Thursday, February 18, 2010

NHS safety failings 'kill 40,000 a year' as patients pay price of target culture

More than 40,000 deaths a year could be avoided if the NHS improved its safety record, campaigners say. They claim the Health Service is ruled by a 'widespread culture of fear' which puts patients at risk. Managers are more concerned with hitting targets than improving systems known to be flawed, said the centreright think-tank Policy Exchange. NHS funding has nearly tripled from £39.9billion to £102billion in 11 years but there are concerns the cash has failed to raise standards.

Using new data from U.S. and European research, Policy Exchange says 78,400 NHS patients a year die as a result of 'adverse events' - brought on by accidents or caused by medication or treatment. More than half of these deaths - 43,000 - could be prevented if hospitals were inspected more rigorously and recommended safety changes were installed. The figure for deaths is based on ten studies suggesting that 6.6 per cent of hospital admissions each year, around 700,000 patients, suffer adverse events - with 11 per cent of them ending in death.

Policy Exchange used Freedom of Information requests to uncover reports showing that patients became a low priority during a string of organisational reforms. They were prepared in 2008 as the Department of Health undertook a major restructuring of NHS regulation. One report, Quality Oversight In England, by the highly-respected Joint Commission International, identified 'the pervasive culture of fear in the NHS and certain elements of the Department of Health'.

Another, by the Institute of Healthcare Improvement, said the 'NHS has developed a widespread culture more of fear and compliance than of learning, innovation and enthusiastic participation in improvement'.

An NHS worker who was interviewed for the report said: 'The risk of consequences to managers is much greater for not meeting expectations from above than for not meeting the expectations of patients and families.'

The revelations follow high-profile failings at health trusts in Tunbridge Wells, Basildon and Mid-Staffordshire, where managers' obsession with targets was blamed for filthy wards and nurse shortages which led to up to 1,200 deaths at Stafford Hospital.

Henry Featherstone, of Policy Exchange, called for hospital death rates to be made public. He said: 'The reports detail a frightening catalogue of flaws in patient safety procedures. Government has dragged its feet over implementing a robust system of inspection and improvement, even after these flaws have been highlighted in the strongest terms. 'Under a proper system of inspection and oversight, coupled with a continual process of performance improvement, hundreds if not thousands of lives would be saved.'

Tory health spokesman Andrew Lansley said the Tories would fight the 'closed culture' in the NHS. He said: 'Labour's obsession with targets has led to many hospitals being forced to prioritise ticking boxes over caring for patients'.

The Department of Health said: 'England is one of the world leaders in the international drive to improve the safety of healthcare. 'We have set up, and work alongside, the National Patient Safety Agency to encourage medical staff to report and learn from incidents, even when no harm was caused. 'Every death or serious injury due to mistakes in medical care must be investigated and the lessons acted upon.' [Blah! blah!]


Canadian company begins real US health care reform

In 2003, Mr. Baker founded Timely Medical Alternatives. It helps Canadians arrange for medical care in the United States. Though Canadian health care is paid for by taxes, waits are long and the system isn’t concerned with minimizing pain and suffering.

Each year 400 to 500 Canadians contact Mr. Baker for help. Some want a diagnostic test. Others want to save their lives. They have waited so long for care that their health has deteriorated to the point where paying thousands of dollars for U.S. care to escape suffering, death, or permanent debilitation seems like a bargain. Some of the stories of the people helped by Timely Medical Alternatives are available at

Christina Woodkey and her husband used all of their retirement savings to pay for surgery in Missoula, Montana to correct her spinal stenosis. They say that they’ll be dependent on welfare for the rest of their old age. Mrs. Woodkey had been disabled and in pain since 2005. After many delays, she was told in June 2009 that she had a September 30th appointment with a specialist. The wait for the actual surgery after that appointment would be 1 to 2 years. She had surgery in September in Missoula, and paid $55,000 for it.

