NHS HOSPITALS DISCOVER PATIENT SAFETY
Every mental health trust in the country is to be instructed to review its approach to patients’ safety after the publication of a report describing alleged rapes, sexual assaults and sexual harassment. Officials have been aware of the report for more than eight months, but published it only yesterday — a week after The Times revealed its contents. They said that a separate inquiry had been started into the most serious alleged incidents, which include 11 reports of rapes by NHS staff. Ministers have faced a barrage of criticism this week for failing to act on the information: no safety alert or progress report was issued, which health campaigners and politicians describe as gross neglect.
The report, With Safety in Mind: Mental Health Services and Patient Safety, describes 122 serious incidents within two years. As well as the 19 rape cases revealed by The Times, there were 20 reported incidents of consensual sex, 13 of exposure, 18 of sexual advance and 26 of touching. Of the nineteen reported rapes, eight were allegedly carried out by a fellow patient and eleven by a member of staff. The report, compiled by the National Patient Safety Agency, acknowledges the likelihood of underreporting of incidents. It also calls for a new definition of “harm” in incident reports to include psychological trauma.
Responding to the publication yesterday, Louis Appleby, the National Director for Mental Health, said that he had started an inquiry into the most serious allegations and that every mental health trust would be asked to review procedures to protect patients. “Although the vast majority of NHS patients receive safe and effective care, any incident where the safety of a patient is compromised is one incident too many,” Professor Appleby said. “We must investigate and learn from all these incidents.”
The report brings into question the Government’s claim to have set up single-sex wards that are safe and ensure personal dignity across the health service. The pledge, made by Tony Blair when in Opposition in 1996, has been fulfilled in 99 per cent of mental health settings, the Government says.
The patient safety agency analysis covers almost 45,000 incidents reported by staff between November 2003 and September 2005. Most of the incidents relating to the 84 mental health trusts took place in the 12 months to last October.
Paul Farmer, chief executive of Mind, the mental health charity, described the report as shocking and called for an urgent audit of single-sex wards. “People who are extremely vulnerable should be treated with the best care and attention, not subjected to abuse,” he said. Andrew McCulloch, chief executive of the Mental Health Foundation, suspected that the levels of violence and abuse described in the report were the tip of the iceberg. “It is scandalous that such abuse is allowed to take place. If a woman went into hospital for a heart operation and was raped during her stay, it would be a national scandal. But women who are raped while in mental health services are simply not believed.”
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Thursday, July 20, 2006
Wednesday, July 19, 2006
INAPPROPRIATE NHS HOSPITALS
Billions of pounds are being spent on hospitals for the NHS that will not be suitable for the planned new patterns of care. A new report claims that the NHS could be left with “white elephants” — huge hospitals that will take 30 years to pay off, when the future of healthcare lies with smaller, more flexible units closer to where people live. The report says that awareness of this in the Department of Health has brought capital investment of all kinds to a shuddering halt just as new policies are changing the ways in which care will be delivered. Opportunities for investing in appropriate new buildings are likely to be missed as the system lurches into the stop part of a “stop-go” cycle.
The report, whose lead author is Professor Nick Bosanquet, of Imperial College, is published by Reform, the market-oriented think-tank that was the first to predict the NHS funding crisis and the need to cut jobs. Reform backs the Government’s health initiatives, such as payment by results, patient choice and the White Paper Our Health, Our Care, Our Say, which seeks to move more care away from hospitals and into primary care, but its report, Investment in the NHS, gives warning that the NHS has spent the past decade building over-large and expensive units and now faces a freeze on the kind of investment that can lead to service improvement.
The evidence that investment has stopped comes from the NHS accounts, which show that there was an underspend of 1.2 billion last year on the capital account, double the level of 2004-05. The report predicts that the current financial year will also show a large underspend. The first large NHS acute hospital to have a self-contained single room for every patient is being planned, with managers predicting a reduced incidence of MRSA, speedier recoveries and cost savings. Pembury Hospital, in Kent, will be demolished and rebuilt for 330 million pounds.
Source
INDIAN UPDATE
I mentioned a month ago that Blue Ridge were considering this. It seems they have now gone ahead. Sad when health costs could send a business broke
Don't look now, but that operation you've been putting off may be outsourced - to India. American companies are encouraging workers to travel to India and other countries for costly medical procedures, Business Insurance magazine reports. "It saves you literally tens of thousands of dollars," said Bonnie Blackley, benefits director at Canton, N.C.-based Blue Ridge Paper Products. A heart valve replacement, for example, that runs between $68,000 and $198,000 in the United States costs only $18,000 in India.
Blackley said that although her company's survival depended on keeping medical costs in check, local health care providers "offered no extra discount or anything." So she contracted with IndUShealth, a "medical tourism" company that specializes in arranging employee travel to accredited hospitals and board-certified physicians in India.
Because of lower labor costs, India, Thailand, Singapore, Mexico and Costa Rica could pose some stiff competition for U.S. medical providers. "We've globalized every other industry. Why not health care?" said Ted Nussbaum, director of North American health care consulting at Watson Wyatt Worldwide in Stamford, Conn.
But Chuck Kelley, medical director at Outrigger Enterprises Inc. in Honolulu, told the magazine it will be hard to persuade employees to travel abroad for medical care. "Health care treatment is a very personal issue for Americans, and when they are sick, they want to be close to their family and in the care of providers they know and trust - even if they are not the best," Kelley said. "They will settle for inferior and more expensive treatment to be home."
Companies like Blue Ridge plan to give their employees a financial incentive to go abroad by offering to cover them and their dependents for any out-of-pocket costs.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Billions of pounds are being spent on hospitals for the NHS that will not be suitable for the planned new patterns of care. A new report claims that the NHS could be left with “white elephants” — huge hospitals that will take 30 years to pay off, when the future of healthcare lies with smaller, more flexible units closer to where people live. The report says that awareness of this in the Department of Health has brought capital investment of all kinds to a shuddering halt just as new policies are changing the ways in which care will be delivered. Opportunities for investing in appropriate new buildings are likely to be missed as the system lurches into the stop part of a “stop-go” cycle.
The report, whose lead author is Professor Nick Bosanquet, of Imperial College, is published by Reform, the market-oriented think-tank that was the first to predict the NHS funding crisis and the need to cut jobs. Reform backs the Government’s health initiatives, such as payment by results, patient choice and the White Paper Our Health, Our Care, Our Say, which seeks to move more care away from hospitals and into primary care, but its report, Investment in the NHS, gives warning that the NHS has spent the past decade building over-large and expensive units and now faces a freeze on the kind of investment that can lead to service improvement.
The evidence that investment has stopped comes from the NHS accounts, which show that there was an underspend of 1.2 billion last year on the capital account, double the level of 2004-05. The report predicts that the current financial year will also show a large underspend. The first large NHS acute hospital to have a self-contained single room for every patient is being planned, with managers predicting a reduced incidence of MRSA, speedier recoveries and cost savings. Pembury Hospital, in Kent, will be demolished and rebuilt for 330 million pounds.
Source
INDIAN UPDATE
I mentioned a month ago that Blue Ridge were considering this. It seems they have now gone ahead. Sad when health costs could send a business broke
Don't look now, but that operation you've been putting off may be outsourced - to India. American companies are encouraging workers to travel to India and other countries for costly medical procedures, Business Insurance magazine reports. "It saves you literally tens of thousands of dollars," said Bonnie Blackley, benefits director at Canton, N.C.-based Blue Ridge Paper Products. A heart valve replacement, for example, that runs between $68,000 and $198,000 in the United States costs only $18,000 in India.
Blackley said that although her company's survival depended on keeping medical costs in check, local health care providers "offered no extra discount or anything." So she contracted with IndUShealth, a "medical tourism" company that specializes in arranging employee travel to accredited hospitals and board-certified physicians in India.
Because of lower labor costs, India, Thailand, Singapore, Mexico and Costa Rica could pose some stiff competition for U.S. medical providers. "We've globalized every other industry. Why not health care?" said Ted Nussbaum, director of North American health care consulting at Watson Wyatt Worldwide in Stamford, Conn.
But Chuck Kelley, medical director at Outrigger Enterprises Inc. in Honolulu, told the magazine it will be hard to persuade employees to travel abroad for medical care. "Health care treatment is a very personal issue for Americans, and when they are sick, they want to be close to their family and in the care of providers they know and trust - even if they are not the best," Kelley said. "They will settle for inferior and more expensive treatment to be home."
Companies like Blue Ridge plan to give their employees a financial incentive to go abroad by offering to cover them and their dependents for any out-of-pocket costs.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Tuesday, July 18, 2006
Australian prisoners lap up $70 million worth of medical perks
And that's just in the State of New South Wales
Inmates are undergoing plastic surgery, hormone therapy and erection dysfunction procedures as taxpayers fund an expanding prison health system costing nearly $70 million-a-year. An investigation by The Daily Telegraph has revealed inmates are getting premium medical care that has featured 256 elective surgery operations over the past two years, including a series of bizarre optional procedures. The erectile dysfunction surgery was required to stop a young inmate feeling pain during erections - despite sex being officially banned inside New South Wales prisons.
Other procedures since 2004 revealed in official Justice Health documents include five cases of plastic surgery, a male circumcision, a tubal ligation, a tonsillectomy, a facial lesion removal and two hip replacements. Seven procedures involved removal of ingrown toenails with one on March 14 this year including "trimming of other toenails". The inventory of elective surgery procedures, obtained under Freedom of Information, even included a caesarian birth five days before Christmas last year. Six natural births also took place and six inmates are receiving hormone therapy. About 1120 are receiving methadone.
Taxpayers spent $69.15 million last year funding Justice Health, an 80 per cent increase on the $38.26 million in 2001. The bill does not cover the costs of surgery and clinical procedures in public hospitals. These are picked up by NSW Health and not covered by Medicare.
The runaway prison medical bill will add to concerns the Iemma Government has gone soft in its management of the state's jails. Last week The Daily Telegraph reported the Government had returned a television set and sandwich maker to serial killer Ivan Milat, despite an outcry from victims' families. The Government was also embarrassed last month by revelations that a gang rapist with cancer had his sperm frozen before undergoing chemotherapy so he could have children on his release.
A spokesman for the the prison officers division of the Public Service Association said he believed inmates got better health care than the rest of the community. "These guys in jail see the nurse for anything and if they need to see a specialist they are referred straight away. Somebody else organises it all for them. They don't have to do a thing," the spokesman said. "Even if they get a pimple on their backside they get themselves down to hospital to get it lanced."
Nurse numbers alone have surged over the past five years, from 142 to 506, equal to one nurse for every 20 prisoners. Martha Jabour, of the Homicide Victims Support Group, said it was disturbing prisoners were getting access to elective surgery for procedures such as erection dysfunction.
Justice Health chief Dr Richard Matthews vigorously defended the care offered to inmates. He denied they jumped waiting list queues that all other patients faced. Dr Matthews said the Justice Health's budget had increased in line with the prison population. But he said inmates should not get inferior care as "punishment". "Our view is that these folks are our patients. We have no interest in their offences, in fact we prefer not to know," said Dr Matthews.
Source
Australia: More of the usual high standards in a government hospital
An expectant mother was forced to wait more than half an hour in the delivery room of Caboolture Hospital while medical staff searched for a clean set of forceps. Now the woman must be tested for hepatitis C because the forceps, when they were found, were not properly sterilised. A Queensland Health spokesman said the hospital had only four sets of forceps, now increased to five. The forceps were not sterilised because there was not time, and excessive demand on the day had used up all the sets. In the end the forceps had only been sterilised chemically, the spokesman said.
Dr Michael Whitby, an expert in infectious diseases, said it was not ideal practice for the hospital to have reused the birthing instruments, but the risk was very low of the mother contracting a disease as long as they were chemically sterilised. Testing the woman was a prudent action, he said. AMA president Dr Zelle Hodge said some visiting doctors take their own surgical instruments to hospitals because the state's equipment was not always good enough. The state Budget did not contain enough funding for basic infrastructure and service delivery costs, Dr Hodge said.
Susan Wheatley's husband, Noel, was in the delivery room as the doctor waited more than 30 minutes for a midwife to find forceps to deliver his child. The doctor had used suction on the baby's head, but the procedure failed. "It just seemed very disorganised to me," he said. "Emergency equipment should be kept in a emergency cupboard, not have people searching for it - I was livid. "I don't know what a set of forceps cost, but probably less than a lunchtime engagement in Parliament."
Opposition health spokesman Bruce Flegg said there should be an immediate inquiry. "You don't use unsterilised instruments - you just don't do it," Dr Flegg said. "The reason you need a sterilisation unit is you don't always know what instruments you need when you do a procedure. "Chemical sterilisation doesn't meet accreditation standards for a hospital. Even in a general practice, it wouldn't pass." Mr Wheatley said he did not plan to sue Queensland Health unless his wife contracted hepatitis. However, he said he wanted to let other women know what his wife endured.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
And that's just in the State of New South Wales
Inmates are undergoing plastic surgery, hormone therapy and erection dysfunction procedures as taxpayers fund an expanding prison health system costing nearly $70 million-a-year. An investigation by The Daily Telegraph has revealed inmates are getting premium medical care that has featured 256 elective surgery operations over the past two years, including a series of bizarre optional procedures. The erectile dysfunction surgery was required to stop a young inmate feeling pain during erections - despite sex being officially banned inside New South Wales prisons.
Other procedures since 2004 revealed in official Justice Health documents include five cases of plastic surgery, a male circumcision, a tubal ligation, a tonsillectomy, a facial lesion removal and two hip replacements. Seven procedures involved removal of ingrown toenails with one on March 14 this year including "trimming of other toenails". The inventory of elective surgery procedures, obtained under Freedom of Information, even included a caesarian birth five days before Christmas last year. Six natural births also took place and six inmates are receiving hormone therapy. About 1120 are receiving methadone.
Taxpayers spent $69.15 million last year funding Justice Health, an 80 per cent increase on the $38.26 million in 2001. The bill does not cover the costs of surgery and clinical procedures in public hospitals. These are picked up by NSW Health and not covered by Medicare.
The runaway prison medical bill will add to concerns the Iemma Government has gone soft in its management of the state's jails. Last week The Daily Telegraph reported the Government had returned a television set and sandwich maker to serial killer Ivan Milat, despite an outcry from victims' families. The Government was also embarrassed last month by revelations that a gang rapist with cancer had his sperm frozen before undergoing chemotherapy so he could have children on his release.
A spokesman for the the prison officers division of the Public Service Association said he believed inmates got better health care than the rest of the community. "These guys in jail see the nurse for anything and if they need to see a specialist they are referred straight away. Somebody else organises it all for them. They don't have to do a thing," the spokesman said. "Even if they get a pimple on their backside they get themselves down to hospital to get it lanced."
