to Information laws show six of 10 allegations made against the manager were substantiated and he was aggressive towards EMQ office staff.

Another EMQ officer was found guilty of swearing at Emergency Service cadets during a camp exercise last year. He referred to them as "little bastards" and told them they were "full of s--- and wouldn't survive in the bush".

Recommendations made as a result included staff training in the department's code of conduct and dealing with conflict in the workplace but it is not known whether the culprits were reprimanded.

Emergency Medical Service Protection Association president Prebs Sathiaseelan said he had received numerous complaints from his members. "EMPSA on a regular basis receives calls from our membership about some form of harassment and bullying – it isn't improving," he said. Mr Sathiaseelan said it was a "culture of fear".

In another case, a Brisbane senior officer was investigated after he "dropped his trousers, exposed his genitalia and simulated oral sex" with another employee against her will. He also made offensive comments against two colleagues in relation to race and sexuality. While at least one recipient of his comments has left the QAS, his language was deemed to be "part of his character" and "generally non-offensive". [????] But a spokesman for QAS Commissioner David Melville this week said the officer concerned was asked to "show cause" at a formal disciplinary hearing. "This officer was not counselled as the Regional Assistant Commissioner determined that the matter was of such a serious nature that this officer should be formally reprimanded." The officer was warned if his behaviour deteriorated again over 12-months he would also be docked two weeks pay.

Another senior officer, who didn't want to be named, contacted The Courier-Mail concerned the organisation was cutting corners trying to keep up with patient demand. "When you stick your hand up and say anything nowadays, you just get smashed and told to shut up," he said.

Emergency Services Minister Neil Roberts said yesterday after discussions with the Director-General, ambulance officers, firefighters, and staff in EMQ and the Department of Community Safety would be able to make complaints to a dedicated phone line and email service, which would then be referred to the panel. "It is my hope that this panel will be utilised by personnel who feel that they cannot confidently report instances of bullying, harassment or intimidation through existing channels," he said.

The panel will comprise Ministerial, Information and Legal Services branch executive director Fiona Rafter, Ethical Standards director Terry Christensen and Legal Services director Tracey Davern. "It is important that employees feel confident that their allegations will be taken seriously, properly investigated and dealt with without any personal ramifications," Mr Roberts said.


Liberal lies about national health care

By Ann Coulter

With the Democrats getting slaughtered – or should I say, "receiving mandatory end-of-life counseling" – in the debate over national health care, the Obama administration has decided to change the subject by indicting CIA interrogators for talking tough to three of the world's leading Muslim terrorists.

Had I been asked, I would have advised them against reinforcing the idea that Democrats are hysterical bed-wetters who can't be trusted with national defense while also reminding people of the one thing everyone still admires about President George W. Bush. But I guess the Democrats really want to change the subject. Thus, here is Part 2 in our series of liberal lies about national health care.

6) There will be no rationing under national health care.

Anyone who says that is a liar. And all Democrats are saying it. (Hey, look – I have two-thirds of a syllogism!). Apparently, promising to cut costs by having a panel of Washington bureaucrats (for short, "The Death Panel") deny medical treatment wasn't a popular idea with most Americans. So liberals started claiming that they are going to cover an additional 47 million uninsured Americans and cut costs ... without ever denying a single medical treatment!

Also on the agenda is a delicious all-you-can-eat chocolate cake that will actually help you lose weight! But first, let's go over the specs for my perpetual motion machine – and it uses no energy, so it's totally green! For you newcomers to planet Earth, everything that does not exist in infinite supply is rationed. In a free society, people are allowed to make their own rationing choices.

Some people get new computers every year; some every five years. Some White House employees get new computers and then vandalize them on the way out the door when their candidate loses. (These are the same people who will be making decisions about your health care.)

Similarly, one person might say, "I want to live it up and spend freely now! No one lives forever." (That person is a Democrat.) And another might say, "I don't go to restaurants, I don't go to the theater, and I don't buy expensive designer clothes because I've decided to pour all my money into my health."

Under national health care, you'll have no choice about how to ration your own health care. If your neighbor isn't entitled to a hip replacement, then neither are you. At least that's how the plan was explained to me by our next surgeon general, Dr. Conrad Murray.

7) National health care will reduce costs.

This claim comes from the same government that gave us the $500 hammer, the $1,200 toilet seat and postage stamps that increase in price every three weeks. The last time liberals decided an industry was so important that the government needed to step in and contain costs was when they set their sights on the oil industry. Liberals in both the U.S. and Canada – presidents Richard Nixon and Jimmy Carter and Canadian P.M. Pierre Trudeau – imposed price controls on oil. As night leads to day, price controls led to reduced oil production, which led to oil shortages, skyrocketing prices for gasoline, rationing schemes and long angry lines at gas stations. You may recall this era as "the Carter years."

