Thursday, March 08, 2007

Replace VA hospitals with VA health cards

A way around the woeful standards of America's war veterans' hospitals. For background on how bad the problem is, see here

Anne Hull and Dana Priest of the Washington Post follow up their scoop on Walter Reed's problems - a scandal that cost the Army secretary his job - with a look at the 157 VA hospitals. Walter Reed is an Army hospital. Senators and presidents use it. The VA hospitals are for veterans and have been a problem for a long time. The opening paragraph ended, "His own VA hospital in Livermore was a mess. The gown he wore was torn. The wheelchairs were old and broken."

May I make a suggestion? Replace the VA hospitals with a VA health card. Let us ex-soldiers use regular hospitals for our health problems. Most of the 24.3 million veterans have some sort of health care. Those who need the VA's help need something better than, as the Washington Post pointed out, "substandard, underfunded care in the 154 VA hospitals and hundreds of community health centers around the country."

VA funding has skyrocketed under Bush. He wants $86 billion next year. That is nearly double the $47 billion it was in the last year of the Clinton presidency.

Money is not the problem; the concept is. We did not build a string of VA colleges to get veterans their education. We do not have a string of Medicaid hospitals or Medicare hospitals. Mainstream the veterans. That should improve their care. This is not to disparage the people who work at VA facilities. I am sure they are good, hard-working, patriotic people. The concept is just so flawed it won't work. You cannot provide access to 24.3 million people with 154 hospitals.

I realize that some of the health problems for veterans are unique to their military experiences. But I am sure civilian psychiatrists and others can adapt to the situation. Maybe if people saw more veterans the nation would understand the military better. And a heart attack is pretty much a heart attack. Instead of plowing in all this money into a string of hospitals that are woefully insufficient to handle all the needs, give the vets who need them a health card and let them go to the local hospital instead of the nearest VA hospital - which may be hundreds of miles away.

Source




NHS Doctors' training system 'a shambles'

Thousands of young doctors have been left without jobs because a new NHS training system has gone "disastrously wrong", it was disclosed yesterday. As much as £2 billion has been spent on the training of up to 8,000 doctors who find themselves without a new job under a Government initiative.

Such is the fury at the scheme, called Modernising Medical Careers (MMC), that doctors have renamed it "Massive Medical Cull". It costs £250,000 to train a doctor and the "shambles" is said to be blighting the careers of dedicated young men and women who may now leave the NHS. Many are also saddled with debts of more than £40,000 after funding their training

The Daily Telegraph has been inundated with letters and emails from despairing doctors and their parents who "feel like crying". This comes a day after this newspaper reported that three out of four trusts were restricting patients' treatment because of the NHS financial crisis. Patricia Hewitt, the Health Secretary, is preparing for further NHS closures by sending managers guidance on how to deal with patients' protests.

The latest crisis has come about because there were only 22,000 jobs for 30,000 junior doctors. The glut in applicants was caused by the introduction of a system where those who started training two years ago are competing for the same jobs as those who began three or four years ago. The doctors' anger has been exacerbated by the introduction of an online system for applying for jobs which is criticised for failing to take full account of their experience and qualifications.

Many of the doctors who have written to The Daily Telegraph complained of a "Kafkaesque" application procedure which asks them "vague and waffling" questions about their personal experience but take insufficient account of their qualifications, references and independent appraisals. As a result, some highly qualified junior doctors have not been offered a single interview. And, because of technical problems, others have been offered interviews for which they did not apply. Doctors said it was easy to lie on the forms. It is alleged that some applicants used companies selling information on how to fill in forms.

Most of the doctors left medical school two to four years ago and are at the point in their careers where they have decided which speciality they want to follow. They would expect to train as specialist registrars for about five years and pass more exams before they could apply to become consultants.

Under MMC, doctors have been required to reapply for their jobs, which end in August. Last night, the Conservatives and the British Medical Association condemned the system. Dr Faith Harries, a junior doctor, who has been offered no interview said: "I came out of medical school with £42,000 debt. "I thought I was guaranteed a job in training in the UK — because I thought I would be able to pay it back. Now I am thinking of going abroad." Another junior doctor said: "Many a tear will be shed this week by brilliant young doctors whose hopes and dreams have been crushed in a quite barbaric fashion". A senior consultant said: "I despair for dedicated hard-working trainees who are being treated so shabbily."

Dr Tom Dolphin, the deputy chairman of the BMA junior doctors' committee, said: "The system is going disastrously wrong. Highly qualified doctors with huge amounts of experience haven't been offered any interviews. "Others have been offered interviews in the wrong speciality or at the wrong level. There are reports that the confidential marking system has been leaked and that unqualified people are being asked to short-listing. People's entire livelihoods are at stake." He said the BMA had been calling for the process to be delayed since last summer. "Now we are seeing the consequences of their failure to listen. They must halt the interview process."

Andrew Lansley, the shadow health secretary said: "This is about motivated young people, who we have trained, being sent away with absolutely no confidence they will get the post they want, or indeed, any post at all. "The new system is a shambles and we have asked Patricia Hewitt for an urgent review." He said he had seen a letter to another MP from a consultant who told of a junior doctor who had threatened suicide.

A spokesman for the Department of Health said: "This is a competitive process so there will be applicants who do not secure an interview in this first round. "Applicants who have not been short-listed will have the opportunity to apply for programmes in the second round where there will be more posts available. "Allegations of plagiarism will be investigated and if applicants are found to have plagiarised or deliberately falsified their application in any way, they may be referred to the GMC."

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 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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