Nurse numbers alone have surged over the past five years, from 142 to 506, equal to one nurse for every 20 prisoners. Martha Jabour, of the Homicide Victims Support Group, said it was disturbing prisoners were getting access to elective surgery for procedures such as erection dysfunction.
Justice Health chief Dr Richard Matthews vigorously defended the care offered to inmates. He denied they jumped waiting list queues that all other patients faced. Dr Matthews said the Justice Health's budget had increased in line with the prison population. But he said inmates should not get inferior care as "punishment". "Our view is that these folks are our patients. We have no interest in their offences, in fact we prefer not to know," said Dr Matthews.
Source
Australia: More of the usual high standards in a government hospital
An expectant mother was forced to wait more than half an hour in the delivery room of Caboolture Hospital while medical staff searched for a clean set of forceps. Now the woman must be tested for hepatitis C because the forceps, when they were found, were not properly sterilised. A Queensland Health spokesman said the hospital had only four sets of forceps, now increased to five. The forceps were not sterilised because there was not time, and excessive demand on the day had used up all the sets. In the end the forceps had only been sterilised chemically, the spokesman said.
Dr Michael Whitby, an expert in infectious diseases, said it was not ideal practice for the hospital to have reused the birthing instruments, but the risk was very low of the mother contracting a disease as long as they were chemically sterilised. Testing the woman was a prudent action, he said. AMA president Dr Zelle Hodge said some visiting doctors take their own surgical instruments to hospitals because the state's equipment was not always good enough. The state Budget did not contain enough funding for basic infrastructure and service delivery costs, Dr Hodge said.
Susan Wheatley's husband, Noel, was in the delivery room as the doctor waited more than 30 minutes for a midwife to find forceps to deliver his child. The doctor had used suction on the baby's head, but the procedure failed. "It just seemed very disorganised to me," he said. "Emergency equipment should be kept in a emergency cupboard, not have people searching for it - I was livid. "I don't know what a set of forceps cost, but probably less than a lunchtime engagement in Parliament."
Opposition health spokesman Bruce Flegg said there should be an immediate inquiry. "You don't use unsterilised instruments - you just don't do it," Dr Flegg said. "The reason you need a sterilisation unit is you don't always know what instruments you need when you do a procedure. "Chemical sterilisation doesn't meet accreditation standards for a hospital. Even in a general practice, it wouldn't pass." Mr Wheatley said he did not plan to sue Queensland Health unless his wife contracted hepatitis. However, he said he wanted to let other women know what his wife endured.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Monday, July 17, 2006
SAN FRANCISCO SOCIALIZED MEDICINE SCHEME
Residents... are driving San Francisco officials to enact a unique but controversial program to offer inexpensive health care to residents who have none. Though the proposal resulted from months of negotiations among a myriad of interests, many in the city's business community oppose the legislation. They cite its requirement that employers set aside a minimum amount per worker to finance either private health insurance or access to the city's new program.
Nonetheless, the proposal is likely to win overwhelming board approval on Tuesday. Even Mayor Gavin Newsom, who describes himself as an ally of business, enthusiastically endorses the proposal and its financing component. "There is a fundamental here," he said during a press conference last week. "That is, an obligation to provide a strategy to create health care for 82,000 people where everybody participates (in its financing) -- employee, employer and government."
Advocates are near giddy about the program, calling it bold, innovative and a model for other local governments and the state. The San Francisco program "does create this sense of, if you can do something like this here, all but for leadership, good process, good deliberations, there is no reason we can't do this in California," said Dr. Sandra Hernandez, who co-chaired a mayoral panel that devised portions of the program. Those are "big ifs," she added.
For one, California voters in 2004 narrowly repealed a law requiring many businesses to pay for most of their workers' health coverage -- a concept that the San Francisco proposal borrows. And other local jurisdictions with a less robust medical infrastructure than San Francisco's may find such a program more difficult to implement. Under the Health Access Program, all San Francisco residents who are not already covered by insurance could enroll and select a primary care doctor. Participants would go to public and private clinics and hospitals for care, and be charged a co-payment based on their income. However, that care will not be "portable"; it could not be obtained outside San Francisco and would not be available to people living outside the city. Hence, the program cannot be called insurance.
Proponents who have long fought for large-scale government-mandated health insurance programs are untroubled by the distinction, given the financial and legal barriers the city faced in crafting the program. They note that people with health insurance frequently get care within their immediate community. The program, to be phased in starting next July, will cost an estimated $200 million annually. Half of that would by financed from funds the city already spends on indigent care. Co-payments would bring in about $56 million. State and federal funds would contribute as much as $20 million. The remainder will come from businesses, with 20 or more workers, which will contribute up to $1.60 per hour for each employee.
Companies can continue to offer coverage as long as it meets the minimum cost requirement set by the legislation. That would discourage employers from "dumping" their workers into the city program, supporters explain. Firms with fewer than 20 workers are exempt, as are nonprofits with fewer than 50 employees. Over time the program should reduce expenditures at costly emergency rooms, where many of the uninsured now go for care, supporters contend. It also should make for better workers who feel more secure about medical care, they add.
Supporters know they face hurdles drafting and implementing the details, and informing potential participants of the program. "The real challenge is going to be . getting the thing up and running," said Supervisor Tom Ammiano, the legislation's chief sponsor.
Business owners applaud the program's intent but blanch at the extra costs. "We want legislation that will work as opposed to legislation that will cripple small and medium businesses," Lara Truppelli, owner of two eateries, told supervisors at a meeting last week. "Your hands are in my checking account," said Susan Lieber, owner of a firm that provides workers for food events. "Don't make this a city of nothing more than chains because nobody (else) can afford to do business here."
Labor unions pushed for the proposal partly because employers are increasingly reducing medical coverage, said Paul Kumar of the Service Employees International Union's San Francisco local. By setting a minimum amount of coverage that companies must meet, the program would stop that erosion, he said.
Jim Lazarus of the San Francisco Chamber of Commerce said unions want to extend the concept of forcing employers to pay for health care into other counties and states. He said he expects someone to file a lawsuit to halt the city's new coverage, though the chamber has made no decision about that step. But political leaders are pushing forward nonetheless. Supervisor Bevan Dufty recounted how a waitress at a favorite restaurant who had no health insurance had to spend $10,000 to diagnose what turned out to be a benign lump in one breast. "There are going to be changes . in the economy of San Francisco" because of the program, Dufty said. "Maybe meals will become more expensive. . But (the city) is going to move forward just a little bit. And we're going to say that we care about people." [With other people's money!]
Source
U.K.: Row over private healthcare role
Public sector union Unison claims the government intends to go ahead with the privatisation of primary care services. In June the Department of Health pulled an advertisement asking private firms to tender for key roles in health care management across Primary Care Trusts. A new ad has now been published in the Official Journal of the European Union, and Unison says it could lead to firms taking over "a huge range of services".
Health Minister Andy Burnham said it was about securing "quality support". Local health managers at primary care trusts (PCTs) currently buy in services, although in some areas it has been devolved to GPs. The government says it is only looking for firms to provide expert advice to PCTs and it would be up to local officials to decide if they wanted to use that private expertise. "If they're able to use the best possible advice and support available from around the world to do that job, then certainly as a health minister, I want them to have access to that high quality support," Mr Burnham told the BBC Radio 4 Today programme.
Last month, Health Minister Lord Warner withdrew an earlier form of the notice from an EU journal when it provoked uproar from unions. He said that a drafting error had been responsible for the mistaken impression that clinical services were up for tender. But according to Unison the new advertisement shows "very, very little difference" with the last one. "It's very clear that this new advert is inviting organisations to provide a huge range of management, health and support services across PCTs," Unison's head of health, Karen Jennings, told the Today programme.
She said other unions and professional organisations shared Unison's concern. "This advert not only enables PCTs to continue to outsource commissioning responsibility, but it's also so unspecified and open-ended in its nature, it is effectively allowing outsourcing to take place on the widest possible scale," she said. "So, for example, a private firm could come in and start to commission for other services for the NHS."
But Mr Burnham denied that the private firms were being brought in to decide what services were offered on the NHS. "They (PCTs) are publicly accountable for the services they commission on behalf of their local population - and that will not change."
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Residents... are driving San Francisco officials to enact a unique but controversial program to offer inexpensive health care to residents who have none. Though the proposal resulted from months of negotiations among a myriad of interests, many in the city's business community oppose the legislation. They cite its requirement that employers set aside a minimum amount per worker to finance either private health insurance or access to the city's new program.
Nonetheless, the proposal is likely to win overwhelming board approval on Tuesday. Even Mayor Gavin Newsom, who describes himself as an ally of business, enthusiastically endorses the proposal and its financing component. "There is a fundamental here," he said during a press conference last week. "That is, an obligation to provide a strategy to create health care for 82,000 people where everybody participates (in its financing) -- employee, employer and government."
Advocates are near giddy about the program, calling it bold, innovative and a model for other local governments and the state. The San Francisco program "does create this sense of, if you can do something like this here, all but for leadership, good process, good deliberations, there is no reason we can't do this in California," said Dr. Sandra Hernandez, who co-chaired a mayoral panel that devised portions of the program. Those are "big ifs," she added.
For one, California voters in 2004 narrowly repealed a law requiring many businesses to pay for most of their workers' health coverage -- a concept that the San Francisco proposal borrows. And other local jurisdictions with a less robust medical infrastructure than San Francisco's may find such a program more difficult to implement. Under the Health Access Program, all San Francisco residents who are not already covered by insurance could enroll and select a primary care doctor. Participants would go to public and private clinics and hospitals for care, and be charged a co-payment based on their income. However, that care will not be "portable"; it could not be obtained outside San Francisco and would not be available to people living outside the city. Hence, the program cannot be called insurance.
Proponents who have long fought for large-scale government-mandated health insurance programs are untroubled by the distinction, given the financial and legal barriers the city faced in crafting the program. They note that people with health insurance frequently get care within their immediate community. The program, to be phased in starting next July, will cost an estimated $200 million annually. Half of that would by financed from funds the city already spends on indigent care. Co-payments would bring in about $56 million. State and federal funds would contribute as much as $20 million. The remainder will come from businesses, with 20 or more workers, which will contribute up to $1.60 per hour for each employee.
Companies can continue to offer coverage as long as it meets the minimum cost requirement set by the legislation. That would discourage employers from "dumping" their workers into the city program, supporters explain. Firms with fewer than 20 workers are exempt, as are nonprofits with fewer than 50 employees. Over time the program should reduce expenditures at costly emergency rooms, where many of the uninsured now go for care, supporters contend. It also should make for better workers who feel more secure about medical care, they add.
Supporters know they face hurdles drafting and implementing the details, and informing potential participants of the program. "The real challenge is going to be . getting the thing up and running," said Supervisor Tom Ammiano, the legislation's chief sponsor.
Business owners applaud the program's intent but blanch at the extra costs. "We want legislation that will work as opposed to legislation that will cripple small and medium businesses," Lara Truppelli, owner of two eateries, told supervisors at a meeting last week. "Your hands are in my checking account," said Susan Lieber, owner of a firm that provides workers for food events. "Don't make this a city of nothing more than chains because nobody (else) can afford to do business here."
Labor unions pushed for the proposal partly because employers are increasingly reducing medical coverage, said Paul Kumar of the Service Employees International Union's San Francisco local. By setting a minimum amount of coverage that companies must meet, the program would stop that erosion, he said.
Jim Lazarus of the San Francisco Chamber of Commerce said unions want to extend the concept of forcing employers to pay for health care into other counties and states. He said he expects someone to file a lawsuit to halt the city's new coverage, though the chamber has made no decision about that step. But political leaders are pushing forward nonetheless. Supervisor Bevan Dufty recounted how a waitress at a favorite restaurant who had no health insurance had to spend $10,000 to diagnose what turned out to be a benign lump in one breast. "There are going to be changes . in the economy of San Francisco" because of the program, Dufty said. "Maybe meals will become more expensive. . But (the city) is going to move forward just a little bit. And we're going to say that we care about people." [With other people's money!]
Source
U.K.: Row over private healthcare role
Public sector union Unison claims the government intends to go ahead with the privatisation of primary care services. In June the Department of Health pulled an advertisement asking private firms to tender for key roles in health care management across Primary Care Trusts. A new ad has now been published in the Official Journal of the European Union, and Unison says it could lead to firms taking over "a huge range of services".
Health Minister Andy Burnham said it was about securing "quality support". Local health managers at primary care trusts (PCTs) currently buy in services, although in some areas it has been devolved to GPs. The government says it is only looking for firms to provide expert advice to PCTs and it would be up to local officials to decide if they wanted to use that private expertise. "If they're able to use the best possible advice and support available from around the world to do that job, then certainly as a health minister, I want them to have access to that high quality support," Mr Burnham told the BBC Radio 4 Today programme.
Last month, Health Minister Lord Warner withdrew an earlier form of the notice from an EU journal when it provoked uproar from unions. He said that a drafting error had been responsible for the mistaken impression that clinical services were up for tender. But according to Unison the new advertisement shows "very, very little difference" with the last one. "It's very clear that this new advert is inviting organisations to provide a huge range of management, health and support services across PCTs," Unison's head of health, Karen Jennings, told the Today programme.
She said other unions and professional organisations shared Unison's concern. "This advert not only enables PCTs to continue to outsource commissioning responsibility, but it's also so unspecified and open-ended in its nature, it is effectively allowing outsourcing to take place on the widest possible scale," she said. "So, for example, a private firm could come in and start to commission for other services for the NHS."
But Mr Burnham denied that the private firms were being brought in to decide what services were offered on the NHS. "They (PCTs) are publicly accountable for the services they commission on behalf of their local population - and that will not change."
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Sunday, July 16, 2006
Unsafe working hours for Australian doctors still ongoing
Doctors in Queensland will continue to work unsafe hours - with some GPs on call for 24 hours a day - until shortages in the health system can be dealt with. As the Beattie Government said it had exceeded recruitment targets by hiring 1200 health staff since the Dr Death scandal, the Queensland Medical Board was preparing a safe working hours inquiry that could exacerbate the state's doctor shortage.
Medical board executive officer Jim O'Dempsey said a discussion paper would be released within a month to guide development of working hours standards. "The Medical Board ... is developing standards of healthy work practices with the medical profession to help doctors realise that taking care of their own health is an important part of taking care of their patients," he said. A draft of the discussion paper, obtained by The Australian, shows the average number of working hours for doctors has already dropped from 46.7 hours a week to 44.4 hours in five years. However, the paper warns that if every doctor in Australia worked three fewer hours a week, Queensland would need an extra 1000 doctors to manage the same amount of work.
Queensland Public Sector Union general secretary Alex Scott said he supported a move to ensure doctors worked safe hours, but not unless there were more doctors to fill the gaps. "The fact is, doctors are not going to walk off the job. They are committed ... and if they are needed they are not going to walk away," he said. "We think a cap (on working hours) is a good idea, but it has to be resourced properly."
Health Minister Stephen Robertson said he believed any move to limit doctors' hours would not exacerbate existing workforce shortages but could help retain staff in the long term. "The responsibility (of safe hours) should be shared," he said. "There's an element of personal responsibility, but the system has to support doctors and nurses who need to manage fatigue ... In the long term, you have to be able to retain your workforce, so they don't leave you because of exhaustion."
Australian Medical Association state president Zelle Hodge noted the case of a Sunshine Coast doctor whose fatigue after working 20 hours straight was found to have contributed to the death of a young girl he had inadequately treated. "The young doctor there was asked to work long hours and when difficulties occurred, Queensland Health did not help," she said.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Doctors in Queensland will continue to work unsafe hours - with some GPs on call for 24 hours a day - until shortages in the health system can be dealt with. As the Beattie Government said it had exceeded recruitment targets by hiring 1200 health staff since the Dr Death scandal, the Queensland Medical Board was preparing a safe working hours inquiry that could exacerbate the state's doctor shortage.
Medical board executive officer Jim O'Dempsey said a discussion paper would be released within a month to guide development of working hours standards. "The Medical Board ... is developing standards of healthy work practices with the medical profession to help doctors realise that taking care of their own health is an important part of taking care of their patients," he said. A draft of the discussion paper, obtained by The Australian, shows the average number of working hours for doctors has already dropped from 46.7 hours a week to 44.4 hours in five years. However, the paper warns that if every doctor in Australia worked three fewer hours a week, Queensland would need an extra 1000 doctors to manage the same amount of work.
Queensland Public Sector Union general secretary Alex Scott said he supported a move to ensure doctors worked safe hours, but not unless there were more doctors to fill the gaps. "The fact is, doctors are not going to walk off the job. They are committed ... and if they are needed they are not going to walk away," he said. "We think a cap (on working hours) is a good idea, but it has to be resourced properly."
Health Minister Stephen Robertson said he believed any move to limit doctors' hours would not exacerbate existing workforce shortages but could help retain staff in the long term. "The responsibility (of safe hours) should be shared," he said. "There's an element of personal responsibility, but the system has to support doctors and nurses who need to manage fatigue ... In the long term, you have to be able to retain your workforce, so they don't leave you because of exhaustion."
Australian Medical Association state president Zelle Hodge noted the case of a Sunshine Coast doctor whose fatigue after working 20 hours straight was found to have contributed to the death of a young girl he had inadequately treated. "The young doctor there was asked to work long hours and when difficulties occurred, Queensland Health did not help," she said.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Saturday, July 15, 2006
Why Socialized Medicine Leads to the Prohibition of Private Medicine
A post lifted from George Reisman
An article in today’s (Feb. 20, 2006) New York Times makes clear that Canada’s much ballyhooed system of socialized medicine, in addition to being plagued by interminable waits for treatment, has prohibited competition from private medicine. But now, as the result of a ruling last June by Canada’s Supreme Court, limited forms of private medical care are apparently in process of being allowed to appear, at least in some provinces. In The Times’ article’s words: “The cracks are still small in Canada's vaunted public health insurance system, but several of its largest provinces are beginning to open the way for private health care eventually to take root around the country.” [See full Times article.]
The Canadian Supreme Court’s decision was the outcome of a lonely and courageous struggle conducted at great personal cost in time and money by a Canadian physician, Dr. Jacques Chaoulli. Dr. Chaoulli went to court with the case of a chemical salesman who had been forced to wait a year for a hip replacement and who at the same time was prohibited from paying for private surgery. As described in an earlier Times article, Dr. Chaoulli argued
To most Americans it may come as something of a shock simply to learn that all is not well with health care in Canada. That’s because Canada’s system has continuously been held up as the model for the United States to follow. Sometimes it seems that every ignoramus with a graduate-school diploma is ready to pontificate on how wonderful medical care is north of the border and that to solve our problems with medical care, all we need do is adopt that wonderful, single-payer Canadian system.
I could stop here, with the satisfaction of conveying knowledge that the system of socialized medical care in Canada is in fact so unwell that the door to its replacement with private medical care has been opened. But there is a deeper point I want to make, which will help to establish why socialized medicine is a profoundly evil and immoral system, that should never be implemented anywhere.
And this is the fact that the prohibition of private medical care that has existed in Canada is not some inexplicable accident but, on the contrary, follows logically from the very nature of socialized medicine. The connection is this:
Socialized medicine is advocated as the means of making medical care free or almost free, thereby enabling even the very poorest people to afford all of it that they need. Unfortunately, when medical care is made free, the quantity of it that people attempt to consume becomes virtually limitless. Office visits, diagnostic tests, procedures, hospitalizations, and surgeries all balloon. If nothing further were done, the cost would destroy the government’s budget. Something further is done, and that is that cost controls are imposed. The government simply draws the line on how much it is willing to spend. But so long as nothing limits the office visits, requests for diagnostic tests, etc., etc., waiting lines and waiting lists grow longer and longer.
Then the government seeks to limit the number of office visits, tests, procedures, etc., etc., by more narrowly limiting the circumstances in which they can occur. For example, a given diagnostic test may be allowed only when a precise set of symptoms is present and not otherwise. A hospitalization or surgery may be denied if the patient is over a certain age.
As part of the process of cost control, the government controls and sometimes reduces the compensation it allows to physicians and surgeons. For example, in the present fiscal year, in the United States, the fees paid to physicians by Medicare are scheduled to fall by four percent. (The New York Times, Feb. 4, 2006.)
Now all one need do to understand why socialized medicine leads to the prohibition of private medicine is simply to hold in mind the combination of deteriorating medical treatment and controlled physician incomes under socialized medicine and ask what would happen if an escape from this nightmare exists in the form of private medicine. Obviously, physicians who want to earn a higher income and to have the freedom to treat their patients in accordance with their own medical judgment will flee the socialized system for the private system and leave basically only the dregs of medicine for what will remain of the socialized system. That is what the government’s prohibition of private medical care is designed to prevent. This was confirmed in arguments before the Canadian Supreme Court. The Times article on the subject reported that
And there you have it. Socialized medicine destroys the quality of medical care and dare not allow the competition of private medical care. To prevent that competition, it must prohibit private medical care and establish a legal monopoly on medical care.
Another Queensland Health bungle plays itself out
They sure know how to hire good staff. At least this guy did not kill anyone so I guess that is progress
An overseas health bureaucrat has had his contract terminated by the State Government in a deal that is likely to cost taxpayers in excess of $100,000 for only five weeks' work. Royal Brisbane and Women's Hospital clinical CEO Dr Thomas Ward left the job yesterday following an incident when he tried to sack the hospital's executive director of nursing services, Lesley Fleming. The Canadian medical bureaucrat was forced into an embarrassing backdown during which he was forced to reinstate Ms Fleming and issue a humiliating apology after action by senior nurses and their union.
Premier Peter Beattie announced Dr Ward's departure yesterday, but would not be drawn on the specifics. "I think it is fair to say we've obviously had negotiations with the doctor concerned and we're keen for everybody to move on," Mr Beattie said. "He has decided to return to Canada and we support that decision. I think he would have been relieved and we support his relief." Mr Beattie said he had approved a termination payment to Dr Ward of three months' pay, an amount which he said was "fairly normal in the circumstances".
Opposition health spokesman Bruce Flegg said senior medical staff had confirmed to him that Dr Ward had been pushed rather than resigned. "When he came back from a meeting on Wednesday morning someone asked him what was wrong and he only said 'I am devastated'," Dr Flegg said. "He was shoved on a flight at 9.30am this morning (Thursday) as part of settlement to get him out of the country so he couldn't be interviewed."
Queensland Nurses Union state secretary Gay Hawksworth said nurses from the Royal Brisbane Hospital attending the QNU conference yesterday greeted the news of Dr Ward's demise "with applause". "I went to a meeting last week and he admitted he had made a huge error - that he had got bad advice and that he knew he was now two years behind where he would want to be because he knew he had lost the confidence of nurses, and that made his position untenable," Ms Hawksworth said.
A media release issued by Mr Beattie and Health Minister Stephen Robertson when Dr Ward was employed in Queensland had described him as "an internationally respected health care systems manager, strategist and planner".
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
A post lifted from George Reisman
An article in today’s (Feb. 20, 2006) New York Times makes clear that Canada’s much ballyhooed system of socialized medicine, in addition to being plagued by interminable waits for treatment, has prohibited competition from private medicine. But now, as the result of a ruling last June by Canada’s Supreme Court, limited forms of private medical care are apparently in process of being allowed to appear, at least in some provinces. In The Times’ article’s words: “The cracks are still small in Canada's vaunted public health insurance system, but several of its largest provinces are beginning to open the way for private health care eventually to take root around the country.” [See full Times article.]
The Canadian Supreme Court’s decision was the outcome of a lonely and courageous struggle conducted at great personal cost in time and money by a Canadian physician, Dr. Jacques Chaoulli. Dr. Chaoulli went to court with the case of a chemical salesman who had been forced to wait a year for a hip replacement and who at the same time was prohibited from paying for private surgery. As described in an earlier Times article, Dr. Chaoulli argued
that regulations that create long waiting times for surgery contradict the constitutional guarantees for individuals of “life, liberty and the security of the person,’' and that the prohibition against private medical insurance and care is for sick patients an “infringement of the protection against cruel and unusual treatment.''
To most Americans it may come as something of a shock simply to learn that all is not well with health care in Canada. That’s because Canada’s system has continuously been held up as the model for the United States to follow. Sometimes it seems that every ignoramus with a graduate-school diploma is ready to pontificate on how wonderful medical care is north of the border and that to solve our problems with medical care, all we need do is adopt that wonderful, single-payer Canadian system.
I could stop here, with the satisfaction of conveying knowledge that the system of socialized medical care in Canada is in fact so unwell that the door to its replacement with private medical care has been opened. But there is a deeper point I want to make, which will help to establish why socialized medicine is a profoundly evil and immoral system, that should never be implemented anywhere.
And this is the fact that the prohibition of private medical care that has existed in Canada is not some inexplicable accident but, on the contrary, follows logically from the very nature of socialized medicine. The connection is this:
Socialized medicine is advocated as the means of making medical care free or almost free, thereby enabling even the very poorest people to afford all of it that they need. Unfortunately, when medical care is made free, the quantity of it that people attempt to consume becomes virtually limitless. Office visits, diagnostic tests, procedures, hospitalizations, and surgeries all balloon. If nothing further were done, the cost would destroy the government’s budget. Something further is done, and that is that cost controls are imposed. The government simply draws the line on how much it is willing to spend. But so long as nothing limits the office visits, requests for diagnostic tests, etc., etc., waiting lines and waiting lists grow longer and longer.
Then the government seeks to limit the number of office visits, tests, procedures, etc., etc., by more narrowly limiting the circumstances in which they can occur. For example, a given diagnostic test may be allowed only when a precise set of symptoms is present and not otherwise. A hospitalization or surgery may be denied if the patient is over a certain age.
As part of the process of cost control, the government controls and sometimes reduces the compensation it allows to physicians and surgeons. For example, in the present fiscal year, in the United States, the fees paid to physicians by Medicare are scheduled to fall by four percent. (The New York Times, Feb. 4, 2006.)
Now all one need do to understand why socialized medicine leads to the prohibition of private medicine is simply to hold in mind the combination of deteriorating medical treatment and controlled physician incomes under socialized medicine and ask what would happen if an escape from this nightmare exists in the form of private medicine. Obviously, physicians who want to earn a higher income and to have the freedom to treat their patients in accordance with their own medical judgment will flee the socialized system for the private system and leave basically only the dregs of medicine for what will remain of the socialized system. That is what the government’s prohibition of private medical care is designed to prevent. This was confirmed in arguments before the Canadian Supreme Court. The Times article on the subject reported that
Various medical experts, government representatives and union leaders argued in court that privatization of insurance and services would bring an exodus of medical talent from public to private practices, and make waiting times even longer.
And there you have it. Socialized medicine destroys the quality of medical care and dare not allow the competition of private medical care. To prevent that competition, it must prohibit private medical care and establish a legal monopoly on medical care.
Another Queensland Health bungle plays itself out
They sure know how to hire good staff. At least this guy did not kill anyone so I guess that is progress
An overseas health bureaucrat has had his contract terminated by the State Government in a deal that is likely to cost taxpayers in excess of $100,000 for only five weeks' work. Royal Brisbane and Women's Hospital clinical CEO Dr Thomas Ward left the job yesterday following an incident when he tried to sack the hospital's executive director of nursing services, Lesley Fleming. The Canadian medical bureaucrat was forced into an embarrassing backdown during which he was forced to reinstate Ms Fleming and issue a humiliating apology after action by senior nurses and their union.
Premier Peter Beattie announced Dr Ward's departure yesterday, but would not be drawn on the specifics. "I think it is fair to say we've obviously had negotiations with the doctor concerned and we're keen for everybody to move on," Mr Beattie said. "He has decided to return to Canada and we support that decision. I think he would have been relieved and we support his relief." Mr Beattie said he had approved a termination payment to Dr Ward of three months' pay, an amount which he said was "fairly normal in the circumstances".
Opposition health spokesman Bruce Flegg said senior medical staff had confirmed to him that Dr Ward had been pushed rather than resigned. "When he came back from a meeting on Wednesday morning someone asked him what was wrong and he only said 'I am devastated'," Dr Flegg said. "He was shoved on a flight at 9.30am this morning (Thursday) as part of settlement to get him out of the country so he couldn't be interviewed."
Queensland Nurses Union state secretary Gay Hawksworth said nurses from the Royal Brisbane Hospital attending the QNU conference yesterday greeted the news of Dr Ward's demise "with applause". "I went to a meeting last week and he admitted he had made a huge error - that he had got bad advice and that he knew he was now two years behind where he would want to be because he knew he had lost the confidence of nurses, and that made his position untenable," Ms Hawksworth said.
A media release issued by Mr Beattie and Health Minister Stephen Robertson when Dr Ward was employed in Queensland had described him as "an internationally respected health care systems manager, strategist and planner".
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Friday, July 14, 2006
The NHS long wait
Hidden waiting lists for NHS treatment, revealed for the first time, indicate that patients wait an average of seven weeks for diagnostic tests. Until now the Government has measured only how long patients wait for their first consultant appointment and then for treatment. Waits for vital diagnostic tests have been ignored.
The promise that all patients will be treated within 18 weeks of referral by a family doctor has obliged the Department of Health to start measuring these diagnostic waits. The results indicated large variations by area and by test - but also that the ambitious 18-week target was achievable, Andy Burnham, a Health minister, said yesterday.
About half of patients were being seen within the target time, officials said, but less than 1 per cent were waiting more than two years. Three quarters of tests are carried out within 13 weeks, the interim target the NHS is aiming for across the service by April 2007.
By April 2008 the target will be six weeks and by the end of that year the entire "patient journey" should be no more than 18 weeks. A small minority is expected to experience longer waits, either for clinical reasons or out of choice. But the department has yet to decide how much "wriggle room" to allow for these patients.
Every month the NHS does 50 million tests. Of the 15 key tests for which waits were measured, slightly more than 200,000 were taking more than 13 weeks to complete. A census of trusts that looked at 500 less common tests found roughly another 250,000 of these were taking more than 13 weeks. That means that, at present, 450,000 tests are taking longer than the target set for next April. This is not a large proportion of the total number of tests done, making next April's target look achievable.
The department's calculations of average waits indicate that the longest are for hearing tests, with colonoscopy taking almost as long. But the department also published data suggesting that waits for MRI and CT scans had fallen sharply since October 2005, when choice was introduced for patients who did not have a scan scheduled within the next 20 weeks.
The data indicate that allowing patients to choose where to go for their scans has cut the number waiting longer than 26 weeks from almost 16 per cent to less than 1 per cent. Andrew Lansley, the Shadow Health Secretary, said that the figures did not give the whole story.
"We know that some patients are forced to wait longer than 26 weeks, but we do not know the maximum wait," he said. "Some patients are waiting longer than two years for crucial diagnostic tests. Any significant wait for diagnosis is unacceptable. It would be an entirely alien concept to a patient in France, Germany, the United States and many other countries that they should have to wait for any diagnostic tests. It should be the same here."
Source
Australia: Mammogram incompetence in Queensland's socialized medicine system
There are increasing concerns about Queensland Health's breast cancer screening service after it emerged yesterday that 9300 women's mammograms had to be reviewed last year. The review was ordered after three of the five radiologists contracted to BreastScreen in Cairns failed to detect the expected number of small cancers in the 2004-2005 financial year. All films taken during that year were checked in the review, which took the service's most experienced radiologist almost five months to complete.
From the checks, 83 women were recalled to repeat their tests and two were found to have ductual carcinoma in situ, a non-invasive form of breast cancer. Two Gold Coast women this week launched legal action against Queensland Health alleging negligence after their aggressive cancers were not detected from their mammograms.
Opposition health spokesman Bruce Flegg accused the Government of a cover-up for not publicly announcing the review, but the Government asserted the review showed quality assurance processes were working. Queensland Health senior director of cancer screening services Jennifer Muller said the review was part of the normal quality control processes. "It's not an unusual event that we would want to do a review because we're committed to providing a high quality service," Ms Muller said.
Health Minister Stephen Robertson said BreastScreen was continually undertaking quality control measures, which led to the "exhaustive review" of the Cairns service. "No service is perfect but when you consider the number of women now using the service throughout Australia we will provide a world-class service," he said. "What we've seen over the last couple of days is experts from that service coming out and saying that we provide a service that identifies nine out of 10 cancers - it's not perfect. "The important thing is when we find problems or the service hasn't met appropriate standards . . . we fix it, and that's what we've done in the Cairns case."
But Dr Flegg accused the Minister of a cavalier approach to public health. "I think it raises some pretty serious issues when they knew there was a quality problem with readings in Cairns," he said.. "I think it does cast a doubt in the minds of patients as to how reliable the reading at BreastScreen Queensland is."
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Hidden waiting lists for NHS treatment, revealed for the first time, indicate that patients wait an average of seven weeks for diagnostic tests. Until now the Government has measured only how long patients wait for their first consultant appointment and then for treatment. Waits for vital diagnostic tests have been ignored.
The promise that all patients will be treated within 18 weeks of referral by a family doctor has obliged the Department of Health to start measuring these diagnostic waits. The results indicated large variations by area and by test - but also that the ambitious 18-week target was achievable, Andy Burnham, a Health minister, said yesterday.
About half of patients were being seen within the target time, officials said, but less than 1 per cent were waiting more than two years. Three quarters of tests are carried out within 13 weeks, the interim target the NHS is aiming for across the service by April 2007.
By April 2008 the target will be six weeks and by the end of that year the entire "patient journey" should be no more than 18 weeks. A small minority is expected to experience longer waits, either for clinical reasons or out of choice. But the department has yet to decide how much "wriggle room" to allow for these patients.
Every month the NHS does 50 million tests. Of the 15 key tests for which waits were measured, slightly more than 200,000 were taking more than 13 weeks to complete. A census of trusts that looked at 500 less common tests found roughly another 250,000 of these were taking more than 13 weeks. That means that, at present, 450,000 tests are taking longer than the target set for next April. This is not a large proportion of the total number of tests done, making next April's target look achievable.
The department's calculations of average waits indicate that the longest are for hearing tests, with colonoscopy taking almost as long. But the department also published data suggesting that waits for MRI and CT scans had fallen sharply since October 2005, when choice was introduced for patients who did not have a scan scheduled within the next 20 weeks.
The data indicate that allowing patients to choose where to go for their scans has cut the number waiting longer than 26 weeks from almost 16 per cent to less than 1 per cent. Andrew Lansley, the Shadow Health Secretary, said that the figures did not give the whole story.
"We know that some patients are forced to wait longer than 26 weeks, but we do not know the maximum wait," he said. "Some patients are waiting longer than two years for crucial diagnostic tests. Any significant wait for diagnosis is unacceptable. It would be an entirely alien concept to a patient in France, Germany, the United States and many other countries that they should have to wait for any diagnostic tests. It should be the same here."
Source
Australia: Mammogram incompetence in Queensland's socialized medicine system
There are increasing concerns about Queensland Health's breast cancer screening service after it emerged yesterday that 9300 women's mammograms had to be reviewed last year. The review was ordered after three of the five radiologists contracted to BreastScreen in Cairns failed to detect the expected number of small cancers in the 2004-2005 financial year. All films taken during that year were checked in the review, which took the service's most experienced radiologist almost five months to complete.
From the checks, 83 women were recalled to repeat their tests and two were found to have ductual carcinoma in situ, a non-invasive form of breast cancer. Two Gold Coast women this week launched legal action against Queensland Health alleging negligence after their aggressive cancers were not detected from their mammograms.
Opposition health spokesman Bruce Flegg accused the Government of a cover-up for not publicly announcing the review, but the Government asserted the review showed quality assurance processes were working. Queensland Health senior director of cancer screening services Jennifer Muller said the review was part of the normal quality control processes. "It's not an unusual event that we would want to do a review because we're committed to providing a high quality service," Ms Muller said.
Health Minister Stephen Robertson said BreastScreen was continually undertaking quality control measures, which led to the "exhaustive review" of the Cairns service. "No service is perfect but when you consider the number of women now using the service throughout Australia we will provide a world-class service," he said. "What we've seen over the last couple of days is experts from that service coming out and saying that we provide a service that identifies nine out of 10 cancers - it's not perfect. "The important thing is when we find problems or the service hasn't met appropriate standards . . . we fix it, and that's what we've done in the Cairns case."
But Dr Flegg accused the Minister of a cavalier approach to public health. "I think it raises some pretty serious issues when they knew there was a quality problem with readings in Cairns," he said.. "I think it does cast a doubt in the minds of patients as to how reliable the reading at BreastScreen Queensland is."
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Thursday, July 13, 2006
NHS CAN'T HANDLE PREMMIES
Premature babies are being sent hundreds of miles to be placed in intensive-care units, an audit has indicated. The UK has the highest rate of premature births in Western Europe, and one of the poorer records in treating premature babies, Bliss, the charity which commissioned the audit, said.
An average of three babies a day have to be transferred. Many are moved more than 100 miles, and the longest recorded journey was 286 miles, Rob Williams, the charity’s chief executive, said. Since the first audit of services last year, things had worsened, he added. Despite a government commitment in 2003 of 70 million pounds to improve care, it still fell short of an acceptable standard. “The money was welcome but nothing like enough to achieve what is needed. The service is overstretched, under- resourced and slow to respond to promising initiatives. “Ninety-five per cent of units are working at overcapacity, and 78 per cent of intensive and special-care units had to close their doors to new admissions, up from 72 per cent in 2004.”
Most importantly, he said, hospitals failed to apply to babies the same nursing care that would be provided to adults. In adult intensive-care units, there was, on average, one nurse for every patient — but only 3 per cent of baby intensive-care units achieved the same standard. Neonatal care for babies is provided by 22 networks of hospitals. But the survey found that transfers outside networks were common. Parents were often poorly informed and not told that their babies might need special care.
Sarah Skates, from Crayford in Kent, gave birth to twins after 26 weeks of pregnancy. One child was transferred to a hospital in Norwich, and the other to a hospital in Surrey, a two-hour journey in the opposite direction. The twins’ father went to stay in Norwich while their mother stayed at home to look after her older child. It was, she said, “the hardest time of my life”.
The research was carried out for Bliss by the National Perinatal Epidemiology Unit at Oxford. The report says that the Department of Health should require intensive-care units to have a nurse for every baby. A spokeswoman for the Department of Health said: “On average, a quarter of neonatal intensive-care cots are empty at any given time, so the creation of local neonatal networks has helped local areas assist each other when demand is greatest. “These provide as much of this care locally as is possible, but there will always be occasions when transfer to a more specialist unit outside the network may offer better outcomes.”
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Premature babies are being sent hundreds of miles to be placed in intensive-care units, an audit has indicated. The UK has the highest rate of premature births in Western Europe, and one of the poorer records in treating premature babies, Bliss, the charity which commissioned the audit, said.
An average of three babies a day have to be transferred. Many are moved more than 100 miles, and the longest recorded journey was 286 miles, Rob Williams, the charity’s chief executive, said. Since the first audit of services last year, things had worsened, he added. Despite a government commitment in 2003 of 70 million pounds to improve care, it still fell short of an acceptable standard. “The money was welcome but nothing like enough to achieve what is needed. The service is overstretched, under- resourced and slow to respond to promising initiatives. “Ninety-five per cent of units are working at overcapacity, and 78 per cent of intensive and special-care units had to close their doors to new admissions, up from 72 per cent in 2004.”
Most importantly, he said, hospitals failed to apply to babies the same nursing care that would be provided to adults. In adult intensive-care units, there was, on average, one nurse for every patient — but only 3 per cent of baby intensive-care units achieved the same standard. Neonatal care for babies is provided by 22 networks of hospitals. But the survey found that transfers outside networks were common. Parents were often poorly informed and not told that their babies might need special care.
Sarah Skates, from Crayford in Kent, gave birth to twins after 26 weeks of pregnancy. One child was transferred to a hospital in Norwich, and the other to a hospital in Surrey, a two-hour journey in the opposite direction. The twins’ father went to stay in Norwich while their mother stayed at home to look after her older child. It was, she said, “the hardest time of my life”.
The research was carried out for Bliss by the National Perinatal Epidemiology Unit at Oxford. The report says that the Department of Health should require intensive-care units to have a nurse for every baby. A spokeswoman for the Department of Health said: “On average, a quarter of neonatal intensive-care cots are empty at any given time, so the creation of local neonatal networks has helped local areas assist each other when demand is greatest. “These provide as much of this care locally as is possible, but there will always be occasions when transfer to a more specialist unit outside the network may offer better outcomes.”
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
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Wednesday, July 12, 2006
THE GOOD OLD GENEROUS AMERICAN TAXPAYER
The recent state budget debate over whether California should provide health insurance for children who are undocumented immigrants largely overlooked one key fact: The government already spends almost $1 billion a year for some health care services for the undocumented through Medi-Cal.
Amid a renewed national focus on illegal immigration, health services for undocumented immigrants in California returned as a political flash point this year for the first time since debate over Proposition 187 roiled the state in the 1990s. Republican lawmakers persuaded Democrats and GOP Gov. Arnold Schwarzenegger to drop $23 million for new insurance coverage for undocumented children. But almost no one was talking about the programs that Proposition 187 was intended to cut before it was blocked in court in the late 1990s: prenatal care, nursing home care and other services funded by Medi-Cal for undocumented immigrants.
Over the past decade, those services have grown by 50 percent into a $1 billion annual program serving hundreds of thousands of people each year. Spending growth has been slower than in the Medi-Cal program overall, which went up more than 100 percent in the past decade, to about $35 billion annually. Both the number of people receiving services and the cost of those services have risen: The number of undocumented women giving birth covered by Medi-Cal rose almost 25 percent from 85,000 in 1995 to 105,000 in 2004. Meanwhile, the overall costs of those births rose by about 135 percent during that time.
State officials say the increases are largely due to inflation in health care costs and to a change in the rules allowing more people to qualify for Medi-Cal. Republican lawmakers say the fight over Proposition 187 has limited their ability to try to cut existing programs. So they're focusing on trying to stop any efforts to expand services to the undocumented. "We've realized our hands are pretty much tied by the fact that the Proposition 187 appeal was dropped in court," said Sen. Dennis Hollingsworth, R-Murietta, one of the lawmakers leading this year's budget fight.
More here
U.K.: NHS FAILURES GO RIGHT TO THE TOP
Poor leadership, bad management and inadequate board members are the main reasons for hospitals and primary care trusts running up deficits, the Audit Commission has found. While managements tend to blame the system, the fault lies not in their stars but in themselves, the commission says. In 2005-06, the commission published 25 public interest reports, in which local auditors were sufficiently alarmed about the financial state of NHS bodies to make their concerns public.
Now the lessons of these reports have been gathered in a single document, Learning the Lessons from Financial Failure in the NHS. Last year the NHS ran up a large deficit, even though it is mandated to balance its books. Although the majority of NHS organisations did so, a minority failed, some by huge margins.
Steve Bundred, the chief executive of the commission, denied that parts of the NHS were underfunded. He said that organisations that ran into difficulties had been warned but had failed to make changes. Of 25 trusts examined the total deficit in 2005-06 was 173.6 million pounds, in spite of “financial support” from other parts of the NHS worth 86 million pounds.
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
The recent state budget debate over whether California should provide health insurance for children who are undocumented immigrants largely overlooked one key fact: The government already spends almost $1 billion a year for some health care services for the undocumented through Medi-Cal.
Amid a renewed national focus on illegal immigration, health services for undocumented immigrants in California returned as a political flash point this year for the first time since debate over Proposition 187 roiled the state in the 1990s. Republican lawmakers persuaded Democrats and GOP Gov. Arnold Schwarzenegger to drop $23 million for new insurance coverage for undocumented children. But almost no one was talking about the programs that Proposition 187 was intended to cut before it was blocked in court in the late 1990s: prenatal care, nursing home care and other services funded by Medi-Cal for undocumented immigrants.
Over the past decade, those services have grown by 50 percent into a $1 billion annual program serving hundreds of thousands of people each year. Spending growth has been slower than in the Medi-Cal program overall, which went up more than 100 percent in the past decade, to about $35 billion annually. Both the number of people receiving services and the cost of those services have risen: The number of undocumented women giving birth covered by Medi-Cal rose almost 25 percent from 85,000 in 1995 to 105,000 in 2004. Meanwhile, the overall costs of those births rose by about 135 percent during that time.
State officials say the increases are largely due to inflation in health care costs and to a change in the rules allowing more people to qualify for Medi-Cal. Republican lawmakers say the fight over Proposition 187 has limited their ability to try to cut existing programs. So they're focusing on trying to stop any efforts to expand services to the undocumented. "We've realized our hands are pretty much tied by the fact that the Proposition 187 appeal was dropped in court," said Sen. Dennis Hollingsworth, R-Murietta, one of the lawmakers leading this year's budget fight.
More here
U.K.: NHS FAILURES GO RIGHT TO THE TOP
Poor leadership, bad management and inadequate board members are the main reasons for hospitals and primary care trusts running up deficits, the Audit Commission has found. While managements tend to blame the system, the fault lies not in their stars but in themselves, the commission says. In 2005-06, the commission published 25 public interest reports, in which local auditors were sufficiently alarmed about the financial state of NHS bodies to make their concerns public.
Now the lessons of these reports have been gathered in a single document, Learning the Lessons from Financial Failure in the NHS. Last year the NHS ran up a large deficit, even though it is mandated to balance its books. Although the majority of NHS organisations did so, a minority failed, some by huge margins.
Steve Bundred, the chief executive of the commission, denied that parts of the NHS were underfunded. He said that organisations that ran into difficulties had been warned but had failed to make changes. Of 25 trusts examined the total deficit in 2005-06 was 173.6 million pounds, in spite of “financial support” from other parts of the NHS worth 86 million pounds.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Tuesday, July 11, 2006
RAPE IN BRITISH "NATIONAL HEALTH" HOSPITALS
Can you imagine the litigation if these were private hospitals? Handwringing is all you get from government hospitals
Women were the victims of more than 100 incidents of rape, sexual assault and sexual harassment in NHS mental health units over two years, according to a confidential report being held by the Government. The Times has learnt that the report, which gives details of more than ten rapes and, in a single year, three unwanted pregnancies, has yet to be published eight months after it was received by the Department of Health. The findings bring into question the Government’s claim to have set up single-sex wards that are safe and ensure personal dignity across the health service. The pledge, made by Tony Blair in 1996, was supposed to have been met by the end of 2002.
Mental health campaigners said the report confirmed growing fears that the Government was compromising patient safety in some of the country’s mental health trusts and psychiatric wards in district general hospitals. Ministers are accused of not tackling the problem as a matter of urgency despite having the information to alert them. Incidents in mental health settings appeared to be a far lesser concern than those in other hospital environments such as cancer wards, campaigners said, even though psychiatric patients were likely to be the worst affected by such experiences.
Details of the report, leaked to The Times by Whitehall sources, come from data collected by the National Learning and Reporting System, a monitoring programme set up in November 2003 by the National Patient Safety Agency (NPSA). All healthcare organisations were linked to the system by the end of 2004, including the country’s 84 mental health trusts, and the first national report was published in July last year. However, such was the concern over sexual assault in mental health settings that a separate study — the Mental Health Observatory Report — was commissioned. Most of the recorded incidents took place in the 12 months to October 2005 as most mental health trusts were among the last organisations to join the reporting programme. It is understood to include both patient-on-patient and staff-on-patient incidents and ranges from men exposing themselves to women, physically assaulting them and committing rape.
The report’s findings reached the Department of Health last November. It is understood that the hold-up has occurred at the NHS “gateway”, a system set up to disseminate inspection information efficiently [!!!!] throughout the service.
Paul Farmer, chief executive of Mind, the leading mental health charity, described the data as “extremely concerning”. With an estimated 22 per cent of safety incidents in the NHS going unreported, the full picture could be even worse, he said. “We are talking about the care of some of the most vulnerable patients. I think people will rightly be appalled by these findings.”
Spending on mental health has increased by 600 million pounds since 2000, with funding for extra nurses, teams in the community and high-security units. But concerns remain that inpatient services — which care for a range of conditions, from severe depression to self-harm and suicidal tendencies — have been overlooked and are likely to suffer further. Health leaders say that the recent deficits are having a severe effect on mental healthcare, with cuts in staff and bed numbers adding to the problems of providing single-sex wards. Estimates from the Conservatives suggest that more than half of NHS trusts have been forced to close wards. The Government says that only 11 trusts have been affected.
Asked about the Mental Health Observatory Report in the House of Lords last month, Lord Warner, the Health Minister, said in a written answer that it would be released later this year. A Freedom of Information request, submitted by Mind in April, was rejected by the NPSA on the grounds that the material was in the process of being published. The agency accepted that it had had the information since the previous November and said it had the “definite intention to publish in the near future”. The Department of Health said yesterday that it did not comment on leaked documents. A spokesperson said that some data needed further analysis before the report could be published
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Can you imagine the litigation if these were private hospitals? Handwringing is all you get from government hospitals
Women were the victims of more than 100 incidents of rape, sexual assault and sexual harassment in NHS mental health units over two years, according to a confidential report being held by the Government. The Times has learnt that the report, which gives details of more than ten rapes and, in a single year, three unwanted pregnancies, has yet to be published eight months after it was received by the Department of Health. The findings bring into question the Government’s claim to have set up single-sex wards that are safe and ensure personal dignity across the health service. The pledge, made by Tony Blair in 1996, was supposed to have been met by the end of 2002.
Mental health campaigners said the report confirmed growing fears that the Government was compromising patient safety in some of the country’s mental health trusts and psychiatric wards in district general hospitals. Ministers are accused of not tackling the problem as a matter of urgency despite having the information to alert them. Incidents in mental health settings appeared to be a far lesser concern than those in other hospital environments such as cancer wards, campaigners said, even though psychiatric patients were likely to be the worst affected by such experiences.
Details of the report, leaked to The Times by Whitehall sources, come from data collected by the National Learning and Reporting System, a monitoring programme set up in November 2003 by the National Patient Safety Agency (NPSA). All healthcare organisations were linked to the system by the end of 2004, including the country’s 84 mental health trusts, and the first national report was published in July last year. However, such was the concern over sexual assault in mental health settings that a separate study — the Mental Health Observatory Report — was commissioned. Most of the recorded incidents took place in the 12 months to October 2005 as most mental health trusts were among the last organisations to join the reporting programme. It is understood to include both patient-on-patient and staff-on-patient incidents and ranges from men exposing themselves to women, physically assaulting them and committing rape.
The report’s findings reached the Department of Health last November. It is understood that the hold-up has occurred at the NHS “gateway”, a system set up to disseminate inspection information efficiently [!!!!] throughout the service.
Paul Farmer, chief executive of Mind, the leading mental health charity, described the data as “extremely concerning”. With an estimated 22 per cent of safety incidents in the NHS going unreported, the full picture could be even worse, he said. “We are talking about the care of some of the most vulnerable patients. I think people will rightly be appalled by these findings.”
Spending on mental health has increased by 600 million pounds since 2000, with funding for extra nurses, teams in the community and high-security units. But concerns remain that inpatient services — which care for a range of conditions, from severe depression to self-harm and suicidal tendencies — have been overlooked and are likely to suffer further. Health leaders say that the recent deficits are having a severe effect on mental healthcare, with cuts in staff and bed numbers adding to the problems of providing single-sex wards. Estimates from the Conservatives suggest that more than half of NHS trusts have been forced to close wards. The Government says that only 11 trusts have been affected.
Asked about the Mental Health Observatory Report in the House of Lords last month, Lord Warner, the Health Minister, said in a written answer that it would be released later this year. A Freedom of Information request, submitted by Mind in April, was rejected by the NPSA on the grounds that the material was in the process of being published. The agency accepted that it had had the information since the previous November and said it had the “definite intention to publish in the near future”. The Department of Health said yesterday that it did not comment on leaked documents. A spokesperson said that some data needed further analysis before the report could be published
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Monday, July 10, 2006
NHS KNOW-NOTHINGS
Thousands of lives are being put at risk every year in the NHS because of the Government's failure to set up an effective system to monitor patient safety and prevent mistakes recurring, an influential cross-party committee said yesterday. A report by the Committee of Public Accounts, the parliamentary spending watchdog, describes the performance of the National Patient Safety Agency, which was set up to improve safety in health settings, as "extremely weak" and "dysfunctional".
In 2004-05 there were more than 1.2 million safety incidents and near-misses, half of which could have been avoided if health trusts had learnt from past mistakes. The report, which is based on work by the National Audit Office and evidence from the Department of Health, the safety agency and the Chief Medical Officer, concludes that a culture of secrecy and inadequate safety regulation is preventing error reduction in the NHS.
A total of 974,000 incidents were reported to the agency in 2004-05, but these represented only about three-quarters of the actual total, the committee found. It said that an average of 22 per cent of incidents go unreported, most of which were medication errors and incidents leading to serious harm.
Edward Leigh, chairman of the committee, said that arguably the most worrying finding was the apparent inability of the health service to reduce avoidable and recurring mistakes. "These statistics would be terrifying enough without our learning that there is undoubtedly substantial under- reporting of serious incidents and deaths . . . The NHS simply has no idea how many people die each year from patient safety incidents," Mr Leigh said. "What this points to are two related and deep-seated failures. One is the failure of the NHS to secure accurate information on serious incidents and deaths. The other is the failure on a staggering scale to learn from previous experience."
The report, A Safer Place for Patients: Learning to Improve Patient Safety, said estimates that one in ten patients admitted to hospitals in developed countries is unintentionally harmed showed the urgent need for an effective system. The errors are costing the health service about o2 billion a year in extra bed days and o400 million in settled clinical negligence claims. The report said that the safety agency had "provided only limited feedback to NHS trusts on solutions to reduce serious incidents". Underreporting by staff, particularly doctors, also remained a problem.
It added that "few trusts have formally evaluated their safety culture" and "insufficient progress" had been made on achieving targets set out by the Department of Health. The report also refers to data showing that less than a quarter of trusts routinely inform patients involved in a reported incident and 6 per cent do not involve patients at all. It noted that the size and complexity of the NHS workload, which treats a million people every 36 hours, meant that errors were inevitable. Peter Walsh, of the patient safety charity Action against Medical Accidents, called for urgent action as a result of the report.
Susan Williams, joint chief executive of the safety agency, said that progress had been made, but more was needed to ensure "even safer healthcare".
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Thousands of lives are being put at risk every year in the NHS because of the Government's failure to set up an effective system to monitor patient safety and prevent mistakes recurring, an influential cross-party committee said yesterday. A report by the Committee of Public Accounts, the parliamentary spending watchdog, describes the performance of the National Patient Safety Agency, which was set up to improve safety in health settings, as "extremely weak" and "dysfunctional".
In 2004-05 there were more than 1.2 million safety incidents and near-misses, half of which could have been avoided if health trusts had learnt from past mistakes. The report, which is based on work by the National Audit Office and evidence from the Department of Health, the safety agency and the Chief Medical Officer, concludes that a culture of secrecy and inadequate safety regulation is preventing error reduction in the NHS.
A total of 974,000 incidents were reported to the agency in 2004-05, but these represented only about three-quarters of the actual total, the committee found. It said that an average of 22 per cent of incidents go unreported, most of which were medication errors and incidents leading to serious harm.
Edward Leigh, chairman of the committee, said that arguably the most worrying finding was the apparent inability of the health service to reduce avoidable and recurring mistakes. "These statistics would be terrifying enough without our learning that there is undoubtedly substantial under- reporting of serious incidents and deaths . . . The NHS simply has no idea how many people die each year from patient safety incidents," Mr Leigh said. "What this points to are two related and deep-seated failures. One is the failure of the NHS to secure accurate information on serious incidents and deaths. The other is the failure on a staggering scale to learn from previous experience."
The report, A Safer Place for Patients: Learning to Improve Patient Safety, said estimates that one in ten patients admitted to hospitals in developed countries is unintentionally harmed showed the urgent need for an effective system. The errors are costing the health service about o2 billion a year in extra bed days and o400 million in settled clinical negligence claims. The report said that the safety agency had "provided only limited feedback to NHS trusts on solutions to reduce serious incidents". Underreporting by staff, particularly doctors, also remained a problem.
It added that "few trusts have formally evaluated their safety culture" and "insufficient progress" had been made on achieving targets set out by the Department of Health. The report also refers to data showing that less than a quarter of trusts routinely inform patients involved in a reported incident and 6 per cent do not involve patients at all. It noted that the size and complexity of the NHS workload, which treats a million people every 36 hours, meant that errors were inevitable. Peter Walsh, of the patient safety charity Action against Medical Accidents, called for urgent action as a result of the report.
Susan Williams, joint chief executive of the safety agency, said that progress had been made, but more was needed to ensure "even safer healthcare".
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Sunday, July 09, 2006
A WONDERFUL STORY BUT NO CREDIT TO THE NHS
Will he ever be told that government doctors intended to kill him?
When doctors turned off James Smart’s life-support machine after he had spent ten days in a coma, his mother believed that her two-year-old son could not survive. But, against all odds, James started to breathe on his own and is on his way to a full recovery. Yesterday he played at home in Wakefield, West Yorkshire, as his mother, Ellie Craven, 21, told how he came back from the brink of death.
James had shown no sign of life after contracting pneumococcal meningitis. Doctors feared that if he survived he would be in a vegetative state for the rest of his life. But, two months after being released from hospital, he continues to amaze medical staff.
James began to feel unwell in February and his mother took him to the doctor. Despite having a high temperature, freezing hands and a sore throat, all that was suspected was a throat infection. Less than 24 hours later meningitis was diagnosed and the boy went into a coma. Ms Craven was in labour with her second child when James was rushed to hospital. He was placed on a life-support machine as medical staff drained fluid from his brain. After ten days, with no sign of progress, he was taken off it. “Nobody could believe it when he started breathing,” Ms Craven said. James suffered a small amount of brain damage, but after nine weeks in hospital, where he underwent intensive physiotherapy and speech therapy, he returned home.
Source
In the USA, coma patients are often kept alive for years. In Britain's "caring" socialized medicine system, this little boy was allowed only 10 days. Personal note: This story moved me to tears
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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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Will he ever be told that government doctors intended to kill him?
When doctors turned off James Smart’s life-support machine after he had spent ten days in a coma, his mother believed that her two-year-old son could not survive. But, against all odds, James started to breathe on his own and is on his way to a full recovery. Yesterday he played at home in Wakefield, West Yorkshire, as his mother, Ellie Craven, 21, told how he came back from the brink of death.
James had shown no sign of life after contracting pneumococcal meningitis. Doctors feared that if he survived he would be in a vegetative state for the rest of his life. But, two months after being released from hospital, he continues to amaze medical staff.
James began to feel unwell in February and his mother took him to the doctor. Despite having a high temperature, freezing hands and a sore throat, all that was suspected was a throat infection. Less than 24 hours later meningitis was diagnosed and the boy went into a coma. Ms Craven was in labour with her second child when James was rushed to hospital. He was placed on a life-support machine as medical staff drained fluid from his brain. After ten days, with no sign of progress, he was taken off it. “Nobody could believe it when he started breathing,” Ms Craven said. James suffered a small amount of brain damage, but after nine weeks in hospital, where he underwent intensive physiotherapy and speech therapy, he returned home.
Source
In the USA, coma patients are often kept alive for years. In Britain's "caring" socialized medicine system, this little boy was allowed only 10 days. Personal note: This story moved me to tears
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Saturday, July 08, 2006
Demeaning the dead -- the NHS continues its downhill slide
By Melanie Phillips
People say that you can measure how civilised a country is by the way it treats its dead. Judging by that yardstick, it would seem that parts of Britain are not very civilised at all. At Queen's Park hospital in Blackburn, the bodies of patients who have died have been left on hospital wards overnight, apparently because a funding crisis has resulted in a shortage of night porters who are needed to move them to the mortuary.
The East Lancashire Trust in charge of the hospital - which subscribes to an NHS scheme entitled `pursuing perfection' -says that because it is under pressure to save 11.6 million pounds by next April, it can't afford to replace four night porters who are off sick or who have resigned. Since it takes two porters to move and lift a body, when staff are left alone overnight it is therefore impossible for them to move from the wards patients who have died. One porter at the hospital has claimed that last week, three bodies were left on the wards for more than eight hours.
This is sickening and revolting. Leaving the bodies of patients in their beds like this is utterly unacceptable. It shows a total lack of respect for the dead, and the likely distress caused to other patients needs no imagination. The NHS budget now runs to a massive annual total of more than 80 billion. Yet the service cannot even afford to treat a dead body with elementary respect. Yes, we all know that despite the astronomical sums being poured into the NHS it has nevertheless managed to get itself into a 500 million deficit and is in a permanent state of crisis as a result.
Yet there is still money to pay the salaries of the serried ranks of bureaucrats, who have helped reduce the NHS to its current parlous state of mismanagement. The East Lancashire Trust itself is currently advertising on its website for a Director of Strategy and Implementation at an annual salary of 95-100,000 pounds. This exalted figure will get the `chance to transform services and improve the patient experience.' It is also advertising for something called a Supply Chain Director, at a salary of 75,000 pounds, a post which is apparently essential to ensure `we obtain maximum value from our 500 milion-plus annual spend within Cumbria and Lancashire.' Is it really `improving the patient experience' or `obtaining maximum value' for patients to find they are sharing their ward with a corpse that has been left in the next bed for hours on end? Isn't there something dramatically wrong with the Trust's priorities here?
Our health service is spending ever increasing sums on cutting-edge medical technology. As a country we are moving into the brave new world of designer babies, face transplants and cloning. These advances are held to be evidence of the superiority and prowess of our civilisation. Yet we seem to be no longer capable of observing even the basic decencies of a civilised society. The way we treat the dead is of the greatest possible significance not just to the health service but to society at large. For if we do not show respect to the dead, we will not show it to the living.
The rituals around our treatment of dead people signify the respect we have for human life itself. That's why the desecration of graves or cemeteries is so shocking. That's why we close the eyes of the deceased, or cover their faces with a sheet; it's why we prepare them decently before we bury them. We treat a dead body with this kind of reverence because to do otherwise would be to show that we have no intrinsic respect for our common humanity and for what it actually means to be a human being. We reaffirm this common bond even towards the physical remains of a life that has departed, precisely to signal that to be human is to be more than a mere assembly of working parts and that we are not just a lump of flesh. If we don't do this, if we treat a dead body as if it were no more than an inanimate thing, we dehumanise not just the person who has died but ourselves and our fellow human beings too.
Yet that is just what was done at the Queen's Park hospital, where dead people were treated with no more thought than bags of refuse waiting to be collected. It is simply no excuse to say there wasn't enough money. It suggests rather a breakdown in some pretty basic codes of decency. It appears that this scandal only came to light when a porter who was unable to move a body from a ward because he was alone wrote an incident report to the management. But what about the other hospital staff who must have noticed that a dead patient had been left for hours on a ward? What about the nurses who were seeing to other patients on these wards? Why didn't they immediately do something about it? Didn't they care? Did they even notice?
Unfortunately, the financial black hole is by no means the worst thing that has happened to our health service. Far more serious and disturbing is the loss of something much more fundamental than money, even though it is more intangible. What has disappeared in distressingly large measure is the ethic of care, at the heart of which is recognition of the dignity of every human being and the intrinsic respect to which that gives rise.
Of course, there are many nurses, doctors and other NHS staff who provide magnificent and sensitive care, particularly where sick children, patients in intensive care or relatively young people suffering life-threatening diseases are concerned. But in too many areas, respect for human dignity has been cast aside. Take mixed-sex wards, for example, which, despite many government promises to phase them out, still exist. These wards cause untold distress to many patients, particularly to elderly people. And it is the elderly who have suffered most of all from this erosion of respect within our health service. In too many of our hospitals, the treatment of elderly patients is simply inhumane. They are neglected so that some who are too frail to feed themselves are left without food. Others have their lives ended altogether by the withdrawal of food and hydration on the grounds that their lives are no longer worth living.
A recent survey found that up to 5,000 frail and elderly patients die each year because they are not put in intensive care beds for monitoring after their operations, having been written off because they are old. Such contempt for old people surely has its roots in the widespread erosion of religious belief, which has resulted in a loss of respect for the innate value of human life. Instead, respect is now afforded in proportion to the presumed usefulness of that life. Dead people, of course, are no longer useful at all - so much so that in some quarters they are not even being regarded as people but as useless objects. The shocking revelations from Blackburn suggest that the NHS is suffering not merely from a financial crisis but a moral one, too - and one that reflects upon all of us.
Source
One of my readers who is a public-hospital medical specialist in the USA wrote to Melanie regarding the above article as follows:
"I was touched like never before by your column on Demeaning the Dead. It was like being at the dentist when he is drilling and he hits a nerve. In a small space, you put into words what is wrong with society. A while ago, some woman was rescuing dogs disposed of in a city dump in South Africa. They were left to die. At first I thought this was extreme on her part. But then my wife said something wise - she said that, in a society that treats animals this way, how do you think they treat people? Likewise, how they treat the dead DOES reflect on how they treat the living.
The motive here is NOT economic. Someone can ALWAYS be recruited in a hospital - supervising nurses, who would have to be coerced to get their hands dirty hauling a body to the morgue. Security personnel, phone operators, cafeteria workers, even doctors. There is ALWAYS SOMEBODY. Leaving a body in a room with a living patient is just a passive aggressive stab at "the system".
And it's not good economics to leave a dead person in a hospital bed. As busy as hospitals are, economic efficiency would be greater with live patients rather than dead patients occupying beds".
The downward spiral continues in Queensland public hospitals
A shortage of nursing staff has forced Queensland's largest public hospital to cut back elective surgery for the next three months. More cuts are likely to limit operations to fewer than 1800. A leaked memo from the hospital revealed that since March "there have been ongoing elective operating sessions cancelled due to insufficient nursing and anaesthetic technical staff to provide safe patient care". "In addition, demand for emergency surgery is exceeding the current emergency OR (operating room) capacity," the memo says.
In the past year, the staffing shortages and additional demand for emergency operations have meant patients have faced last-minute cancellation of elective surgery. Several people who contacted The Courier-Mail said they had operations cancelled after they had been prepared and wheeled into the operating theatre.
Queensland Health Central Area Health Service acting general manager Terry Mehan said planned cuts in elective surgery were more appropriate than making last-minute cancellations to elective surgery lists. Mr Mehan said the hospital usually conducted 30 to 32 elective surgery sessions each day and the new roster would reduce that to 24 or 26 sessions each day. "Emergency surgery is exactly that. It is surgery that cannot wait. And this new roster system developed by the clinicians at the coalface aims to ensure emergency cases will not have to wait," he said. "We believe this will be a great improvement on ad hoc last-minute elective surgery cancellations. Last-minute cancellations result in stress and inconvenience for patients." Mr Mehan said demand for elective and emergency surgery was increasing throughout the state. "And there is a shortage of nursing staff, particularly of nurses with operating theatre skills," he said.
Australian Medical Association Queensland president Zelle Hodge said last-minute cancellations of elective operations had been "going on for some time" at RBWH. Dr Hodge said the shortage of beds meant Queensland's public hospitals were operating at full capacity and had no room to move should there be a disaster or seasonal fluctuations. "Ideally hospitals should plan to run at 85 per cent capacity to deal with these fluctuations," Dr Hodge said. "But we know the RBWH is constantly running at about 130 per cent capacity. This means patients with serious cancers have to wait. They are being significantly disadvantaged in our public hospital system."
Opposition health spokesman Bruce Flegg said that previously a lack of doctors had been blamed for cancellations. "Now it is a lack of technical staff and nurses to open operating theatre," he said. "This is the same government which has recently spent millions of taxpayers' money on promoting how things have changed inside our public hospitals because of its successful recruitment programs for doctors and nurses."
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
By Melanie Phillips
People say that you can measure how civilised a country is by the way it treats its dead. Judging by that yardstick, it would seem that parts of Britain are not very civilised at all. At Queen's Park hospital in Blackburn, the bodies of patients who have died have been left on hospital wards overnight, apparently because a funding crisis has resulted in a shortage of night porters who are needed to move them to the mortuary.
The East Lancashire Trust in charge of the hospital - which subscribes to an NHS scheme entitled `pursuing perfection' -says that because it is under pressure to save 11.6 million pounds by next April, it can't afford to replace four night porters who are off sick or who have resigned. Since it takes two porters to move and lift a body, when staff are left alone overnight it is therefore impossible for them to move from the wards patients who have died. One porter at the hospital has claimed that last week, three bodies were left on the wards for more than eight hours.
This is sickening and revolting. Leaving the bodies of patients in their beds like this is utterly unacceptable. It shows a total lack of respect for the dead, and the likely distress caused to other patients needs no imagination. The NHS budget now runs to a massive annual total of more than 80 billion. Yet the service cannot even afford to treat a dead body with elementary respect. Yes, we all know that despite the astronomical sums being poured into the NHS it has nevertheless managed to get itself into a 500 million deficit and is in a permanent state of crisis as a result.
Yet there is still money to pay the salaries of the serried ranks of bureaucrats, who have helped reduce the NHS to its current parlous state of mismanagement. The East Lancashire Trust itself is currently advertising on its website for a Director of Strategy and Implementation at an annual salary of 95-100,000 pounds. This exalted figure will get the `chance to transform services and improve the patient experience.' It is also advertising for something called a Supply Chain Director, at a salary of 75,000 pounds, a post which is apparently essential to ensure `we obtain maximum value from our 500 milion-plus annual spend within Cumbria and Lancashire.' Is it really `improving the patient experience' or `obtaining maximum value' for patients to find they are sharing their ward with a corpse that has been left in the next bed for hours on end? Isn't there something dramatically wrong with the Trust's priorities here?
Our health service is spending ever increasing sums on cutting-edge medical technology. As a country we are moving into the brave new world of designer babies, face transplants and cloning. These advances are held to be evidence of the superiority and prowess of our civilisation. Yet we seem to be no longer capable of observing even the basic decencies of a civilised society. The way we treat the dead is of the greatest possible significance not just to the health service but to society at large. For if we do not show respect to the dead, we will not show it to the living.
The rituals around our treatment of dead people signify the respect we have for human life itself. That's why the desecration of graves or cemeteries is so shocking. That's why we close the eyes of the deceased, or cover their faces with a sheet; it's why we prepare them decently before we bury them. We treat a dead body with this kind of reverence because to do otherwise would be to show that we have no intrinsic respect for our common humanity and for what it actually means to be a human being. We reaffirm this common bond even towards the physical remains of a life that has departed, precisely to signal that to be human is to be more than a mere assembly of working parts and that we are not just a lump of flesh. If we don't do this, if we treat a dead body as if it were no more than an inanimate thing, we dehumanise not just the person who has died but ourselves and our fellow human beings too.
Yet that is just what was done at the Queen's Park hospital, where dead people were treated with no more thought than bags of refuse waiting to be collected. It is simply no excuse to say there wasn't enough money. It suggests rather a breakdown in some pretty basic codes of decency. It appears that this scandal only came to light when a porter who was unable to move a body from a ward because he was alone wrote an incident report to the management. But what about the other hospital staff who must have noticed that a dead patient had been left for hours on a ward? What about the nurses who were seeing to other patients on these wards? Why didn't they immediately do something about it? Didn't they care? Did they even notice?
Unfortunately, the financial black hole is by no means the worst thing that has happened to our health service. Far more serious and disturbing is the loss of something much more fundamental than money, even though it is more intangible. What has disappeared in distressingly large measure is the ethic of care, at the heart of which is recognition of the dignity of every human being and the intrinsic respect to which that gives rise.
Of course, there are many nurses, doctors and other NHS staff who provide magnificent and sensitive care, particularly where sick children, patients in intensive care or relatively young people suffering life-threatening diseases are concerned. But in too many areas, respect for human dignity has been cast aside. Take mixed-sex wards, for example, which, despite many government promises to phase them out, still exist. These wards cause untold distress to many patients, particularly to elderly people. And it is the elderly who have suffered most of all from this erosion of respect within our health service. In too many of our hospitals, the treatment of elderly patients is simply inhumane. They are neglected so that some who are too frail to feed themselves are left without food. Others have their lives ended altogether by the withdrawal of food and hydration on the grounds that their lives are no longer worth living.
A recent survey found that up to 5,000 frail and elderly patients die each year because they are not put in intensive care beds for monitoring after their operations, having been written off because they are old. Such contempt for old people surely has its roots in the widespread erosion of religious belief, which has resulted in a loss of respect for the innate value of human life. Instead, respect is now afforded in proportion to the presumed usefulness of that life. Dead people, of course, are no longer useful at all - so much so that in some quarters they are not even being regarded as people but as useless objects. The shocking revelations from Blackburn suggest that the NHS is suffering not merely from a financial crisis but a moral one, too - and one that reflects upon all of us.
Source
One of my readers who is a public-hospital medical specialist in the USA wrote to Melanie regarding the above article as follows:
"I was touched like never before by your column on Demeaning the Dead. It was like being at the dentist when he is drilling and he hits a nerve. In a small space, you put into words what is wrong with society. A while ago, some woman was rescuing dogs disposed of in a city dump in South Africa. They were left to die. At first I thought this was extreme on her part. But then my wife said something wise - she said that, in a society that treats animals this way, how do you think they treat people? Likewise, how they treat the dead DOES reflect on how they treat the living.
The motive here is NOT economic. Someone can ALWAYS be recruited in a hospital - supervising nurses, who would have to be coerced to get their hands dirty hauling a body to the morgue. Security personnel, phone operators, cafeteria workers, even doctors. There is ALWAYS SOMEBODY. Leaving a body in a room with a living patient is just a passive aggressive stab at "the system".
And it's not good economics to leave a dead person in a hospital bed. As busy as hospitals are, economic efficiency would be greater with live patients rather than dead patients occupying beds".
The downward spiral continues in Queensland public hospitals
A shortage of nursing staff has forced Queensland's largest public hospital to cut back elective surgery for the next three months. More cuts are likely to limit operations to fewer than 1800. A leaked memo from the hospital revealed that since March "there have been ongoing elective operating sessions cancelled due to insufficient nursing and anaesthetic technical staff to provide safe patient care". "In addition, demand for emergency surgery is exceeding the current emergency OR (operating room) capacity," the memo says.
In the past year, the staffing shortages and additional demand for emergency operations have meant patients have faced last-minute cancellation of elective surgery. Several people who contacted The Courier-Mail said they had operations cancelled after they had been prepared and wheeled into the operating theatre.
Queensland Health Central Area Health Service acting general manager Terry Mehan said planned cuts in elective surgery were more appropriate than making last-minute cancellations to elective surgery lists. Mr Mehan said the hospital usually conducted 30 to 32 elective surgery sessions each day and the new roster would reduce that to 24 or 26 sessions each day. "Emergency surgery is exactly that. It is surgery that cannot wait. And this new roster system developed by the clinicians at the coalface aims to ensure emergency cases will not have to wait," he said. "We believe this will be a great improvement on ad hoc last-minute elective surgery cancellations. Last-minute cancellations result in stress and inconvenience for patients." Mr Mehan said demand for elective and emergency surgery was increasing throughout the state. "And there is a shortage of nursing staff, particularly of nurses with operating theatre skills," he said.
Australian Medical Association Queensland president Zelle Hodge said last-minute cancellations of elective operations had been "going on for some time" at RBWH. Dr Hodge said the shortage of beds meant Queensland's public hospitals were operating at full capacity and had no room to move should there be a disaster or seasonal fluctuations. "Ideally hospitals should plan to run at 85 per cent capacity to deal with these fluctuations," Dr Hodge said. "But we know the RBWH is constantly running at about 130 per cent capacity. This means patients with serious cancers have to wait. They are being significantly disadvantaged in our public hospital system."
Opposition health spokesman Bruce Flegg said that previously a lack of doctors had been blamed for cancellations. "Now it is a lack of technical staff and nurses to open operating theatre," he said. "This is the same government which has recently spent millions of taxpayers' money on promoting how things have changed inside our public hospitals because of its successful recruitment programs for doctors and nurses."
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Friday, July 07, 2006
YOUR REGULATORS WILL PROTECT YOU (1)
20% of U.S. Transplant Centers Are Found to Be Substandard
About a fifth of federally funded transplant programs fail to meet the government's minimum standards for patient survival or perform too few operations to ensure competency, a Los Angeles Times investigation has found. The U.S. Centers for Medicare and Medicaid Services has allowed 48 heart, liver and lung transplant centers to continue operating despite sometimes glaring and repeated lapses, the newspaper's review found. There are 236 approved centers nationwide.
Although many of the substandard programs treat small numbers of patients, their collective failings carry a significant toll. Consider the latest available statistics, for transplants performed between 2002 and 2004. Nine lung programs failed to meet the minimum Medicare standards for survival, number of surgeries or both. These hospitals accounted for 21 more deaths than would be expected, based on a government-funded analysis of how all patients fare nationwide within a year of surgery. It is adjusted for the condition of the patients and the organs. Three dozen heart transplant programs didn't meet federal standards for survival or volume. They accounted for 43 more deaths than expected. Altogether, the programs examined by The Times had 71 more patients die than expected within a year of transplant.
"The bottom line message is that there are too many programs in the United States that need to be shut down," said Dr. Mark L. Barr, a cardiothoracic transplant surgeon at USC and president of the International Society for Heart and Lung Transplantation.
The disclosure of Medicare's failings follows a series of reports in The Times detailing dangerous lapses in oversight of the national transplant system. Three transplant centers in California have closed since September after their problems came to light. Medicare, which funds most of the nation's transplant centers, requires programs to perform a minimum number of transplants and to achieve a specific survival rate to be certified for funding. The benchmarks vary by organ, and there are none for kidney transplants. Should the programs later fall short, Medicare rules mandate no sanction, only that the programs turn themselves in.
The agency has the authority to pull certification - and therefore funding - from any center that does not meet its standards. But it rarely does. It has cut off funding to 11 centers since 2000. In nearly all of those cases, it moved only after the programs had voluntarily ceased operations, according to federal documents reviewed by The Times. In one case, its decertification came eight months after the program shut down.
Only recently, after The Times began asking detailed questions, did the agency step up its scrutiny. In March, it sent letters to all its approved programs, asking for information about their staffing and performance. It already has found about 25 programs that are "seriously out of compliance" with Medicare standards, said one agency official who spoke on condition of anonymity because the findings are preliminary. Some programs have problems so severe that the agency is considering immediate decertification, the official said. That could force closure.
Some transplant surgeons say Medicare has been too permissive, continuing to support poor-performing programs abandoned by private insurers. "This is a continued artificial bolstering of the programs that shouldn't exist," Barr said. To decertify such programs, he said, "would have been the natural Darwinian process to occur. The weakest in the herd get weeded out." The records of these centers are no secret. The Times identified the 48 programs by examining the total number of transplants performed in 2005 by each Medicare-approved center, as well as the latest survival statistics made public in January by government-funded transplant researchers. All of the information is available on the websites of the United Network for Organ Sharing and the Scientific Registry of Transplant Recipients.
More here
YOUR REGULATORS WILL PROTECT YOU (2)
Rapist doctor back to work in Australia
The Medical Board of Queensland is set to renew the practising rights of a doctor convicted and jailed four years ago for violent criminal offences, including rape. James Samuel Manwaring's probable reprieve under strict conditions imposed by the registration body has appalled his former employer, original complainant Dr Bruce Flegg, and stunned his victim.
Dr Manwaring, who graduated as a medical student from the University of Queensland in 1985, had a history of drug addiction which compromised the care he provided in jobs in Australia, the US and the United Kingdom. He committed his most serious offences in 2000 against a woman, who suffered serious physical injuries and mental trauma. After pleading guilty in late 2002 to rape, attempted rape, deprivation of liberty and assault, Dr Manwaring was told by District Court Judge Brian Hoath that nothing could "excuse your involvement in these offences". "During the course of your sexual assault on the complainant, she suffered multiple bruises and the aggravation of pre-existing degenerative changes in her jaw," Judge Hoath said.
Medical board head Jim O'Dempsey declined to be interviewed late yesterday, but confirmed in a written statement that Dr Manwaring "has met the stipulation of the Health Practitioners Tribunal to be eligible to apply for re-registration". Dr Manwaring could not be contacted late yesterday. The board's statement said that 24 conditions, including the testing of his hair for traces of drugs, would be closely monitored. "It should be noted Dr Manwaring cannot start practice as there are a number of the conditions imposed by the tribunal where he requires board approval prior to commencement of practice," the statement said.
Sources close to the medical board said it had not used its power and discretion to reject Dr Manwaring "despite the inescapable grounds that the man is a convicted and violent criminal with a shocking history as a practitioner".
Dr Flegg, who owned a medical practice before becoming a Liberal Party state MP, yesterday slammed the board's decision as reckless and irresponsible. "Serious violent criminal offences are not compatible with professional standards. I believe the board has been weak and feeble in not wanting to be legally challenged," Dr Flegg said yesterday. "Manwaring is a violent convicted criminal and a serious professional offender. "The board is supposed to be the guardian of standards and public confidence."
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
20% of U.S. Transplant Centers Are Found to Be Substandard
About a fifth of federally funded transplant programs fail to meet the government's minimum standards for patient survival or perform too few operations to ensure competency, a Los Angeles Times investigation has found. The U.S. Centers for Medicare and Medicaid Services has allowed 48 heart, liver and lung transplant centers to continue operating despite sometimes glaring and repeated lapses, the newspaper's review found. There are 236 approved centers nationwide.
Although many of the substandard programs treat small numbers of patients, their collective failings carry a significant toll. Consider the latest available statistics, for transplants performed between 2002 and 2004. Nine lung programs failed to meet the minimum Medicare standards for survival, number of surgeries or both. These hospitals accounted for 21 more deaths than would be expected, based on a government-funded analysis of how all patients fare nationwide within a year of surgery. It is adjusted for the condition of the patients and the organs. Three dozen heart transplant programs didn't meet federal standards for survival or volume. They accounted for 43 more deaths than expected. Altogether, the programs examined by The Times had 71 more patients die than expected within a year of transplant.
"The bottom line message is that there are too many programs in the United States that need to be shut down," said Dr. Mark L. Barr, a cardiothoracic transplant surgeon at USC and president of the International Society for Heart and Lung Transplantation.
The disclosure of Medicare's failings follows a series of reports in The Times detailing dangerous lapses in oversight of the national transplant system. Three transplant centers in California have closed since September after their problems came to light. Medicare, which funds most of the nation's transplant centers, requires programs to perform a minimum number of transplants and to achieve a specific survival rate to be certified for funding. The benchmarks vary by organ, and there are none for kidney transplants. Should the programs later fall short, Medicare rules mandate no sanction, only that the programs turn themselves in.
The agency has the authority to pull certification - and therefore funding - from any center that does not meet its standards. But it rarely does. It has cut off funding to 11 centers since 2000. In nearly all of those cases, it moved only after the programs had voluntarily ceased operations, according to federal documents reviewed by The Times. In one case, its decertification came eight months after the program shut down.
Only recently, after The Times began asking detailed questions, did the agency step up its scrutiny. In March, it sent letters to all its approved programs, asking for information about their staffing and performance. It already has found about 25 programs that are "seriously out of compliance" with Medicare standards, said one agency official who spoke on condition of anonymity because the findings are preliminary. Some programs have problems so severe that the agency is considering immediate decertification, the official said. That could force closure.
Some transplant surgeons say Medicare has been too permissive, continuing to support poor-performing programs abandoned by private insurers. "This is a continued artificial bolstering of the programs that shouldn't exist," Barr said. To decertify such programs, he said, "would have been the natural Darwinian process to occur. The weakest in the herd get weeded out." The records of these centers are no secret. The Times identified the 48 programs by examining the total number of transplants performed in 2005 by each Medicare-approved center, as well as the latest survival statistics made public in January by government-funded transplant researchers. All of the information is available on the websites of the United Network for Organ Sharing and the Scientific Registry of Transplant Recipients.
More here
YOUR REGULATORS WILL PROTECT YOU (2)
Rapist doctor back to work in Australia
The Medical Board of Queensland is set to renew the practising rights of a doctor convicted and jailed four years ago for violent criminal offences, including rape. James Samuel Manwaring's probable reprieve under strict conditions imposed by the registration body has appalled his former employer, original complainant Dr Bruce Flegg, and stunned his victim.
Dr Manwaring, who graduated as a medical student from the University of Queensland in 1985, had a history of drug addiction which compromised the care he provided in jobs in Australia, the US and the United Kingdom. He committed his most serious offences in 2000 against a woman, who suffered serious physical injuries and mental trauma. After pleading guilty in late 2002 to rape, attempted rape, deprivation of liberty and assault, Dr Manwaring was told by District Court Judge Brian Hoath that nothing could "excuse your involvement in these offences". "During the course of your sexual assault on the complainant, she suffered multiple bruises and the aggravation of pre-existing degenerative changes in her jaw," Judge Hoath said.
Medical board head Jim O'Dempsey declined to be interviewed late yesterday, but confirmed in a written statement that Dr Manwaring "has met the stipulation of the Health Practitioners Tribunal to be eligible to apply for re-registration". Dr Manwaring could not be contacted late yesterday. The board's statement said that 24 conditions, including the testing of his hair for traces of drugs, would be closely monitored. "It should be noted Dr Manwaring cannot start practice as there are a number of the conditions imposed by the tribunal where he requires board approval prior to commencement of practice," the statement said.
Sources close to the medical board said it had not used its power and discretion to reject Dr Manwaring "despite the inescapable grounds that the man is a convicted and violent criminal with a shocking history as a practitioner".
Dr Flegg, who owned a medical practice before becoming a Liberal Party state MP, yesterday slammed the board's decision as reckless and irresponsible. "Serious violent criminal offences are not compatible with professional standards. I believe the board has been weak and feeble in not wanting to be legally challenged," Dr Flegg said yesterday. "Manwaring is a violent convicted criminal and a serious professional offender. "The board is supposed to be the guardian of standards and public confidence."
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Thursday, July 06, 2006
CALIFORNIA PANDERS TO THE MERCURY FREAKS
Probably wise if it lifts vaccination rates
Vaccines containing a mercury-based preservative are now largely off-limits to children under 3 and pregnant women in California. The only exception to the new state law, which took effect on Saturday, is the vaccine against Japanese encephalitis virus, a deadly mosquito-borne illness endemic to certain parts of Asia. The new law, by Fran Pavley, D-Agoura Hills, was aimed at reducing the risk of neurodevelopmental problems such as autism, which many parents believe can be traced to exposure to thimerosal, long used as a preservative in many vaccines.
Several large federal studies have shown no link between childhood vaccines and autism, but additional research is continuing. The U.S. Public Health Service and the American Academy of Pediatrics in 1999 began to advocate the elimination of thimerosal from vaccines because some infants who received them were exposed to mercury at levels that exceeded Environmental Protection Agency guidelines. Except for trace amounts, which are allowable under the new law, thimerosal has been removed from childhood vaccines.