The Canadian government may or may not decide to pay for Mrs. Woodkey’s surgery. Mrs. Woodkey says that regardless of the government’s decision, she’s happy that she took control of her own health care. She would do it again, she says, because money isn’t much good if you are in such pain that you can’t do anything. She says that Canadian doctors don’t care, not because they are horrible people but because under the government controlled system they can’t do anything for you.

Canadian physicians can’t affect waiting lists by working more because the government budget pays them for only a certain amount of work. Hospitals can’t open more beds because the government doesn’t fund them. It is illegal for physicians to accept payment from patients for care that the government is supposed to pay for.

Timely Medical Alternatives depends on Mr. Baker’s ability to find U.S. hospitals and doctors who have good outcomes, treat his patients promptly, and charge fair prices. His newest business, North American Surgery, will help Americans get much lower prices in exchange for cash payment from a network of 22 surgical centers in 13 states.

The differences between the package prices that Mr. Baker negotiates, and the prices charged by providers in most insurance networks, are huge. For example, the standard U.S. price for a hysterectomy is $20,000, while the North American Surgery price is a significantly lower $7,500. A hip/knee replacement that normally costs over $43,000 is much less expensive through Baker’s network at $15,000. And bypass surgery, usually hugely expensive at $100,000, is instead a more reasonable $15,000.

Why do such enormous price differentials exist? At least one of the physicians in Mr. Baker’s network notes that hospitals threaten to withdraw from insurer networks if insurers include lower cost providers in their networks. And insurers don’t have much of an incentive to fight those contract provisions because they can simply pass higher costs along in the form of higher premiums.

Mr. Baker plans to offer his services to people who have high deductible insurance, to people who don’t buy health insurance because they instead prefer to pay cash for care, and to people who just want to pay less for good health care. He and others like him offer the best plan for lowering the cost of American health care and improving its outcomes.


Truth and Reconciliation

The Democrat plan to force health care onto Obama's desk

"Those unversed in the arcana of Congressional procedure should familiarize themselves with 'reconciliation.' It's just another word for nothing left to lose -- that is, it's the tactic Democrats seem increasingly likely to use to bypass the ordinary legislative rules and railroad ObamaCare into law with a bare partisan majority of 50 Senators, plus Vice President Joe Biden.

Speaker Nancy Pelosi announced ... that Democrats 'have set the stage' for reconciliation. 'It's up to us to make sure the public knows that this is not extraordinary,' she said. 'It would be a reflection on us if we could not convince people that this is not an unusual place to go.' Yet the reconciliation gambit really would be unprecedented for social legislation of this cost and scale. And as a matter of procedure, it would also be unusual, to say the least.

As Mrs. Pelosi's senior health adviser, Wendell Primus, explained ... House Democrats would pass a series of 'fixes' to the Senate bill. The Senate would then pass the House reconciliation bill, sending amendments to President Obama to a bill that -- strictly speaking -- didn't exist, because it hadn't yet emerged from the House.

The House would then retroactively pass the Senate bill as is. Democrats say this will all be kosher as long as Mr. Obama signs the Senate bill before he signs the reconciliation bill. 'There's a certain skill, there's a trick,' Mr. Primus conceded, 'but I think we'll get it done.'

So even as Democrats themselves acknowledge that one reason the public hates ObamaCare so much is the corrupt tactics they have used to advance it through Congress, they still plan to try to land this Pelosian triple-handspring-quadruple pole vault to passage."


Poll: Start over on health reform

The American public wants Congress to start the health care debate over from scratch - just as Republicans have been pushing - amid growing talk among Democrats about the need to use a procedural end run to ram through a revised overhaul bill.

A Zogby International poll released Tuesday shows that 57 percent of Americans do not like either of the competing health care bills produced by the Senate and House and say Congress should start over, as a group of bipartisan lawmakers head to a health care summit with President Obama next week.

White House officials say they plan to unveil their revised proposal ahead of the summit, prompting Republicans to question whether the meeting is an attempt at real negotiation or just strong-arming.

