Lazy and arrogant NHS midwives kill baby

Staff at one of London’s top teaching hospitals ignored a man’s pleas for help as his newborn baby died, an inquest was told yesterday. Iain Croft, 42, a journalist for the BBC’s World Service, told the inquest that staff at the Royal Free Hospital left him to monitor his child’s faltering heart rate after his wife, Heather Paterson, 43, had begged to see a doctor. Their son, Riley, died of asphyxia 35 minutes after being born, on March 25, 2005, after a ten-hour labour.

Giving evidence at St Pancras Coroner’s Court, Mr Croft said that the couple were initially turned away from the hospital when they reported to have their baby induced. He said: “They said no beds were available. In fact we were taunted by some staff who said, ’There’s no room at the inn, you’ll have to go home’.” The couple waited nearly eight hours the next day to see a doctor, before a midwife who induced the birth told Ms Paterson that she was a “silly girl” who was not really in pain.

Mr Croft said that a midwife had told them, “very firmly” that she would induce the birth herself, by applying the gel Prostin, which immediately left his wife in crippling pain. He said: “Heather’s arms and legs were convulsing because of the intense pain. “Heather was becoming very distressed because of the pain and was literally screaming for someone to come and help her with pain relief or give her a Caesarean section. “I asked several times if my wife could be seen by a doctor and we were refused. The midwife kept saying to her that her pain was not real. She said ‘no pain, no gain. This is what you have to go through, this is what it’s like’. . . . At some time she said to my wife, ‘You are a silly girl. You don’t deserve this baby. I’m going to take it off you’. Six hours later the baby was dead.”

Mr Croft said that two midwives, Ine Toby and Beverly Blankson, ignored the couple’s pleas for help. He was then told to monitor the baby’s heart-rate himself, and to trigger an alarm button if it fell below a certain level. He said: “It did drop three times and I pressed the button each time. In the end I had to go out into the corridor to bring her back in to look at it. She kept telling us not to be so fussy.”

The couple did not see a doctor until shortly before the baby was finally born. Mr Croft said: “All of a sudden the room was filled with doctors attending to the baby and at 8.28am they asked for permission to stop. Our baby was dead.” A postmortem examination, which Mr Croft said staff tried to “bully” him out of having, showed that the child died from asphyxia.

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Australia: State cancer care in crisis

SECRET waiting lists have revealed how Queensland Health consistently exposes cancer victims to deadly treatment delays. Internal hospital documents show hundreds of victims are routinely forced to wait more than three times longer than recommended for potentially life-saving radiation treatment. The "Report on Delay for Treatment" documents show there has been little or no improvement since The Courier-Mail obtained the same figures 10 months ago.

At the time, Health Minister Stephen Robertson downplayed the figures as a week-to-week prospect and insisted the Government was addressing the problem. There is now growing concern in Queensland's hospitals that efforts to address the radiation therapy waiting times have failed.

Coalition health spokesman John-Paul Langbroek yesterday said there was clearly an ongoing problem the Government must urgently address. "People are dying in our system because of these poor services," he said.

According to the figures for the Princess Alexandra, Mater and Townsville hospitals, priority-two patients, who have been diagnosed with aggressive cancers and internal bleeding, are now waiting up to 49 days for radiation treatment. Queensland Health's recommended maximum waiting time is 14 days to avoid "a significant adverse effect on outcomes". Priority-three patients, who predominantly suffer breast and prostate cancers, are waiting up to 69 days for treatment. The recommended maximum waiting time is 28 days. The Royal Brisbane and Women's Hospital was the only cancer-treating facility in Queensland at or below recommended treatment times.

However, hospital sources said this was because of a shortage of oncologists to refer patients for treatment. A Queensland Health spokesman admitted therapy waiting times were yet to show improvement. "Despite an overall improvement in elective surgery waiting times through the $10 billion health action plan, radiation therapy waiting times continue to be exacerbated by a national shortage of specialist nursing staff and oncologists," he said. The spokesman said Queensland Health would continue to pursue radiation professionals to reduce waiting times.

Source

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

For more postings from me, see TONGUE-TIED, GREENIE WATCH, POLITICAL CORRECTNESS WATCH, FOOD & HEALTH SKEPTIC, GUN WATCH, EDUCATION WATCH INTERNATIONAL, AUSTRALIAN POLITICS, DISSECTING LEFTISM, IMMIGRATION WATCH INTERNATIONAL and EYE ON BRITAIN. My Home Pages are here or here or here. Email me (John Ray) here. For times when blogger.com is playing up, there are mirrors of this site here and here.

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Vast sums spent on NHS record-keeping but records useless when needed

Women wrongly told they are not pregnant but nobody knows who they are

Thousands of women in Britain may have been given faulty pregnancy tests that wrongly indicate they are not having a baby, the Independent has learned. Up to 50 hospitals across the country are seeking to trace women who may be unaware they are pregnant because of a faulty batch of Clearview HGC. There are believed to be 44 potentially erroneous tests but tens of thousands of women may have been given the product in the past three months before the problem was spotted. The NHS is unsure which women received the faulty tests and one general hospital is seeking to alert 1,400 women. Tracing the women is important in case they endanger their baby by drinking heavily or by engaging in other activity unsuitable behaviour.

Clearview HGC tests, made by the US-based Inverness Medical Innovations, are also designed to detect ectopic pregnancies. The abnormality, where the baby grows outside of the womb, can cause severe internal bleeding. The tests are also often used in accident and emergency departments. Last night Inverness Medical Innovations said it was confident that it had rectified the problem, which occurred when an extra strip was added to the tests during production. It said: "We would like to apologise for any inconvenience this recall may have caused to our customers or their patients." Doctors are urging anyone who may have received the tests to visit their GP, local hospital or to buy a pregnancy testing kit from a chemist.

At least three months elapsed between the delivery of the first faulty products to the NHS and a product recall begun last week. The fault was spotted by one unnamed hospital, which contacted Inverness Medical Innovations. The US global health care group then began an investigation that culminated in a product recall on May 31, when it wrote to up to 50 hospitals. It said in a statement: "Our investigation indicated that the fault was caused by one strip of material that was incorporated into 44 tests, so, our investigation indicated the problem was limited to 44 tests. "We determined that these 44 tests could be in up to 50 specific hospitals and we immediately alerted the hospitals concerned. "We are confident that the problem has been correctly diagnosed and is being rectified by changes to our manufacturing process." However it refused to say which hospitals were affected, citing customer "confidentiality."

Kingston Hospital in south-west London disclosed that 1,400 women were tested with Clearview HGC between April 12 and June 1. It said in a statement: "We have been made aware by a supplier that a small number of pregnancy test kits that may have been used at the hospital could be faulty.

Source

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

For more postings from me, see TONGUE-TIED, GREENIE WATCH, POLITICAL CORRECTNESS WATCH, FOOD & HEALTH SKEPTIC, GUN WATCH, EDUCATION WATCH INTERNATIONAL, AUSTRALIAN POLITICS, DISSECTING LEFTISM, IMMIGRATION WATCH INTERNATIONAL and EYE ON BRITAIN. My Home Pages are here or here or here. Email me (John Ray) here. For times when blogger.com is playing up, there are mirrors of this site here and here.

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British health boss in trouble

The political career of health secretary Patricia Hewitt is lying on a trolley in some dark hospital corridor, very probably labelled “Do not resuscitate”. In a couple of weeks, Dr Brown is expected on his rounds to put Hewitt out of her misery. But until then she must put up with the pain. She’s already been attacked in recent weeks by midwives and junior doctors. Last week hospital consultants joined the fight by accusing Labour of crippling the health service.

Dr Jonathan Fielden, chairman of the British Medical Association’s consultants committee, said the service had been harmed by botched reforms. “Political meddling has brought the NHS to its knees,” he told the association’s annual consultants’ conference. He was speaking despite an announcement by Hewitt that, as a patient, the NHS was showing a modest recovery. After running up debts of 547m last year, the latest accounts showed a 510m surplus.