Then, the white knight Ronald Reagan became president and immediately deregulated oil prices. The magic of the free market – aka the "profit motive" – produced surges in oil exploration and development, causing prices to plummet. Prices collapsed and remained low for the next 20 years, helping to fuel the greatest economic expansion in our nation's history. You may recall this era as "the Reagan years."

Freedom not only allows you to make your own rationing choices, but also produces vastly more products and services at cheap prices, so less rationing is necessary.

8) National health care won't cover abortions.

There are three certainties in life: a) death, b) taxes, and c) no health-care bill supported by Nita Lowey and Rosa DeLauro and signed by Barack Obama could possibly fail to cover abortions. I don't think that requires elaboration, but here it is:

Despite being a thousand pages long, the health-care bills passing through Congress are strikingly nonspecific. (Also, in a thousand pages, Democrats weren't able to squeeze in one paragraph on tort reform. Perhaps they were trying to save paper.)

These are Trojan Horse bills. Of course, they don't include the words "abortion," "death panels" or "three-year waits for hip-replacement surgery." That proves nothing – the bills set up unaccountable, unelected federal commissions to fill in the horrible details. Notably, the Democrats rejected an amendment to the bill that would specifically deny coverage for abortions.

After the bill is passed, the Federal Health Commission will find that abortion is covered, pro-lifers will sue, and a court will say it's within the regulatory authority of the health commission to require coverage for abortions. Then we'll watch a parade of senators and congressmen indignantly announcing, "Well, I'm pro-life, and if I had had any idea this bill would cover abortions, I never would have voted for it!"

No wonder Democrats want to remind us that they can't be trusted with foreign policy. They want us to forget that they can't be trusted with domestic policy.


Health Insurance and the Lure of Someone Else

By Jon N. Hall

Insurance is all about "someone else" paying your bills. However, if everyone's healthcare bills were the same, if our bodies failed and expired in the same way and on the same schedule, if our little lives were as predictable as those of the adult mayfly, we wouldn't have a health insurance industry. Insurance makes sense only if it's for the unpredictable.

But we are not a uniform species like the mayfly. Our bodies differ dramatically. Some folks are rarely sick; one day their bodies simply stop, incurring little if any cost to the insurance industry and government treasuries. Healthy people are all alike, perhaps a bit like the mayfly. Sick folks are all different. And the variety of ailments they suffer from beggar the imagination. Some have multiple degenerative diseases, all at the same time. Some are basket cases from birth.

If everyone had absolutely wretched health, would Congress be so intent on insuring us all? It is because there are only a few of us who have truly wretched health that health insurance is feasible. Insurance makes sense only if claims vary.

And those who make the fewest insurance claims get the worst deal from insurance. If everyone were to pay the same in health insurance premiums, the healthier half would be better off to "go it alone", i.e. be self-insured. Betsy McCaughey reports that in America "about 5 percent of the populace uses 50 percent of treatment dollars", citing the Congressional Budget Office. Could that possibly mean that 94+ percent of us would be better off financially if self-insured? (Check out Ms. McCaughey's more detailed critique of the healthcare debate here, at The American Spectator.)

Some say: "healthcare is a right". But where in the Constitution is this right conferred? Perhaps these folks are confusing "is" for "should be". The Constitution doesn't even say we have a right to be fed by the feds. If they want healthcare to be a right, there's a way to bring that about: amend the Constitution. It would be interesting to see if such an amendment could ever be ratified; I have my doubts. (During last year's campaign, I expressed my doubts about the constitutionality of the individual mandate, which is still under consideration.)

In her blog for Fox Business, Elizabeth MacDonald quotes economist Ed Yardeni: "Ask doctors and hospital administrators about Medicare and Medicaid and they will tell you that it amounts to a theft of their services because the government doesn't pay them enough to cover their expenses for the care they provide. So they pass those costs on to patients covered by private health insurance."

If the "reformers" in Congress want to create a real market for healthcare, they would enact a law that demands this: No individual nor private health insurance company can be billed more for a medical expense than what government programs pay. This would help end price discrimination, which Uwe Reinhardt describes as "the practice of charging different payers different prices for identical health care goods or services". The same should be done for drugs: No co-op, foreign government, nor bargaining bloc could be given special prices. Let's put the kibosh on the "cost shifting" that has sent the price of private insurance soaring and distorted the market.

If the "reformers" in Congress weren't in the hip pocket of trial lawyers, they would put a cap on malpractice torts. Recently, columnist Charles Krauthammer, who happens to be an MD, provided an elegant solution for malpractice: "The penalty would be losing your medical license. There is no more serious deterrent than forfeiting a decade of intensive medical training and the livelihood that comes with it."

The "reformers" in Congress claim they want to bring competition, choice and cost savings to healthcare. If so, they should enact a law that allows workers to direct their employers to drop them from company-provided health insurance and then add to their paychecks whatever their employers were paying for them in health insurance. And if these workers then elect to buy health insurance on their own, they would get the same tax break as their employers get. Or, they could pocket the money and "go it alone" -- if they're diligent about their health regimens (and lucky), they'll save money.