Neither Republicans nor Democrats seem to seriously think the event will produce a meaningful negotiation. In fact, four Democrats asked Majority Leader Harry Reid on Tuesday to pursue reconciliation - a complicated procedural move that would allow the Senate to pass a bill with 51 votes and bypass the chance for Republicans to filibuster.

The Democrats - Sens. Michael Bennet of Colorado, Kirsten Gillibrand of New York, Jeff Merkley of Oregon, and Sherrod Brown of Ohio - support the public insurance plan, a government-run health care program that didn't have enough support to get the 60 votes needed to overcome a filibuster in the Senate, even before Republican Sen. Scott Brown's win in Massachusetts chilled support for such a plan on Capitol Hill. "Although we strongly support the important reforms made by the Senate-passed health reform package, including a strong public option would improve both its substance and the public's perception of it," the group said in a letter released Tuesday.

Reconciliation would be complicated, and many of the policy initiatives in a public-option bill or any health bill wouldn't be able to pass using the procedural tool, warned former Senate parliamentarian Robert B. Dove. He called the option an "exhausting process" during a conference call on Tuesday organized by the conservative Galen Institute.

Mr. Obama will review his proposed solution - which is not expected to include a public option - at the televised bipartisan health summit, planned for Feb. 25, White House spokesman Robert Gibbs said Tuesday. He said he expects Republicans to do the same, but minority lawmakers have been skeptical of the summit and haven't formally accepted the invitation.

House Minority Leader John A. Boehner said that after the summit, Democrats would embark "on a legislative course that Democratic congressional aides acknowledge has also been predetermined - a partisan course that relies on parliamentary tricks to circumvent the will of the American people and engineer a predetermined outcome. It doesn't sound much like bipartisanship to me."

Mr. Gibbs said it would be hypocritical for Republicans to turn down the invitation after they chastised Democrats for months for not including them in the health reform conversation. "Not accepting an invitation to do what they'd asked the president to do - if they decide not to, I'll let them leap the chasm that's there and try to explain why they're now opposed to what they said they wanted most to do," Mr. Gibbs said.

The White House's health care bill is expected to include many of the elements that already passed in both the House and the Senate bills, such as insurance industry reforms, requirements for all Americans to purchase insurance and strong incentives or a mandate that employers provide coverage. The sharpest differences among the plans include how to pay for it and how to limit federal funding of abortions.

The Zogby poll found that respondents largely oppose the current shape of the legislation, but a majority say they are more supportive of congressional reform of the health care system than they were a year ago.

Fifty percent of respondents strongly or somewhat oppose the legislation in both the House and Senate plans. But 33 percent of respondents said they were more supportive of reforming the health care system now versus a year ago and 24 percent said they are just as supportive. An ABC News/Washington Post poll released last week has similar findings. It showed that 63 percent of Americans want Congress to pursue a way to reform the health care system.


Australia: Hospital boss dumped for misuse of funds but details kept secret

THE boss of the Royal Children's Hospital has been dumped from the top job as Queensland Health is forced to repay thousands of dollars to the hospital's charity after it was incorrectly spent on luxury beauty treatments for nurses.

RCH chief operations manager Doug Brown has been demoted and will be relocated within the department following the completion of a two-year probe by the Crime and Misconduct Commission. Another unidentified hospital staffer has suffered a pay cut, while two other unnamed officers will undergo retraining in financial management.

Queensland Health will repay $6500 to the RCH Foundation after Mr Brown approved beauty treatments for 65 nurses as part of an alleged pay-off after they missed out on free parking.

The foundation raises money for lifesaving research but, as revealed by The Courier-Mail last year, the funds were instead spent on body polishes, manicures and pedicures at a beauty salon in 2007.

After months of insisting it would comment once the probe was finalised, Queensland Health yesterday refused to release the final report, including the findings, recommendations and exactly why certain staff were disciplined.

The demotion of Mr Brown is an embarrassment for Queensland Health after the department chose him over other candidates to run the RCH last year while he was being investigated.


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