The flu vaccine had been an exception. But concerns about its safety re-emerged in 2004, after the federal government recommended that babies between 6 months and 2 years be added to the list of those who should get annual flu shots. Aventis Pasteur, the company that manufactures the lion's share of flu vaccine, has increased the supplies of its thimerosal-free version in response to demand. "Based on what we know, we anticipate there will be an adequate supply of thimerosal-free flu vaccine for pregnant women and children under 3," said Department of Health Services spokesman Ken August.
The state has ordered 684,480 doses of flu vaccine to be distributed to counties for the upcoming season. The total includes 50,000 doses of thimerosal-free vaccine for children ages 1-3 and 15,000 doses for pregnant women. In addition, the state ordered 10,000 doses of FluMist, also thimerosal-free, for use in healthy people ages 5-49.
Aventis had opposed the Pavley bill, citing in a statement concerns that the ban could "undermine public confidence in immunization and ultimately deprive children of access to needed influenza vaccine." In response to industry worries and related concerns cited by the American Academy of Pediatrics, the legislation ultimately was amended to give the industry more time to stock up on thimerosal-free flu vaccine. The new law also allows for exceptions when no other alternatives are available or during public health emergencies.
August said Kim Belshe, health and human services secretary, issued an exception for the Japanese encephalitis virus vaccine: "Given the absence of a mercury-free vaccine against Japanese encephalitis virus and because the risks of fatal disease or brain injury far exceed any risk of mercury in the vaccine, the secretary is exercising her authority and temporarily exempting the vaccine from the provision of the law for a 12-month period." About 50,000 cases of the disease are reported annually in Asia. There is no cure, and up to 25 percent of those infected die from the disease.
August said that California distributes about 32,000 doses of the three-dose vaccine annually. Last year, 19,000 went to the military and the rest to people traveling to certain parts of Asia. It is unknown how many of those doses went to very young children or pregnant women.
Source
Bad bill of health for Queensland
Services provided by Queensland public hospitals have deteriorated during the tenure of the Beattie Government, and new national data rates the performance of the state's hospitals as among the worst in Australia. Released yesterday, the State of Our Public Hospitals June 2006 Report measures each state against its performance in 1998-99 and 2004-05.
Premier Peter Beattie said yesterday that he had not seen the report, but dismissed the findings, saying they were based on old figures. Mr Beattie said his Government had increased funding in October's mini-Budget and again in this year's Budget. "We've dramatically increased funding . . . $9 billion extra over the next five years," he said.
However, the report does provide a report card on the first seven years of his Government, according to the state Opposition and the Australian Medical Association. When Mr Beattie was elected in 1998, the number of people being admitted to public hospitals was above the national average. In 2004-05, the number admitted was 9 per cent lower than the national average. Public hospital beds reflect a similar trend. In 1998-99, Queensland had more hospital beds than the national average. But by 2004-05, it was below the national average. In terms of funding, in 1998-99, public patients in Queensland received only 81 per cent of the national average. This had declined to 79.8 per cent by 2004-05. Even the area of elective surgery, in which Queensland was rated the best in the country, has recorded a similar fall -- from 16 per cent above the national average in 1998-99 to just above the national average in 2004-05.
Federal Health Minister Tony Abbott was critical of the information provided by Queensland on elective surgery. "The report is only as good as the quality of the information provided by the states. If the states give us dodgy information then we will get a dodgy result," Mr Abbott said.
AMA Queensland president Zelle Hodge acknowledged that the report had come out before the recent mini-Budget which increased public hospital funding. In spite of this, she said the report showed Queensland still had "a very, very, very long way to go". Dr Hodge said most of the recent health funding increases had gone in salaries and did not address the critical shortage of beds which was now affecting the provision of services in public hospitals.
Source
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Probably wise if it lifts vaccination rates
Vaccines containing a mercury-based preservative are now largely off-limits to children under 3 and pregnant women in California. The only exception to the new state law, which took effect on Saturday, is the vaccine against Japanese encephalitis virus, a deadly mosquito-borne illness endemic to certain parts of Asia. The new law, by Fran Pavley, D-Agoura Hills, was aimed at reducing the risk of neurodevelopmental problems such as autism, which many parents believe can be traced to exposure to thimerosal, long used as a preservative in many vaccines.
Several large federal studies have shown no link between childhood vaccines and autism, but additional research is continuing. The U.S. Public Health Service and the American Academy of Pediatrics in 1999 began to advocate the elimination of thimerosal from vaccines because some infants who received them were exposed to mercury at levels that exceeded Environmental Protection Agency guidelines. Except for trace amounts, which are allowable under the new law, thimerosal has been removed from childhood vaccines.
The flu vaccine had been an exception. But concerns about its safety re-emerged in 2004, after the federal government recommended that babies between 6 months and 2 years be added to the list of those who should get annual flu shots. Aventis Pasteur, the company that manufactures the lion's share of flu vaccine, has increased the supplies of its thimerosal-free version in response to demand. "Based on what we know, we anticipate there will be an adequate supply of thimerosal-free flu vaccine for pregnant women and children under 3," said Department of Health Services spokesman Ken August.
The state has ordered 684,480 doses of flu vaccine to be distributed to counties for the upcoming season. The total includes 50,000 doses of thimerosal-free vaccine for children ages 1-3 and 15,000 doses for pregnant women. In addition, the state ordered 10,000 doses of FluMist, also thimerosal-free, for use in healthy people ages 5-49.
Aventis had opposed the Pavley bill, citing in a statement concerns that the ban could "undermine public confidence in immunization and ultimately deprive children of access to needed influenza vaccine." In response to industry worries and related concerns cited by the American Academy of Pediatrics, the legislation ultimately was amended to give the industry more time to stock up on thimerosal-free flu vaccine. The new law also allows for exceptions when no other alternatives are available or during public health emergencies.
August said Kim Belshe, health and human services secretary, issued an exception for the Japanese encephalitis virus vaccine: "Given the absence of a mercury-free vaccine against Japanese encephalitis virus and because the risks of fatal disease or brain injury far exceed any risk of mercury in the vaccine, the secretary is exercising her authority and temporarily exempting the vaccine from the provision of the law for a 12-month period." About 50,000 cases of the disease are reported annually in Asia. There is no cure, and up to 25 percent of those infected die from the disease.
August said that California distributes about 32,000 doses of the three-dose vaccine annually. Last year, 19,000 went to the military and the rest to people traveling to certain parts of Asia. It is unknown how many of those doses went to very young children or pregnant women.
Source
Bad bill of health for Queensland
Services provided by Queensland public hospitals have deteriorated during the tenure of the Beattie Government, and new national data rates the performance of the state's hospitals as among the worst in Australia. Released yesterday, the State of Our Public Hospitals June 2006 Report measures each state against its performance in 1998-99 and 2004-05.
Premier Peter Beattie said yesterday that he had not seen the report, but dismissed the findings, saying they were based on old figures. Mr Beattie said his Government had increased funding in October's mini-Budget and again in this year's Budget. "We've dramatically increased funding . . . $9 billion extra over the next five years," he said.
However, the report does provide a report card on the first seven years of his Government, according to the state Opposition and the Australian Medical Association. When Mr Beattie was elected in 1998, the number of people being admitted to public hospitals was above the national average. In 2004-05, the number admitted was 9 per cent lower than the national average. Public hospital beds reflect a similar trend. In 1998-99, Queensland had more hospital beds than the national average. But by 2004-05, it was below the national average. In terms of funding, in 1998-99, public patients in Queensland received only 81 per cent of the national average. This had declined to 79.8 per cent by 2004-05. Even the area of elective surgery, in which Queensland was rated the best in the country, has recorded a similar fall -- from 16 per cent above the national average in 1998-99 to just above the national average in 2004-05.
Federal Health Minister Tony Abbott was critical of the information provided by Queensland on elective surgery. "The report is only as good as the quality of the information provided by the states. If the states give us dodgy information then we will get a dodgy result," Mr Abbott said.
AMA Queensland president Zelle Hodge acknowledged that the report had come out before the recent mini-Budget which increased public hospital funding. In spite of this, she said the report showed Queensland still had "a very, very, very long way to go". Dr Hodge said most of the recent health funding increases had gone in salaries and did not address the critical shortage of beds which was now affecting the provision of services in public hospitals.
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
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Wednesday, July 05, 2006
BRITAIN NOW HAS A "SURPLUS" OF NURSES (AS WELL AS DOCTORS)
Because the overspent NHS has now sacked so many of them and cannot afford to hire as many as are needed
Nurses from outside the EU will require work permits to take up jobs in the NHS, in a move designed to give homegrown nursing graduates a better chance of getting a job. Nearly 11,500 foreign nurses came to Britain from outside the EU in 2004-05, the last year for which complete records are available. India supplied the most, followed by the Philippines and Australia. Now it will be difficult for others to come, because a work permit will be granted only if a job cannot be filled by British or EU applicants. The rule removes nurses from the Home Office shortage occupation list and applies to nurses in bands 5 and 6 — those who have between a few months and 18 months’ experience.
The move is a reaction to a growing surplus of nurses, which has made it harder for many British graduates to find a job; but the Royal College of Nursing (RCN) was critical. Dr Beverly Malone, general secretary of the RCN, said: “International nurses have always been there for the UK in times of need and it beggars belief that they are now being made scapegoats for the current deficits crisis. “Removing nursing from the list of recognised shortage professions is short-termism in the worst possible sense. We know that the vast majority of international nurses are employed in bands 5 and 6, the very bands which are going to be affected. “If this goes ahead, I guarantee that the effects will be far-reaching and immediate. Over 150,000 nurses are due to retire in the next five to ten years and we will not replace them with homegrown nurses alone.”
Lord Warner, the Health Minister, said that large-scale recruitment of international nurses was only ever intended to be a short-term measure. Extra investment in training meant that there was no longer a need to hire junior nurses from abroad, he said. The change does not affect nurses already working in Britain and there would still be specialist nursing vacancies.
Last week a survey of 20 universities by the Council of Deans showed that more than 80 per cent of nurses qualifying this summer have yet to find a job, compared with 30 per cent at this time last year. The council, which represents the universities who train nurses, said that the situation was very serious. It showed, for example, that only a quarter of students who have already graduated from one London university have found work, while just 5 per cent from a midwifery faculty in the North East have secured a post. Andrew Murrison, the Shadow Health Minister, said: “This move is presumably designed to save the Government’s blushes as hospitals cut jobs and freeze nursing posts in a desperate attempt to resolve deficits.”
Source
PAIN IN GERMANY
With the country distracted by the prospect of tomorrow's World Cup semi-final against Italy, Angela Merkel's Government quietly announced the most painful reform yet of the national health system. The overhaul - immediately denounced as suspect, inadequate and antisocial by the opposition - came after all-night negotiations between the Christian Democrats and the Social Democrats, the two governing parties.
The health reforms provide for compulsory health insurance for all children - at an extra cost next year of 1.5 billion Euros - which has been a long-standing aim of the Social Democrats. However, Frau Merkel, the Chancellor, insisted that this could not be financed through yet another tax increase. So health insurance contributions for the whole nation will go up by 0.5 per cent from next year.
The reforms were vehemently criticised by the state insurers, patients' associations and by employers. Big business argues that it will become even more expensive to hire new employees.
The fundamental aim of the change is to give more choice to patients and to meet the huge costs of prescribed medicines.
Economists predict that from January next year domestic demand in Germany is likely to dribble away as consumers are squeezed by higher taxes. Political analysts predict that the Government will run into trouble in the second half of the year. "I don't see how this current line-up can hope to last the course," Herr Westerwelle said.
More here
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Because the overspent NHS has now sacked so many of them and cannot afford to hire as many as are needed
Nurses from outside the EU will require work permits to take up jobs in the NHS, in a move designed to give homegrown nursing graduates a better chance of getting a job. Nearly 11,500 foreign nurses came to Britain from outside the EU in 2004-05, the last year for which complete records are available. India supplied the most, followed by the Philippines and Australia. Now it will be difficult for others to come, because a work permit will be granted only if a job cannot be filled by British or EU applicants. The rule removes nurses from the Home Office shortage occupation list and applies to nurses in bands 5 and 6 — those who have between a few months and 18 months’ experience.
The move is a reaction to a growing surplus of nurses, which has made it harder for many British graduates to find a job; but the Royal College of Nursing (RCN) was critical. Dr Beverly Malone, general secretary of the RCN, said: “International nurses have always been there for the UK in times of need and it beggars belief that they are now being made scapegoats for the current deficits crisis. “Removing nursing from the list of recognised shortage professions is short-termism in the worst possible sense. We know that the vast majority of international nurses are employed in bands 5 and 6, the very bands which are going to be affected. “If this goes ahead, I guarantee that the effects will be far-reaching and immediate. Over 150,000 nurses are due to retire in the next five to ten years and we will not replace them with homegrown nurses alone.”
Lord Warner, the Health Minister, said that large-scale recruitment of international nurses was only ever intended to be a short-term measure. Extra investment in training meant that there was no longer a need to hire junior nurses from abroad, he said. The change does not affect nurses already working in Britain and there would still be specialist nursing vacancies.
Last week a survey of 20 universities by the Council of Deans showed that more than 80 per cent of nurses qualifying this summer have yet to find a job, compared with 30 per cent at this time last year. The council, which represents the universities who train nurses, said that the situation was very serious. It showed, for example, that only a quarter of students who have already graduated from one London university have found work, while just 5 per cent from a midwifery faculty in the North East have secured a post. Andrew Murrison, the Shadow Health Minister, said: “This move is presumably designed to save the Government’s blushes as hospitals cut jobs and freeze nursing posts in a desperate attempt to resolve deficits.”
Source
PAIN IN GERMANY
With the country distracted by the prospect of tomorrow's World Cup semi-final against Italy, Angela Merkel's Government quietly announced the most painful reform yet of the national health system. The overhaul - immediately denounced as suspect, inadequate and antisocial by the opposition - came after all-night negotiations between the Christian Democrats and the Social Democrats, the two governing parties.
The health reforms provide for compulsory health insurance for all children - at an extra cost next year of 1.5 billion Euros - which has been a long-standing aim of the Social Democrats. However, Frau Merkel, the Chancellor, insisted that this could not be financed through yet another tax increase. So health insurance contributions for the whole nation will go up by 0.5 per cent from next year.
The reforms were vehemently criticised by the state insurers, patients' associations and by employers. Big business argues that it will become even more expensive to hire new employees.
The fundamental aim of the change is to give more choice to patients and to meet the huge costs of prescribed medicines.
Economists predict that from January next year domestic demand in Germany is likely to dribble away as consumers are squeezed by higher taxes. Political analysts predict that the Government will run into trouble in the second half of the year. "I don't see how this current line-up can hope to last the course," Herr Westerwelle said.
More here
***************************
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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
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