How has this been done? According to NHS figures, 17,000 jobs have gone in the past year and training budgets have been trimmed. And, according to critics, the cuts are endangering the government’s drive to cut waiting lists. “Half a million hospital patients could be waiting more than a year for treatment,” The Times reported.

Andy Burnham, the health minister, defended the government’s record, saying all but eight trusts have reduced waiting times. Not everybody does so badly. There is one area of the country where 98% of patients are treated on time. That’s Leicester – whose MPs include Hewitt.

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Australia: Ambulance Service in crisis -- pleads for volunteers

As is so often the case with government "services", more funding simply leads to worse service -- with the extra money just going to an ever more obstructive bureaucracy. The Queensland Ambulance Service is a prime example -- perhaps even worse than Britain's "National Health". There was very little controversy about the ambulance service when it was funded by private subscription but since it was "socialized" a few years ago, the complaints have never stopped

The Queensland Ambulance Service desperately wants help. It is asking for volunteers to pull people out of car wrecks and drive them to hospital in an ambulance. The extraordinary plea came days after the State Government promised $50 million and 250 new paramedics for the trouble- plagued service. The ambulance volunteers also will be expected to do basic first aid. They will need no particular skills - but will receive training and uniforms.

Opposition Leader Jeff Seeney said the calls for emergency drivers made a mockery of Premier Peter Beattie's claim that the state had the world's best service. "It is clear the Premier's promise was as hollow as every other promise he's made on health, water, electricity and roads," he said.

Last month Sunday Mail reports revealed frontline anger at roster reform, excessive hours, lack of staff, vehicles and equipment, and lack of management support. As Emergency Services Minister Pat Purcell boasted of improved service, the officers in stations near Gladstone pleaded for help.

An advertisement in Wednesday's Calliope Shire newsletter read: "Wanted- Emergency Ambulance Drivers. The role includes emergency driving to hospital, extrication of patients from vehicles and residences..."

The above story by DARRELL GILES appeared in the Brisbane "Sunday Mail" on June 10, 2007

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

For more postings from me, see TONGUE-TIED, GREENIE WATCH, POLITICAL CORRECTNESS WATCH, FOOD & HEALTH SKEPTIC, GUN WATCH, EDUCATION WATCH INTERNATIONAL, AUSTRALIAN POLITICS, DISSECTING LEFTISM, IMMIGRATION WATCH INTERNATIONAL and EYE ON BRITAIN. My Home Pages are here or here or here. Email me (John Ray) here. For times when blogger.com is playing up, there are mirrors of this site here and here.

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The failure of cost consciousness is already a big limiting problem with U.S. health care

Even the NYT article below can see that problem -- but is very light on solutions

In a saner world, the place where you live wouldn't have much effect on how doctors treated your back problems. In our world, it can make all the difference. In Idaho Falls, Idaho, anyone suffering from the sort of lower back pain that may conceivably be helped by the fusing of two vertebrae is quite likely to have the surgery. It's known as lumbar fusion, and the rate at which it is performed in Idaho Falls is almost five times the national average. The rate in Idaho Falls is 20 times that in Bangor, Me., where lumbar fusion is less common than anywhere else.

These numbers come from the wonderful Dartmouth Atlas of Health Care. The Dartmouth researchers adjust the numbers to take into account age, race and sex, which is another way of saying that there is no good explanation for the huge variations they find. Doctors in the Idaho Falls area are probably just being more aggressive than doctors elsewhere.

But it's not clear that their patients are any better off. The evidence for lumbar fusion is incredibly mixed. It seems to help people with certain kinds of pain, but many others recover just as well without the surgery. Of course, doctors are almost always better off if the surgery is done: The typical hospital bill for lumbar fusion is roughly $50,000.

This is about as good an example as you can find of the health care mess. The number of lumbar fusions performed in this country has more than tripled since the early 1990s, and Medicare now spends more than $600 million a year on the procedure. It's one reason your health insurance bill has gone up.

Now stop and ask yourself a quick question about the lumbar fusion story: Does it have anything to do with the fact that almost 50 million people in this country don't have health insurance? Clearly, it does not. And that's precisely the problem with the current debate over health care reform.

After more than a decade in the wilderness, health care has returned to the center of the political discussion. But the only topic getting any serious attention is universal health insurance. It's the entire point of the ambitious new program in Massachusetts and a similar proposal in California. Universal coverage has dominated both the news media's coverage of the Democratic presidential candidates' reform ideas and the candidates' own jockeying over those ideas.

In a debate in New Hampshire on Sunday night, John Edwards needled Barack Obama for offering a plan that wasn't "completely universal." (A fair criticism.) Mr. Obama's aides like to counter that Mr. Edwards is underestimating the cost and logistical difficulties of covering every last person. (That's probably fair, too.) People in both campaigns are fond of pointing out that Hillary Clinton still hasn't come up with her own plan for universal coverage. In the 2008 campaign, expanded health insurance is apparently the new "middle class": there's an arms race to see who can be most in favor of it.

Let me add my name to the list of fans before the e-mail starts pouring in. Universal coverage is a great idea. The unlikely crew of Democratic state legislators, Republican governors and Democratic presidential candidates who have forced the issue onto the agenda deserve enormous credit. A world where everyone could afford health insurance - where no one had to choose between fixing a cavity and paying the rent - would be a much better place.

But if we are really at the start of a once-in-a-generation push to fix health care, we need to be clear about the true problem. The main reason so many people lack health insurance is because of its cost. And a big reason for that cost is the explosion of expensive, medically questionable care, be it knee replacement, preventive angioplasty or lumbar fusion. The route to an affordable health insurance solution runs straight through this thicket.

Along these lines, the three leading Democratic candidates have quietly come up with nearly identical ideas. Deep inside their health care plans, Mrs. Clinton, Mr. Edwards and Mr. Obama have each called for the creation of a national institute to figure out which kinds of medical care actually work. This institute would sort through the scientific research on, say, spinal fusion and help people understand when it may make sense and when it's likely to be just another big medical expense that doesn't solve anything. Medicare and private insurers could then use the research findings to determine when a procedure or a drug would be covered. There would be room for exceptions, based on a doctor's judgment. In general, though, a doctor and a patient could proceed with dubious treatment only if they didn't stick the rest of us with the bill. [That's exactly what happens in Britain already with NICE -- with widely condemned results -- but you cannot expect an NYT writer to know that]

So far, the candidates have been careful to describe the institute as a place that would merely collect and distribute information, not one with the power to block wasteful spending. To pay for expanded health insurance, they are instead focusing on unobjectionable (and unproven) ways to save money, like computerized medical records. "None of the candidates have offered a specific plan to seriously rein in the growth of health care costs," says Jonathan Skinner, an economist at Dartmouth who works on the Atlas of Health Care.

But campaign advisers acknowledge that any institute will ultimately help set insurance payments, and they are not the only ones pushing the idea. Peter Orszag, the head of the Congressional Budget Office, has mentioned it when talking about the fiscal disaster that awaits if Medicare spending isn't slowed. A number of Republican health care experts also favor some sort of cost-effectiveness institute. It's another way to cut wasteful government spending.

Still, we shouldn't be naive: a lot of people would lose if medical care came to be based more on what actually worked. Right now, drug companies and medical device makers can go to the Food and Drug Administration and get approval for an expensive new product so long as they show that it's as effective as its predecessor. They can then turn around and suggest to doctors that the new product is more effective than its predecessor. The doctors often profit, too. And many patients demand the latest, most expensive procedure, regardless of the evidence.

So reforming the system will require a fight - not just over the meaning of the word "universal" but also over finding tough, sensible ways to save money. As David Cutler, one of the Obama campaign's health care advisers, said, "These things are really hard, so they ought to be in the foreground." The simple truth is that medical spending can't continue to rise at its current rate. Somehow, we need to make choices.

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

For more postings from me, see TONGUE-TIED, GREENIE WATCH, POLITICAL CORRECTNESS WATCH, FOOD & HEALTH SKEPTIC, GUN WATCH, EDUCATION WATCH INTERNATIONAL, AUSTRALIAN POLITICS, DISSECTING LEFTISM, IMMIGRATION WATCH INTERNATIONAL and EYE ON BRITAIN. My Home Pages are here or here or here. Email me (John Ray) here. For times when blogger.com is playing up, there are mirrors of this site here and here.

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Conservative bureaucracy-lovers

The Left is now thanking Romney for making HillaryCare respectable again. Jonathan Cohn has an article in the latest New Republic titled "Hillary Was Right" [$] that helpfully explains similarities between HillaryCare and RomneyCare... Cohn is not even referring to some obscure aspect of RomneyCare that was forced down Romney's throat by a left-wing legislature - which is how Romney's defenders have tried to explain away parts of the plan, such as the individual mandate, that are unpopular with conservatives. According to Cohn, the aspect of RomneyCare that most resembles HillaryCare is its very centerpiece, which Romney borrowed from the conservative Heritage Foundation: the health insurance "Connector."

Cohn is essentially correct. The objective of the "Connector" bureaucracy, as described by Heritage Foundation scholars, reads like an exercise in government planning. The "Connector" is supposed to "reorganize[e].a large part of the state's private insurance system into a `single market' structure with uniform rules and a central `clearinghouse' for administering coverage."

Why, exactly, do we need a new layer of government bureaucracy to do these things? So we will have someplace to buy health insurance? We're getting along just fine without layering more bureaucracy on our auto insurance. In fact, we already have a connector for both health and auto insurance. It's called the Internet. Has anyone ever heard of eHealthInsurance.com?

Why do we need a "Connector" to tell health insurers what to sell and at what price? Those sorts of price controls and mandated benefits are exactly the kind of government planning that is making health insurance so unaffordable. Shouldn't conservatives be trying to repeal those laws, instead of creating new bureaucracies that will propose, enforce, and defend them?

Aren't such efforts a distraction from reforms that would reduce government planning? For example, conservatives should be pushing Congress to let individuals and employers purchase coverage from insurers in other states. That would make health insurance more affordable by allowing those purchasers - are you listening, Massachusetts? - to avoid the costly regulations imposed by their own state government. A nationwide market for health insurance would make the Heritage/Romney approach look less like a "Connector" than a "Constrictor."

If health-insurance markets don't work as well as they should, it's because state and federal governments are doing too much planning already. Most importantly, the federal tax code denies workers ownership of their health care dollars and slaps a huge tax penalty on those without job-based coverage. Shouldn't conservatives be rolling back those government interventions instead of cooking up even more?

If I were advising Sen. Clinton, I would be urging her to boast that her approach to health-care reform enjoys support from conservatives like the Heritage Foundation and Gov. Romney. If I were advising Gov. Romney, I would prescribe a severe case of amnesia and a health-care agenda that actually reduces the role of government.

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NHS negligence has killed nearly half a million Scots

POOR NHS treatment has led to almost half a million Scots dying in the last 30 years, a new study has revealed. Doctors at Glasgow University found that between 1974 and 2003, a total of 462,000 people died in Scotland as a result of health service failings. It means Scotland has one of the highest avoidable death rates in western Europe.

The study examined the number of deaths caused by a lack of "timely and effective health care". The vast majority of people - around 250,000 - who died due to inadequate or delayed treatment were heart or stroke patients. Another 7300 had cancer and slightly more than 2000 were pneumonia patients.

The study revealed that avoidable deaths among men in Scotland over the time period was 176 for every 100,000 people. This compared with 159 in Portugal, 129 in Austria and 100 in Italy. Rates for women were 123 per 100,000, also higher than every other European country investigated.

Source

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

For more postings from me, see TONGUE-TIED, GREENIE WATCH, POLITICAL CORRECTNESS WATCH, FOOD & HEALTH SKEPTIC, GUN WATCH, EDUCATION WATCH INTERNATIONAL, AUSTRALIAN POLITICS, DISSECTING LEFTISM, IMMIGRATION WATCH INTERNATIONAL and EYE ON BRITAIN. My Home Pages are here or here or here. Email me (John Ray) here. For times when blogger.com is playing up, there are mirrors of this site here and here.

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NHS is on brink of collapse, say consultants

The NHS is on the brink of collapse and cannot be saved unless Gordon Brown intervenes when he becomes prime minister to give doctors the authority to organise a recovery, the leader of Britain's 33,000 hospital consultants will claim today. Jonathan Fielden, chairman of the British Medical Association's consultants committee, will tell Mr Brown: "Political meddling has brought the NHS to its knees. Unshackle the profession, give us back the health service, and we will rebuild it. Fail to do so and you will rightly be condemned for destroying the best piece of social capital the country has ever had."

Dr Fielden will make his plea as Patricia Hewitt, the health secretary, announces the NHS's financial results for the year to March. She is expected to confirm a report in the Guardian last week that it made a surplus of about 500m. Dr Fielden will blame the Department of Health for cutting services too aggressively last autumn, when ministers panicked about the possibility of another deficit. "It takes weeks to cut, but years to rebuild trust," he will tell the BMA consultants' conference in London. "We are angry with the government for a woeful dereliction of duty - towards patients, towards the profession and towards the future. We have lost all confidence that the government can solve the problems it has created."

The service suffered from too little strategic direction and too many ministerial policy initiatives. It had become "a distorted skeleton". The government diverted billions of pounds from improving efficiency to create an internal market in which hospitals competed for patients. "The excessive use of private firms to provide NHS services has been costly, disruptive and has fragmented care. The independent sector should only be used where the NHS needs it, not thrust into its midst like a carelessly placed hand grenade."

Mr Brown should work with doctors, patients and other healthcare professionals to stem the loss of trust and collapse in morale. "We will not stand by and see the Trojan horse of the independent sector rolled in to take over the health service from within."

Source






Outrage over NHS cutbacks and bookkeeping fiddles

Patricia Hewitt was accused yesterday of aggravating regional inequalities in NHS care to meet her promise to stem health service deficits in the last financial year. The Health Secretary faced a barrage of criticism from economists and health professionals over her stewardship of the NHS after disclosing that it had underspent its budget by 510 million pounds last year. The figure fulfilled a government pledge to avoid a third year in the red, but provoked outrage over "excessive" cuts and their impact on waiting lists. The latest unaudited data show that more than one in five NHS bodies in England are still in debt, with about one in ten classed as facing long-term financial challenges.

Jonathan Fielden, of the British Medical Association, described the cost-cutting strategy as "wreaking havoc on the NHS and return[ing] it to boom and bust health economics". The combined debt of the 22 per cent of NHS organisations who failed to break even in 2006-07 was 911 million. In the previous financial year the NHS ran up an overall deficit of more than 500 million, and the gross deficit - the total of all those organisations which ran up debts - was 1.3 billion.

However, the NHS, which had a budget of over 70 billion for 2006-7, has only managed to balance the books by taking money from elsewhere. A leaked e-mail, reported yesterday by The Times, suggested that in addition to lost jobs and raids on training budgets, the climate of cost-cutting has stalled progress on the flagship policy to ensure no patient waits longer than 18 weeks for hospital treatment........

Peter Carter, general secretary of the Royal College of Nursing, said that yesterday's budget figures "expose the tragedy and farce of NHS finances". He condemned the Government's refusal to give nurses their 2.5 per cent pay award immediately instead of staged over the year. "With a NHS surplus of more than half a billion pounds and the threat of industrial action on the horizon, it is surely time for ministers to do the decent thing and give nurses the fair pay deal they deserve," he said. "Stop-go economics is no way to run the NHS." NHS Trusts have been spending more than œ1 billion a year on agency nurses due to poor planning, a group of MPs said. The Public Accounts Committee said that the bill grew by 40 per cent in the five years to 2005 - despite the number of permanent nurses in the health service rising by one fifth over the same period.

Source

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

For more postings from me, see TONGUE-TIED, GREENIE WATCH, POLITICAL CORRECTNESS WATCH, FOOD & HEALTH SKEPTIC, GUN WATCH, EDUCATION WATCH INTERNATIONAL, AUSTRALIAN POLITICS, DISSECTING LEFTISM, IMMIGRATION WATCH INTERNATIONAL and EYE ON BRITAIN. My Home Pages are here or here or here. Email me (John Ray) here. For times when blogger.com is playing up, there are mirrors of this site here and here.

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Cuts to NHS services blow out already-long waiting times

Drastic cost-cutting ordered by the Government across the NHS has derailed its flagship policy to ensure that no patient waits longer than 18 weeks for hospital treatment. A leaked e-mail seen by The Times reveals that the Department of Health is so worried that new data showing that some patients will have to wait “in excess of one year” will be highlighted by the media that it has issued special guidance on how to spin the news.

The Government is expected to announce today that the NHS has made a surplus of more than 500 million pounds in the past financial year after an aggressive drive to reduce spending by health trusts. The e-mail says that more than half of patients are still waiting longer than 18 weeks for treatment. It calls into question the Government’s ability to honour its key health pledge that all patients would be treated within this time by the end of 2008.

The memo, containing advice from the Department of Health sent to local NHS communications managers, reveals that 52 per cent of hospital inpatients are waiting longer than 18 weeks across the country. Full data on the situation will be published for the first time by the Government tomorrow. Ministers have pledged that by the end of next year no patients should wait longer than that time after being referred by their doctors.

The e-mail contains advice from the Department of Health for local NHS communications managers on how to handle media inquiries on publication of the figures and outlines “overarching messages” for press officers to quote in an apparent attempt to spin the story. It says: “The [referral to treatment] data due to be published on 7 June is a brand new data collection . . . While this new measurement – from referral to treatment – better reflects the patient experience, there are some issues for communicators to be aware of. “The data will show variations in referral to treatment waiting times across your area by provider and commissioner. It will also show differences by specialty. “There will be some long waits – of up to, and in excess of one year, in some areas. “There is a risk that the media’s attention will focus around long waits, and make claims that these new, more transparent measures of waiting times, undermine the effort to date to tackle waiting in the NHS.”

The e-mail, circulated by a press officer from the South Central Strategic Health Authority (SHA), appears to have been sent in error to a number of local MPs, including David Cameron. Peter Campion, the SHA’s head of communications and author of the e-mail, writes that the waiting time figures “have potential to generate negative inquiries locally”, but warns colleagues that they are “hamstrung” to prepare responses before the local data is revealed. The memo also suggests that differences seen across regions might be used as further evidence for a “postcode lottery” of treatment in the NHS.

Patricia Hewitt, the Health Secretary, is expected to announce today that the health service underspent by up to 500 million last year. She put pressure on local health chiefs to make savings after promising to resign if the NHS went into the red in 2006-07. But the drive to balance the books is thought to have come at the expense of other services, and attempts to cut waiting times. The 18-week target, set in 2004, is widely considered to be among the most ambitious of the Government’s aims for the NHS. A baseline estimate published in December suggested that 35 per cent of patients across the country were treated within this time.

At that time up to a quarter of patients needing operations such as hip or knee replacements were estimated to wait between one and two years for surgery, with a small number waiting longer than this. The figures showed that most specialities treat between 30 and 50 per cent of inpatients within 18 weeks. In trauma and orthopaedics the figure is only 20 per cent. The Government has set an interim target of 85 per cent of admitted patients and 90 per cent of nonadmitted to be treated within 18 weeks by March next year.

A spokesperson for the Department of Health said that the data concerning waiting times would be set out tomorrow. “This data is bound by the publication protocols of national statistics and we will not be commenting ahead of publication,” she said

Source






Your government will protect you -- again

An Australian aged care system is overseen by lazy, fat-bottomed bureaucrats who don't give a damn as long as all the boxes are ticked

NURSING homes found to be neglecting, mistreating or providing poor care to patients are being protected by a government-appointed agency, according to aged care critics. The agency is lacking in transparency and reliant on residents and staff too scared to speak out, they say. The watchdog is also accused of being too reliant on paperwork by aged care management and not investigating what is happening in patients' rooms. The frequency of audits by the ACSAA has also been called into question.

And critics also claim the Aged Care Standards and Accreditation Agency, which is responsible for checking the standards of nursing homes throughout Australia, does not provide a true and accurate picture of what is happening in homes because it fails to disclose past reports on its website. The Courier-Mail can confirm aged care facilities which have been sanctioned in the past for horrific standards have their damning reports taken off the ACSAA's website once problems have been "fixed".

Agedcarecrisis.com founder Lynda Saltarelli said this system was protecting homes and failing consumers as it denied future residents and their families access to a home's track record. Ms Saltarelli said some homes were repeat offenders, but consumers had no way of knowing this. Diane Bates, founder of Daniels Shield (Doesn't Allow Neglect In Elderly Lives), said as a former aged care worker, she knew staff were drilled on what to tell the agency when inspections were made - and many residents interviewed were too scared to tell the truth in fear of being thrown out. "Most of their checking is done by checking the bookwork," Ms Bates said. "Now, if I tick a box and say I just won Gold Lotto, it doesn't mean to say I did."

But an ACSAA spokesman defended the agency's reporting rules, saying that while past reports were not on the website anybody wanting a copy of an older report could request it. "That said, the most recent report is usually the most relevant," the spokesman said. He also said 10 per cent of residents or relatives representing them were always interviewed privately and this was always cross-checked with the paperwork compiled.

Source

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

For more postings from me, see TONGUE-TIED, GREENIE WATCH, POLITICAL CORRECTNESS WATCH, FOOD & HEALTH SKEPTIC, GUN WATCH, EDUCATION WATCH INTERNATIONAL, AUSTRALIAN POLITICS, DISSECTING LEFTISM, IMMIGRATION WATCH INTERNATIONAL and EYE ON BRITAIN. My Home Pages are here or here or here. Email me (John Ray) here. For times when blogger.com is playing up, there are mirrors of this site here and here.

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Bureaucratic attack on NHS superbugs

Futile tokenism. Cleanliness and asepsis is what is needed and they can afford neither. They can only afford an army of bureaucrats -- and bureaucratic pay comes first

Hospitals face being served with an “improvement notice” if they fail to tackle superbug infections such as MRSA and Clostridium difficile, the health watchdog announces today. Inspectors from the Healthcare Commission will carry out unannounced spot checks on 120 NHS trusts in England over the next year in an attempt to cut rates of hospital-acquired illness. Those that are found not to be up to scratch could find themselves served with an improvement notice or be put in special measures. The crack-down comes after figures which show that cases of C. diff are on the rise.

Health Protection Agency statistics released in April identified 55,681 cases of the potentially fatal bug in patients aged 65 and over in England in 2006 – an increase of 8 per cent on the number of reported cases in the previous year. The figures also revealed 1,542 cases of MRSA blood-stream infection in England between October and December 2006, down 7 per cent on the previous quarter. Despite the fall, the Government is widely expected to miss its target of halving rates of MRSA before next April.

The Healthcare Commission will use existing data on infection rates and cleanliness to identify trusts that may need help. Those not doing well will be a priority, but up to two thirds of NHS acute trusts will be checked each year as part of the programme. Their performance will be assessed against the Government’s hygiene code, which sets out 11 compulsory duties to prevent and cope with hospital superbugs. Assessment managers will visit about ten trusts a month, examining their procedures for isolating patients, hand-washing and cleaning equipment. Under the code, trusts must have specialist infection control teams and should submit regular reports to the trust board.

If the code has been breached, trusts will be given a deadline to set out an an action plan for rectifying problems. If they fail to assure the watchdog that appropriate steps have been taken, the commission will publicly issue the trust with an improvement notice. Failure to comply could end up with the Health Secretary imposing special measures on a trust and personally overseeing an improvement programme.

At present, the commission does not inspect every trust on all the Government’s core health standards. But from this year, the 20 per cent of all trusts inspected will be checked for compliance with the hygiene code. The commission is currently investigating Maidstone and Tunbridge Wells NHS trust after concerns about rates of C. diffthere since 2004. Last year Stoke Mandeville Hospital, part of the Buckinghamshire Hospitals NHS Trust, was criticised in a commission report after 33 people died after outbreaks there.

Anna Walker, chief executive of the commission, said: “Boards at all acute trusts must take notice: chances are you’re going to be assessed against the hygiene code, so make sure you’re ready. We don’t want to catch trusts out. We would much prefer to find that everything is in place to protect patients and the public. “The 120 assessments will be in-depth, and visits will be unannounced so that we can see the hospital in action. What we want to know is whether trusts are taking infection control seriously.”

Lord Hunt, the Health Minister, welcomed the move. “Reducing healthcare-associated infections is a top priority for the NHS and all NHS bodies have a duty to comply with the code of practice,” he said.

Source






Hospital cutbacks in Tasmania provoke rage

THOUSANDS of concerned demonstrators marched through the cold and rain at Latrobe yesterday to protest against the planned downgrade of the Mersey Hospital. Labor Braddon MHA Brenton Best was one of the estimated 2000 to express anger at the sweeping health reforms.

Mr Best's colleague Health Minister Lara Giddings, who last week pleaded with the people of the North-West to give her plan a chance, did not attend the rally. She wants to make the Mersey Hospital a dedicated hospital for minor day surgery. Under her plan, Burnie would become the emergency and acute-care centre for the North-West.

Mr Best, who has built his political career on supporting the Mersey, told the hostile crowd he would consider crossing the floor to vote against the reform. West Coast Mayor Darryl Gerrity said the promise had drawn applause. He said there was a lot of distrust of Ms Giddings in regional Tasmania, which would feel the hospital downgrades and closures the most. "We are now officially second-class citizens," he said.

He said there was anxiety on the West Coast, where the Rosebery Hospital will lose its 24-hour staffing. "There is no public transport, we can't get up (to Burnie)," Cr Gerrity said. "All we have got on the West Coast is volunteer ambulance officers."

Mersey Community Hospital support group chairman Steve Martin said yesterday's march showed the community's passion for the hospital. "It's the biggest march I think Latrobe has ever seen." He said Ms Giddings had no real plan, funding or personnel and not enough ambulances. "This will put people's lives at risk," Mr Martin said.

The State Opposition chose yesterday to air its first concerns about the reform. Opposition health spokesman Brett Whiteley said the Government had not listened to the smaller communities, such as Rosebery and Ouse. "One thing of which people can be sure is that we won't be in lock-step with Ms Giddings on absolutely everything she proposes," he said. He said Rosebery was an isolated community with dangerous roads to the nearest hospitals.

Treasurer Michael Aird said the Government had no choice but to introduce reforms, which were driven by safety and financial sustainability.

Source

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

For more postings from me, see TONGUE-TIED, GREENIE WATCH, POLITICAL CORRECTNESS WATCH, FOOD & HEALTH SKEPTIC, GUN WATCH, EDUCATION WATCH INTERNATIONAL, AUSTRALIAN POLITICS, DISSECTING LEFTISM, IMMIGRATION WATCH INTERNATIONAL and EYE ON BRITAIN. My Home Pages are here or here or here. Email me (John Ray) here. For times when blogger.com is playing up, there are mirrors of this site here and here.

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Folly in Colorado

By Paul Hsieh, M.D.

The Colorado Blue Ribbon Commission on Health Care Reform recently selected four health care reform proposals for eventual consideration by the Colorado legislature. Although they differ in their details, these differences are dwarfed by their fundamental similarity - they all entail a massive increase in government interference in medicine in the name of "universal coverage." All four plans inject government force into the doctor-patient relationship. They include some combination of forcing all residents into a single health program, forcing some or all individuals and/or businesses to purchase a state-approved insurance policy, requiring insurance companies to provide new additional benefits, establishing a new bureaucracy to set payments to the doctors for services they provide, and doubling the Colorado Medicaid population.

These are just disguised forms of socialized medicine. Similar programs already have been tried in states and other countries. They have all failed, resulting only in higher costs and lower quality patient care. The TennCare disaster - Tennessee's failed attempt at "universal coverage" - offers an important lesson for Colorado. In the 1990s, the Tennessee government expanded the state Medicaid program to include people earning up to 300 percent of the federal poverty line, i.e., a middle-class family of four making $55,000 a year. The state also forced insurance companies to offer expensive new benefits and forced employers to either buy health insurance for their employees or else pay into a state fund for the uninsured. Many employers chose the second option, shifting their employees' health costs onto taxpayers.

Because of the new regulations, many insurance companies withdrew from Tennessee, forcing more patients into the state health plan. The Tennessee government initially offered a generous benefits package. Predictably, costs skyrocketed because patients had no incentives to spend prudently. In response, the government attempted to control costs by slashing payments to doctors and hospitals. Hospitals closed and doctors left the state in droves. Many doctors who remained stopped seeing TennCare patients since they lost money on each one. Families with sick children often had to drive long distances to find a doctor who would see them. And they had no alternatives to TennCare because the state regulations had all but destroyed the insurance market.

Ironically, TennCare ended up causing the most harm to the very people it was intended to help - the working poor and rural patients. Nor did TennCare save money. Instead, it nearly bankrupted the state budget. The problems of TennCare are not aberrations that can be fixed with a few minor reforms. They are inherent in any system of government medicine. Under such systems, bureaucrats and politicians decide what care individuals can receive, not doctors and patients. This has long been the case in Canada's "single-payer" socialized medical system, with its infamous waiting lists for critical medical tests and treatments.

For the sake of my patients and myself, I don't want this to happen in Colorado. Socialized medicine is not the cure for Colorado's health care problems. Forcing everyone into a government-run medical program because some people are uninsured would be just as wrong as forcing everyone to live in a government-run housing project because some people are homeless.

Instead, Colorado should adopt free market reforms such as the FAIR Program ("Free-Markets, Affordability & Individual Rights") proposed by Brian Schwartz, Ph.D. Such programs are especially good at providing affordable quality care for the working poor and rural patients. They work precisely because they encourage individual responsibility and they respect the right of the individual to spend his health care dollar according to his best judgment.

Colorado has an opportunity to become a real innovator in health care reform. Instead of recycling failed government programs, we should set an example for the rest of the country by adopting free market solutions. Only the free market can provide Coloradans with the high-quality, affordable health care they need and deserve.

Source




Incredible bungle: Queensland hospital bureaucrats build TWO unusable operating theatres

HOSPITAL bosses spent $2.5 million building two operating theatres, and then shut them down because doctors said they were unsafe to use. The theatres built for cardiac surgery at Brisbane's Prince Charles Hospital have been out of action for a month while modifications are made. Doctors say it has put a strain on resources, meaning patients are having to wait even longer for operations.

But managers described the situation as "normal" and denied that patients were suffering. They refused to reveal how much the renovation work would cost taxpayers, but said it involved changing benches, a stock room, flooring, airconditioning and electrics [just a few things!] in order to meet workplace health and safety guidelines.

One senior staff member, who can't be named because Queensland Health has banned its staff from speaking out, said the situation was "extremely serious". He said: "The fact is, people needing cardio procedures are dying while we sit here and look at new surgical theatres we can't use because the Government stuffed up building them. "They're boarded up because they are the wrong size and the wrong building materials have been used."

Figures show there are 391 patients on the waiting list for heart operations at the Prince Charles Hospital, of whom 57 have been waiting longer than is considered clinically safe. The theatres were in use for only two months before staff found the range of problems.

Mary Montgomery, district manager for Northside Health Service District, said staff had since been consulted [What an original idea!] about the modifications. "It is normal for any new operating theatre to have an adjustment period in which some refinements and modifications may need to be made," she said. "It is only through using the new theatre that any necessary adjustments can be identified."

Opposition health spokesman John-Paul Langbroek said it was not "normal" to factor an adjustment period into an expensive project. "I can't believe we have credible people saying it's normal to spend $2.5 million on operating theatres and then to find fault with them," he said. "It doesn't happen in private enterprise because businesses would go broke if they ran things like that."

Queensland Health has a history of shutting down its operating theatres. In March, The Sunday Mail reported how theatres at Ipswich, Logan and Redland hospitals were out of action because there were too few staff to run them. Previously, a theatre at the Princess Alexandra Hospital was used as a storeroom for four years. It was opened only after a Sunday Mail report prompted health bosses to take action.

The above story by HANNAH DAVIES appeared in the Brisbane "Sunday Mail" on May 3, 2007

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

For more postings from me, see TONGUE-TIED, GREENIE WATCH, POLITICAL CORRECTNESS WATCH, FOOD & HEALTH SKEPTIC, GUN WATCH, EDUCATION WATCH INTERNATIONAL, AUSTRALIAN POLITICS, DISSECTING LEFTISM, IMMIGRATION WATCH INTERNATIONAL and EYE ON BRITAIN. My Home Pages are here or here or here. Email me (John Ray) here. For times when blogger.com is playing up, there are mirrors of this site here and here.

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NHS hits smokers

SMOKERS are to be asked to give up their habit before they are put on the waiting list for routine operations such as hip replacements and heart surgery. National Health Service managers say smokers take more time to recover from surgery, blocking beds for longer and costing more to treat. One primary care trust will launch a consultation on the new curbs this summer to coincide with the ban on smoking in public places to be enacted on July 1. Rod Moore, assistant director of public health at Leicester City West Primary Care Trust, said it should become the norm for patients to stop smoking before all routine surgery. “If people give up smoking prior to planned operations it will improve their recovery,” Moore said. “It would reduce heart and lung complications and wounds would heal faster. Our purpose is not to deny patients access to operations but to see if the outcomes can be improved.”

NHS managers want patients not to have smoked any cigarettes for a full month before surgery. But as they would be expected to take about two months to stop, operations could be delayed by up to three months. The managers do insist, however, that it is up to doctors to decide whether the surgery can still go ahead if the patient fails to give up. Some doctors argue that the policy could deter smokers from attending appointments because they believed that they would not qualify for treatment.

By December next year, all patients will need to have had surgery within 18 weeks of having been referred to hospital by their GP, according to new government targets. To avoid endangering the targets, patients would not be added to waiting lists until they had given up smoking. Moore said: “If this were to be introduced, it would happen prior to referral [to hospital]. The clock would not start ticking. It would not interfere with the 18-week target.”

Leicester is believed to be the first trust to be planning such a wide-ranging measure since 2005, when the National Institute of Health and Clinical Excellence issued guidance that it was reasonable for smokers to be denied treatment if their habit would affect the outcome and cost of medical care. For example, doctors routinely deny smokers surgery for blocked blood vessels in the legs because they say the problem will go away if they stop smoking. Doctors also argue that if the patient continues smoking the vessels will quickly become blocked again.

Now NHS managers say patients should give up smoking whether their condition is directly caused by the habit or not. Vanessa Bourne, head of special projects for the Patients Association, said: “If the NHS is trying to reduce the number of people who qualify for surgery it should be frank about this and not pretend this is medically driven. “If hospitals really wanted to improve outcomes for patients after surgery then there are other priorities such as tackling hospital infections.

“If these patients were being treated privately they would not need to give up smoking ahead of surgery, which suggests this has more to do with money than what is in the best interests of the patient.”

Source






Australia: More cutbacks in Melbourne public hospitals

WARDS are being closed, surgeries cancelled and hospitals left in disrepair as the health network serving some of Melbourne's poorest battlers reaches breaking point. Western Health network is slashing its services, including to children, because of costs. Surgeons in the network -- which includes Western Hospital, Sunshine Hospital and Williamstown Hospital -- were told of the deepening crisis this week. It is understood there will be budget cuts estimated at $15 million. The consequences are believed to be:

MORE than 2000 elective operations to be axed in the '07/'08 financial year

ONE ward being closed at Western Hospital, with patient numbers down by about 100

UP TO 40 people waiting on trolleys each day in emergency departments at Western and Sunshine

AND two of the three pediatric surgeons at Sunshine Hospital are taking leave because their working hours are being slashed.

A Western Health network spokesman confirmed the budget troubles on Friday. Staff in the Western Health network have confirmed the ward closure at Western Hospital. Staff told of there often being "more than 20 people in the Emergency Department on trolleys awaiting admission". AMA Victoria president Dr Douglas Travis confirmed Western Health had over-run its budget. He said: "There is a planned general reduction in services. "Administrators go through great anguish deciding how best to 'cut the cloth to fit'."

Source

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

For more postings from me, see TONGUE-TIED, GREENIE WATCH, POLITICAL CORRECTNESS WATCH, FOOD & HEALTH SKEPTIC, GUN WATCH, EDUCATION WATCH INTERNATIONAL, AUSTRALIAN POLITICS, DISSECTING LEFTISM, IMMIGRATION WATCH INTERNATIONAL and EYE ON BRITAIN. My Home Pages are here or here or here. Email me (John Ray) here. For times when blogger.com is playing up, there are mirrors of this site here and here.

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British government rats to desert a sinking ship

Buckpassing on a national scale proposed

A top NHS strategist called yesterday for Government control of the health service to end so that it could be run by an independent body. Brian Edwards, Emeritus Professor of Healthcare Development at the University of Sheffield, and a former chief executive of a major NHS authority, said the treatment of the NHS as a political football had a negative impact on staff morale, decision-making, recruitment and doctor-patient relationships. The health service was also in danger of being "encased in political ice".

Gordon Brown, soon to take over as Prime Minister, is understood to be keen on the idea of removing the health service from political control, after his much-praised move to give the Bank of England control of interest rates. He has said he will make the NHS his "priority" and there has been speculation that he intends to replace the current Health Secretary, Patricia Hewitt, who has suffered much criticism.

Prof Edwards said that anything that took up almost nine per cent of a country's wealth was never going to be free of political influence, but the current NHS structure was unsustainable and change by the next prime minister was "essential". In a 72-page report commissioned by the Nuffield Trust, an independent health policy charity, Prof Edwards said that with the establishment of foundation trusts - which are independent of Whitehall - the current structure of the NHS had already altered fundamentally. "It is time to give the leaders of the health professions room to move the system. Ministers can never escape their ultimate responsibilities for the health of the people of the UK and creating more space for the NHS to modernise will require an act of great political courage and wisdom."

Labour and the Tories are looking at how much ministers should be involved in running the NHS. Kim Beazor, of the Nuffield Trust, said: "This report reviews the options available for alternative systems of governance that have so far escaped analysis. The Trust commissioned this project to move the debate on to neutral territory." He said the Government was used to developing regulatory structures for organisations such as the BBC and postal services and it was now time to look at the NHS. "With a new Prime Minister about to enter Downing Street, it seems likely that the issue of NHS independence will once again be on the agenda, and we hope this report will help ensure a balanced and rational debate," Mr Beazor said.

Last night Andrew Lansley, the shadow health secretary, said the Nuffield Trust report put fresh pressure on Mr Brown to declare his plans for the NHS. Mr Lansley said Mr Brown appeared to have "gone cold" on giving the NHS more independence. "As this report illustrates, we need to combine greater day-to-day freedoms and better outcomes for patients with a robust accountability structure."

Source




Australia: Wait for elective surgery getting longer

WAITING times for elective surgery have jumped, with patients nationally now typically having to wait more than a month before receiving the treatment they need -- and in many cases nearly a year. Median waiting times for patients admitted to hospital from waiting lists have been creeping up since 2001-02 by one extra day each financial year, reaching 29 days in 2004-05.

The latest nationwide hospital statistics, published today by the Australian Institute of Health and Welfare, show patients needing elective surgery had to wait a median of 32 days in 2005-06. This means half of the patients waited 32 days or more. Waiting times are blowing out on some other measures too, such as the time needed to get 90 per cent of patients admitted. In 2005-06 this was 237 days, up from 217 days a year earlier, and 44 days more than in 2003-04.

However, the Australian Hospital Statistics 2005-06 report found a lot of variation between states and territories. Queensland took only 127 days to see 90 per cent of the patients, whereas the ACT took more than a year, 372 days. The ACT was the worst performer on elective surgery waiting times, with 10.3 per cent of its elective patients waiting for more than a year.

Of the states, Tasmania performed the worst, with 8.7 per cent of elective admissions taking more than a year and 90 per cent of patients seen within 332 days. The Northern Territory was next (7.7 per cent waiting for more than a year, and 313 days needed to see 90 per cent of patients), followed by NSW (5.4 per cent and 291 days). However, the proportion of patients nationally having to wait more than a year fell slightly - from 4.8 per cent in 2004-05 to 4.6 last year.

A spokesman for ACT Health Minister Katy Gallagher said the territory's median waiting figures had increased due to a policy of targeting patients facing extremely long waits. An extra 94 patients who had been waiting two to three years had their operations in 2005-06 and the "additional throughput" had affected median waiting times. A spokesman for the Tasmanian Government said the biggest hospital reforms in the state's history, including plans for an elective surgery hospital, had been launched. A spokeswoman for NSW Health Minister Reba Meagher said more elective surgery was being done than ever before, and only 66 people had been waiting longer than a year for elective surgery - down from more than 10,000 in January 2005.

John Dwyer, chairman of the Australian Healthcare Reform Alliance, said long waits cost the system more because patients often required expensive drugs.

Source

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

For more postings from me, see TONGUE-TIED, GREENIE WATCH, POLITICAL CORRECTNESS WATCH, FOOD & HEALTH SKEPTIC, GUN WATCH, EDUCATION WATCH INTERNATIONAL, AUSTRALIAN POLITICS, DISSECTING LEFTISM, IMMIGRATION WATCH INTERNATIONAL and EYE ON BRITAIN. My Home Pages are here or here or here. Email me (John Ray) here. For times when blogger.com is playing up, there are mirrors of this site here and here.

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Wrong RX: Dr. Obama doesn't know what he's talking about

Another Obama policy that reveals him as an empty vessel without a single orginal idea in his head

Barack Obama's presidential campaign is supposed to represent a new politics that transcends traditional partisanship, open to new ideas from all sides, and leavened with optimism. But if Obama's new health-care plan is an example of this new politics, give me old fashioned partisan bickering and gridlock anytime.

That plan, unveiled Monday in Des Moines, is a dog's breakfast of bad ideas from Left, Right, and center, topped with an unhealthy amount of wishful thinking. If enacted it would cost Americans dearly - in higher taxes, lost jobs, reduced freedom of choice, and lower quality health care.

From the Left, along with the usual mishmash of increased subsidies, Obama, has taken the idea of an employer mandate. Obama would establish a "play or pay" system under which employers would be required to provide their workers with health insurance or pay a payroll tax to fund government-provided insurance. There are two big problems with this approach. First, it flies in the face of basic economics. The amount of compensation a worker receives is a function of his productivity, and an employer is indifferent as to whether that compensation is in the form of wages, taxes, health insurance, or other benefits. Such a mandate simply increases the cost of hiring workers without increasing their productivity. Employers will therefore have to find ways to offset the added costs. This they can do by raising prices, lowering wages or reducing future wage increases, reducing other benefits such as pensions, or hiring fewer workers. Almost certainly, employees will be the net losers under such a mandate, with the low-skilled suffering most.

Second, an employer mandate locks us further into an employment-based health insurance system at a time when there is a growing bipartisan consensus that we should be moving in the opposite direction. There is no logical reason for tying health insurance to employment. There are many good reasons for not doing so.

At the same time, he looks right to call for a Massachusetts-style insurance "connector," an idea being promoted by the Heritage Foundation among others. (Obama calls it "an exchange.") The exchange would allow workers to purchase individual health insurance with pre-tax dollars, leveling the playing field for individual insurance and giving workers the chance to buy personal and portable insurance - a good idea. The problem is that "exchanges" are also regulatory bodies. Indeed, Obama wants the "exchange" to regulate all sorts of things, including minimum benefit packages, premium caps, limits on copayments and deductibles, and "standards of quality and efficiency."

Like Hillary Clinton, who announced part of her health-care plan last week, Obama would require insurers to cover everyone regardless of their health status and charge community-rated premiums. One goal of health-care reform should be to encourage people to enter the insurance pool while they are young and healthy. We can do this by making insurance inexpensive for them, and penalizing them if they wait to buy insurance when they are old and sick. Community rating and guaranteed issue does precisely the opposite, raising the cost of insurance for the young and healthy and removing any penalty for waiting. Inevitably, this means more young healthy people will make the rational choice to go without insurance. Hillary Clinton (and former Massachusetts Governor Mitt Romney, for that matter) dealt with this by mandating that everyone buy insurance. Obama seems unaware of the problem he is creating.

Finally, there is the question of how to pay for all this. Obama does not put a price tag on his plan, but there is no doubt it will be expensive. Indeed, it will almost certainly be far more expensive than he assumes, since his ideas for cost savings are mostly figments of his imagination. For example, Obama assumes that allowing the federal government to directly negotiate Medicare drug prices will yield substantial savings. But the Congressional Budget Office has said that private insurance plans have already reduced drug prices about as far as they can go, and unless the government is prepared to severely restrict drug formularies, denying seniors access to some drugs, further savings are unlikely.

And Obama, like everyone else from Newt Gingrich to Hillary Clinton, assumes that there will be enormous savings from having the government design a system for electronic medical records. Electronic medical records would undoubtedly be a good thing and would reduce both costs and medical errors. The private sector is already moving rapidly in that direction. But the federal government has not yet figured out how to get the FBI's computers to talk to each other. What makes anyone think that a single federally-imposed medical IT system will be more efficient? [And Britain has already spent 12 billion pounds on attempting to implement such a system -- and seems unlikely ever to get it to work. See here]

So far three Democrats (Obama, Hillary Clinton, and John Edwards) and one Republican, (Mitt Romney) have put forward plans for health-care reform. For supporters of free market health care, it is looking like a very long and disappointing campaign.

Source





Another gross bungle in a Melbourne public hospital



In the photo above the former patient is holding the plum stone the careless public hospital doctors could not see -- plus the X-rays they could not see either

A PROFESSIONAL opera singer performed eight shows with a plum stone stuck in her throat after doctors failed to see it in an X-ray, even though it was "clearly visible". Soprano Tania de Jong could not eat solid food for six days after the emergency department bungle. The Alfred hospital later admitted it had misread the X-ray and vowed to review its procedures.

"I underwent the most excruciating pain," Ms de Jong said. "It felt like I was being strangled. "The stone was sitting between my mouth and vocal cords, and it really hurt to do anything - eat, drink, sing."

After the April 2005 debacle, Ms de Jong was forced on to a diet of baby food, painkillers and anaesthetic sprays for a week until she sought advice from a different hospital. X-rays revealed the object in her badly swollen oesophagus, and the stone was removed in an urgent operation.

The Herald Sun has seen letters in which the Alfred admitted its mistake and agreed to reimburse Ms de Jong's medical expenses on condition the law graduate did not sue. The hospital's emergency department head, Prof Mark Fitzgerald, wrote in an email sent in May 2005 that the stone was "clearly visible" and "should not have been missed". On July 7, the hospital apologised to her in writing, saying it would introduce a system of "double checking" X-rays.

Ms de Jong is satisfied the hospital has reviewed its systems. The accomplished performer founded singing group Pot-Pourri and runs entertainment consultancy Music Theatre Australia. "It could have been life-threatening, and with me being an opera singer it could have affected my whole livelihood," she said. "I was told I may never sing again because they'd have to stretch my vocal cords so much to get it out. "It was very, very frightening."

Her story follows the Herald Sun's report this week about nurse Bernadette Ireland, who says the Alfred sent her packing after she swallowed part of a mussel shell. Prof Fitzgerald last night said such cases were common. "Often the symptoms resolve and then people aren't sure whether they still have something in their throat or whether it's a scratch on the surface of the oesophagus that's caused in the passage of the object," he said. Some objects did not show up clearly on X-rays and it was easy to overlook them because of "variation in light and shade". He said he was still investigating the case of Ms Ireland, who had not lodged a formal complaint with the hospital.

Health Minister Bronwyn Pike said yesterday an Australian Institute of Health and Welfare report showed Victoria's emergency departments were the nation's best. Half of all patients were seen by a doctor five minutes faster than the national average. [So the other half weren't! Meaning no overall difference!]

But Opposition health spokeswoman Helen Shardey said the same report revealed median elective surgery waiting times had increased by four days - more than for any other state.

Source

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

For more postings from me, see TONGUE-TIED, GREENIE WATCH, POLITICAL CORRECTNESS WATCH, FOOD & HEALTH SKEPTIC, GUN WATCH, EDUCATION WATCH, AUSTRALIAN POLITICS, DISSECTING LEFTISM, IMMIGRATION WATCH INTERNATIONAL and EYE ON BRITAIN. My Home Pages are here or here or here. Email me (John Ray) here. For times when blogger.com is playing up, there are mirrors of this site here and here.

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NHS: Amateur midwives??

NHS trusts could be risking the safety of mothers and babies by using maternity support workers to do the work of trained midwives, according to a report. An independent study for the Department of Health found that a number of trusts across England were converting midwife positions into posts for lesser-qualified maternity support workers.

When challenged by midwives, Patricia Hewitt, the Health Secretary, has always insisted that support workers would not be used as substitutes for professionally qualified midwives. The report found, however, that in some places they were doing tasks deemed to be within the role of midwives and requiring specialist knowledge and training. The report said that a lack of consistency in the training and role of support workers had the potential to leave midwives and hospital managers uncertain about their competence, and placed patients at risk from a low standard of care.

King's College London, which surveyed trust managers in England, noted that there was no statutory requirement for support workers to undergo training, nor any regulation to ensure public protection. Midwives have legal responsibility for the work of their support workers, but systems to enable them to fulfil this task were variable, the report said. It recommends a national framework to set training and standards and said that the tasks that could be delegated needed to be identified urgently.

The NHS collected little data on support workers' cost-effectiveness and the report called for scrutiny where they were being trained to take on complex new roles. It found that they made an important contribution to maternity care and managers were enthusiastic about their role, reporting that they freed midwives to spend more time with women and babies. Their role included breastfeeding advice and support; outreach services to vulnerable women; running antenatal and postnatal groups; assisting midwives at home births and in birth centres; and working in operating theatres.

Ms Hewitt promised last month that support workers would not act as a substitute for qualified midwives, as she outlined plans to guarantee expectant mothers a "full range of birthing choices" by 2009. She described reports to the contrary as completely untrue: "They are there to support the midwife and free up a midwife's time for the work that only she can do. They are not a substitute for a midwife."

Professor Jane Sandall, who led today's research, said: "There is a danger that support workers could cease to become `another pair of hands', freeing the midwife and other members of the maternity team from administrative and routine duties in order to look after women. Instead, they may be called upon to substitute care provided by midwives, without sufficient investment in their training or development."

A Department of Health spokeswoman said: "This study shows that in only a tiny proportion of trusts were inappropriate tasks such as minor examinations being undertaken by maternity support workers. It is completely unacceptable if a hospital is using a maternity support worker as a substitute for a midwife and the Chief Nursing Officer has written out to all trusts to clarify this and asked that they review the working practices of all support workers, ensuring maternity services are provided safely.

"We are very clear about what the role of a maternity support worker is: to support the maternity team in their day-to-day duties, such as clerical work, supporting women with breastfeeding, increasing access for vulnerable women and enhancing the quality of care. In trusts where maternity support workers have been introduced, up to 64 per cent of midwifery time was saved each week and new mothers gained greater choice over where to give birth. This means that midwives have more time to undertake tasks that only they are trained to do. "Every baby must be delivered by a registered midwife or a doctor. This is a legal requirement not an option."

Jon Skewes, director of employment relations at the Royal College of Midwives, welcomed the report, saying: "It identifies some major problems regarding the introduction of support workers in England. "Chief among those is the uncertainty about what support workers can and cannot do, and what a midwife can delegate to them. There is a need for greater control, and the report suggests there needs to be better standardisation of training."

Source




Australia: Gross public hospital negligence



A WOMAN claims emergency doctors at The Alfred hospital told her to go home and take a Panadol after she had a mussel shell wedged in her throat. Experienced nurse Bernadette Ireland, 56, said she endured four days of excruciating pain and edged perilously close to death before medics finally took an X-ray. It revealed the razor-sharp shell lodged in her oesophagus at the base of her neck.

Ms Ireland said she was shocked when doctors in the hospital's emergency department suggested she had only imagined her problem. "They said, 'You only think it's in your throat -- it's only scratched your throat when it went down'," she claimed. Ms Ireland, a nurse of 35 years, said her protests fell on deaf ears. She said she told them: "I'm a registered nurse and I'm pretty sure it's in my throat."

The aged care nurse had been dining at Albert Park's Misuzu Japanese restaurant on April 27 when the shell piece -- bigger than a 20c coin -- lodged in her throat. Ms Ireland kept her composure and called for an ambulance but was told her case was not urgent enough, so she drove to The Alfred.

After she waited 45 minutes, a doctor said she would not be X-rayed as it would probably not reveal any shell fragment. "Nobody would listen to me, that's the worst part," Ms Ireland said.

She said she could not swallow after the ordeal but was instructed to down pain-killers. "They said, 'Take two Panadol and go home and the pain will go'," Ms Ireland claimed, so she took soluble Panadol every two hours overnight and into the weekend. Weak and unable to eat, she visited a GP on Monday morning who told her to get back to the hospital urgently.

Ms Ireland said she arrived with a fever of 38C and X-rays finally revealed the shell. It was surgically removed under anaesthetic about 11pm that day. Ms Ireland stayed in hospital for the next three days on an intravenous drip of antibiotics.

She said the hospital offered no explanation. "I didn't even get a sorry," Ms Ireland said. She said she went public because she feared her case would not be taken seriously if she went back to the hospital.

An Alfred hospital spokeswoman said it was looking into the claims. Ms Ireland's is the latest horror story to emerge since Health Minister Bronwyn Pike was forced to defend claims hospital were taking drastic steps to cut costs as the financial year ends.

A great-grandmother, 91, died from heart disease 15 hours after she was discharged from the Royal Melbourne Hospital in April. A memo, published in the Herald Sun, revealed that the Royal Melbourne Hospital has set discharge quotas ahead of July 1. The Monash Medical Centre has blacked out most elective surgery procedures this week, leaving doctors idle and patients waiting.

Source

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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