If the "reformers" in Congress want to overhaul America's healthcare system and erect some "comprehensive" new system, then Congress should first demonstrate to the American People that they are competent at holding down healthcare inflation. But they can't do that.

That's because Congress itself is responsible for healthcare inflation. Congress caused healthcare inflation by mandates (e.g. Medicare) that it refused to fully pay for, thus shifting costs to "someone else", i.e. the private sector; by disallowing the purchase of insurance across state lines, thereby quashing competition; by mandating that emergency rooms take everyone and then not paying for it (shifting those costs to "someone else"); by mandating that illegal aliens be treated in emergency rooms; by disallowing the purchase of drugs from Canada; by cordoning off vast chunks of the economy which they reserve for healthcare; etc; etc; etc.

Despite having run up the deficit by a factor of 10 in just 2 years, despite the recently revealed $2 Trillion bump up in the projected deficits over the next decade, despite an unemployment trend that continues to worsen, despite being in 2 wars, and despite an Iran that gets ever closer to the bomb, our brilliant Congress wants to create the largest entitlement of! This is the most irresponsible Congress in modern history. And that's a pity, because just as for the mayfly, our time is running out.


Under the Cover of a Backroom Deal

Excuse me, but weren't we just talking about health care? After scanning news this week, one might notice a startling dearth of health care stories making headlines. Surprisingly, for most media outlets--be they liberal, conservative, a major news network or a basement blog--stories regarding public options, death panels, Obama's waning support, insurance companies, and the like were nowhere to be found.

Their absence might make the average news junkie feel like he's entered a non-parallel universe. But please don't be alarmed: it is entirely calculated. Simply put, it's not that health care is no longer newsworthy; it's just that Barack Obama is deliberately making his news bigger to block it out.

As a self-described "gifted" orator, Mr. Obama has demonstrated a clear understanding and flawless execution of one of the most crucial strategies of effectively dominating the conversation: changing the subject when the discussion gets too uncomfortable. Health care, it seems, was becoming too difficult of a conversation for the gifted one to stomach. Something had to be done. So, in the past two days alone, the President and/or White House officials have announced:

* That he will appoint a special prosecutor to investigate CIA interrogation abuses.
* That he will nominate Ben Bernanke to a second term as chairman of the Federal Reserve.
* That he demands the media leave him and his daughters alone while on vacation.
* That 90,000 Americans could die from swine flu this fall (and most of them will be kids).
* That the budget deficit this year will skyrocket to an unexpected record of $1.6 trillion.
* That he will soon part the waters of the Nantucket Sound (okay, not yet – but just wait).

With such an onslaught of manufactured news fodder—all “breaking” in two days, mind you—it is no wonder the health care debate got pushed off the front page. And that’s exactly what Barack Obama intended. Some schemes are best hatched undercover.

The fact is: the national health care debate had become far too politically damaging for the Obama Administration. Ever since kicking his government-run healthcare plan into high-gear at the beginning of the summer, Mr. Obama’s poll numbers have plummeted as a direct result. According to Rasmussen Reports, Barack Obama had a +7 approval index on June 1st. As of August 25th, the President scored a -11 on the approval index. That’s an 18-point swing in three months.

What Obama clearly intended to be the sparkling set-piece of his “transformational” Administration has quickly become a burgeoning blight destroying his lofty approval rating – and already threatening his all-important legacy as well.

Moreover, Barack Obama’s minions—the multitudes of Democrat representatives, senators, and White House officials scattered across the nation during the August recess—have likewise felt the burn from hordes upon hordes of Americans upset with the Democrats’ plans for government-run health care. Despite the best—no, make that worst—efforts of the Administration and Obamaton media to paint the concerned American people as “angry racist mobs,” the embarrassment and sinking poll numbers are as plain as the lengthening nose on Obama’s face.

Their embarrassment is Obama’s embarrassment. And all of the Administration’s prevarications about “misunderstandings” aren’t going to change the hardscrabble facts. So, for Obama and Co., now is the perfect time to avert attention by changing the subject.

Abandoning their health care agenda, however, is far from the goal. Displacing health care with a barrage of other news stories needs to be seen for what it is—a cynical cover up for a backroom deal.

With both the media and the public looking the other way, the President can quietly take the health care debate off the front page and return to the kind of backroom, bare-knuckle politics he truly enjoys —those that don’t involve the American people. After all, it’s become increasingly evident that if Mr. Obama involves the American people, his sweeping government-run health care scheme would never be carried out.

So while the politically-damaging health care chaos may have been pushed from the front page, it won’t end up on the obit page—buried and forgotten. If Barack Obama has his way, it will next appear as a “Second-Coming Headline” proclaiming, “Obamacare Passed Without Debate” as America’s healthcare industry is scrapped under the obscene cover of a backroom deal.


No comments: