New EU working laws will be disaster for NHS
Changes to hospital working hours which come into force this summer under European law will be "disastrous" for patient care and result in "major service failure", Britain's top surgeon has warned.
John Black, president of the Royal College of Surgeons, has issued a dramatic warning that the National Health Service will not be able to cope with the effects of the controversial European Working Time Directive. From August, hospitals face heavy fines if they allow any health care staff, including surgeons, to work more than 48 hours a week, despite warnings from hospitals that they are not able to make the change. In his February newsletter, Mr Black said the new rules were "an impending disaster" which will "devastate" medical training because no surgeon will be able to work a shift long enough to gain proper experience.
The multiple handovers of staff needed to comply with the rules will mean that patients do not see the same doctor for more than a few hours, he said. And he warned there could be "dangerous" lapses in patient care, especially at night. "With nobody able to work more than 48 hours a week from August, the effects on patient care in the NHS are potentially disastrous," Mr Black said. "Out-of-hours cover will be so thin, on occasions non-existent, that major service failure with unplanned reconfiguration of services appears inevitable. "It is well known that dangerous incidents are far more likely to happen at night and weekends, and this will get worse with even fewer doctors available. "This is not to mention the dangers of multiple handovers or the frustration and alarm felt by patients who rarely see the same doctor for more than a few hours. This is all being done under social chapter legislation, supposed to make people's lives better."
Mr Black is meeting Alan Johnson, the Health Secretary, in February to propose a "speciality opt-out" and an upper limit on surgeons' hours of 65 to 70 hours a week. "I have no doubt we will be told that it is impossible to alter or bypass the European law. I do not believe this. All manner of EC law must have been bent or ignored in nationalising a bank in 24 hours. The Government can do it if it has the political will," Mr Black said.
The European Working Time Directive has proved a massive challenge for the NHS since it was introduced in 1998. At first, certain staff were exempt, but a 58-hour limit was introduced in 2004, falling to 56 in 2007 with the final drop to 48 required by August 2009. With time running out to make the changes to rotas needed, a survey of hospital trusts in November last year found that only 18% were hitting the 48 hour limit.
A Department of Health spokesperson said: "A few hospitals have implemented the maximum 48 hour week across all rotas. We are monitoring the situation as some smaller specialities and isolated hospitals may find meeting the deadline more challenging."
SOURCE
Australia: The "caring" Leftist mania for closing down public hospitals continues
Yesterday it was Queensland. Today it is South Australia. And once again the bureaucrats think they know better than the doctors. They didn't even bother talking to the doctors! My suspicion is that some Leftist hater just didn't like the "Royal" in the name of the existing hospital. They are small-minded enough for that. Witness all their whining about politically correct words
Eminent medical specialists have launched a campaign to save the Royal Adelaide Hospital, saying the city does not need the planned $1.7 billion Marjorie Jackson-Nelson Hospital. A group of respected senior doctors who have spent the past year "brooding and alarmed" have decided to go public with their opposition and have formed a committee dedicated to saving the RAH from being bulldozed. "We want genuine discussion about whether the RAH really needs to be closed," spokesman Dr James Katsaros said yesterday. "We have a responsibility to look at whether we are making a terrible mistake in spending $1.7 billion on something that is not needed while erasing an iconic institution. ". . . as senior members of the medical community we came to the view that if we did not stand up against this lunancy, no one would. "We have been brooding on this for a long time, whispering in corridors and over coffees about the madness of the plan, which was announced without consultation with the medical community."
The "Save the RAH Medical Committee" says the state does not need a new hospital and the RAH's patient accommodation could be upgraded for far less than the Marj's ballooning $1.7bn cost - and the work completed far earlier than the Marj's 12-year time frame. The Save the RAH group includes leading and retired orthopaedic surgeons, cardiologists, plastic surgeons, oncologists and pathologists, as well as people who have held representative positions such as Australian Medical Association office holders. Members so far include Dr Peter Hetzel, Dr John Sangster, Dr Daryl Teague, Dr Francis Ghan, Dr Randall Sach, Dr Peter Malycha, Dr Philip Harding and Dr Katsaros.
The committee is holding a meeting for the medical fraternity at the RAH on March 16 to discuss the issues and see if there is genuine support for the new hospital. If the meeting shows a lack of support for the Marj, the committee will widen the debate to public meetings. The key concerns of the Save the RAH group include:
A LACK of consultation by the State Government with the medical community or the AMA before the plan was announced;
A LACK of convincing arguments in favour of building the Marj;
MISINFORMATION about the state of the RAH, which they say has been substantially upgraded in recent years;
DESTRUCTION of the close working relationship between the RAH, Adelaide University Medical School, Hanson Institute and Institute of Medical and Veterinary Science, which are all on the one city campus;
ABOLITION of the brand name "Royal Adelaide Hospital" - world famous within medical circles.
Dr Katsaros, committee chairman and director of the plastic and reconstructive surgery at the RAH, said the group represented conservative people who otherwise would not want to be caught in a political row. "There was no review to see if it was actually needed, no public debate, just an announcement," he said. "We have been alarmed ever since the announcement was suddenly made and the discussions among doctors have been ones of alarm and incredulity. "Being conservative, it has taken a while to band together and go public, but we have to show leadership and generate genuine discussion about whether we need a new hospital. "While we as senior doctors feel we must stand up, we also have the support of many junior staff as well as nurses and allied health workers who believe the RAH should be retained. "I believe we do not need a new hospital at all; but if the overwhelming view of the medical community after we have discussions is that we do need one, then we will say `so be it' and move on."
Dr Katsaros noted the RAH was world respected, both in facilities and in name that also promoted the city. "The RAH has a brand new emergency (department), which is state-of-the-art, an intensive care area the envy of most hospitals, a world-class burns unit, modern dialysis unit and so on," he said. "Every hospital has to start planning upgrades virtually as soon as they are built, but the RAH right now is at a point where the most urgent thing is a new patient accommodation wing. "That could be built for around $300 million, rather than $1.7 billion, and could be completed in a couple of years rather than waiting 12 years."
The committee will meet AMA officials this week with a request it notify members of the March 16 meeting in the hope of having the largest possible number of the medical fraternity on hand to voice their opinions about whether a new hospital is needed.
Dr Katsaros said the Marj announcement came without any review into whether it was needed. "The existing institution can be refurbished and rejuvenated, as was done in the 1960s when a larger RAH was rebuilt on site without major problems," he said. Dr Katsaros emphasised the RAH name was a respected and valuable brand name for SA. "Can you imagine the folk in Minnesota bulldozing the Mayo Clinic and building the Michael Jordan Hospital 1km away?" he said. "They'd be a laughing stock."
SOURCE
Australia: And a corrupt hospital system in Victoria too
A SENIOR Victorian doctor will this week use a parliamentary inquiry to blow the whistle on alleged corruption, negligence and bureaucratic bungling in our public health-care system. Peter Lazzari is to release a report that says a "deepening crisis in our hospitals" is costing hundreds of Victorian lives every year. Dr Lazzari, head of an acute unit of medicine at Angliss Hospital and deputy chair of the Victorian State Committee of the Royal Australian College of Physicians, says a deteriorating standard of care and training is responsible for more than 500 deaths each year. In a submission to the Upper House Parliamentary Inquiry Into Public Hospital Performance Data, Dr Lazzari is to:
ACCUSE the Brumby Government and health executives of incompetence and intimidation of doctors, calling medical service directors "doctors of death".
CLAIM nurses are frequently violently and sometimes sexually assaulted by patients and that hospital administrators leave them without protection, "terrified" and "alone" at the bedside.
ACCUSE hospital boards and bosses of deliberate and "widespread cruelty to patients, doctors and nurses".
REVEAL several hospital buildings are putting patients' lives at risk because they are riddled with asbestos, have "crumbling internal walls" and have operating theatres that shake when trucks pass.
In a separate submission, Dr Lazzari will tackle "fraudulent waiting list reporting", claiming many hospitals "fudge" waiting list figures, to avoid penalties and claim government bonuses. He says hospitals tweak elected surgery waiting lists for up to a year, then claim it was the patients' choices. Others keep a second set of waiting lists and only enter them into the system when beds are available. He says it is "sentencing patients to pain, suffering and death". Both reports, expected to be released within days, call for major reforms.
SOURCE
Monday, January 19, 2009
Sunday, January 18, 2009
Another reduction of medical services in a socialized medical system
In both Britain and Australia, "caring" Leftist governments have a mania for closing down hospitals and shrinking the number of beds available. The pretext is that they want to combine several hospitals into one to provide bigger, better and brighter services. It is utter crap, of course. It is about cost-cutting and nothing else. Standards decline rather than rise. We see the latest iteration of this "compassionate" Leftist policy in Queensland, Australia, where the government wants to replace two childrens' hospitals with one new one. Result? Everyone is going to be shortchanged. Even the size of consulting rooms has been reduced to the point where they are too small to fit a wheelchair in. And this is a hospital?
One of Queensland's leading doctors sent a disturbing email to nearly 100 colleagues that was leaked to me last week. Dr Brent Masters, a specialist in respiratory medicine at the Royal Children's Hospital asked if anyone was happy with the planned move to the new Queensland Children's Hospital. The planning process was "truly getting out of hand", he wrote. "I recommend you all read the book On Bullshit: you can buy it at the Medical School bookshop for about $15," he said. "It points out that basing decisions on bullshit are (sic) fraught with dire consequences - indeed worse than basing decisions on lies . . .
"The complete lack of intellectual honesty has let pediatrics down badly in this state . . . "I again point out that this hospital should not be about secondary level pediatrics (the bullshit factor) but about tertiary pediatrics: You can not have a world class hospital based on secondary-level pediatrics." Then he gave an ominous warning about underfunded hospitals. "You can cross the road 100 times with your eyes closed and you will get away with it 90 times," he said.
Despite some positive announcements on the new hospital this week, Dr Masters, like many other specialists, remains sceptical. He has to be. He leads a team treating 350 young cystic fibrosis patients. "People come from all over the world to train with them," said a doctor. They are that good." He is backed up by Dr Ann Chang, a leading researcher and devout Catholic who is a world authority on respiratory disease. This week Chang is in Darwin and soon she heads to New York and Miami to present papers to international medical forums.
For Dr Masters it is a demanding clinical load. CF is an unforgiving genetic disease characterised by frequent lung infections. It is incurable. Even lung transplants have only a 50 per cent success rate. Masters and Chang fear the new hospital simply doesn't have enough space to treat existing cases, let alone the 125 new cases who will come onstream in the next five years. And hospital planners neither seem to understand nor care about necessary research. This is a common complaint among specialists, from pathology to neurology.
Gastroenterologists fear they have been sidelined by planners who "stole" some of their space for respiratory medicine. "Gastroenterology is seriously compromised at QCH, with the complete disintegration of our diagnostic unit," said Dr Looi Ee last week.
Doctors practising nuclear medicine and medical imaging fear they, too, have been short-changed, with not enough MRI scanners.
Professor Jenny Batch told colleagues she needed rooms for diabetics and growth hormone therapy and a permanent patient-family education centre. "I share the concerns that there will not be adequate rooms," she said in another email leaked to me.
Space shortages also worried Dr Jane Peake, a pediatric immunologist who deals in allergies, eczema and auto-immune deficiencies. She feared there would not even be enough space to store research papers. She thought she was looking at a "poorly designed rabbit warren" with "small and grossly inadequate consulting rooms".
Dr Kate Sinclair agrees. She says proposed, open-plan office space will be unsuitable. Privacy will be endangered and deeply personal conversations with patients will be difficult.
Several doctors also questioned plans to cut queues at the new hospital by running clinical sessions in a day starting at 7am and finishing at 8pm.
Dr Lynne McKinlay, the director of pediatric rehabilitation at the Royal, noted the apparent lack of large consulting rooms. She said rooms would be "unsuitable" for children who arrived with both parents, siblings and a stroller, "let alone children who come with wheelchairs and walkers".
The proposed research centre remains unfunded and clinicians in allied health, genetics and dentistry believe their patients, too, will suffer in the shift to South Brisbane.
SOURCE
Socialized health care fundamentally changes the relationship between citizens and state
For most of our nation's history, our approach to economics has favored enterprise, self-reliance and the free market. While the American economy has never been entirely laissez-faire, we have historically cared more about equality of opportunity than equality of results. And while Americans have embraced elements of the New Deal, the Great Society and progressive taxation, we have traditionally viewed welfare as a way to help those in dire need, not as a way of life for the middle class. We have grasped, perhaps more than any other nation, that there is a long-run cost to dependency on the state, including an aversion to risk that eventually enervates the entrepreneurial spirit necessary for innovation and prosperity.
This outlook, once assumed, is now under attack due to a recent series of political and economic events. The first is the unprecedented intervention by the federal government, in the form of a $700 billion relief package intended for our financial institutions after the credit crisis last September. This was followed by extending billions of dollars of federal assistance to America's auto makers in order to prevent their imminent bankruptcy -- the first emergency bailout that went to companies outside the financial sector. We understand why the federal government did this, and even supported legislation that, while hardly perfect, prevented an economic meltdown.
Nonetheless, the consequences of this undertaking are enormous. Not only has the size of the expenditures been staggering -- there is talk of another stimulus package worth an estimated $825 billion -- but we are witnessing a fundamental transformation of government's relationship with the polity and the economy.
The last several months are a foreshadowing of a new era of government activism, rather than an unfortunate but necessary (and anomalous) emergency action. We will soon shift from a market-based economy to a political one in which the government picks winners and losers and extends its reach and power in unprecedented ways.
This shift is exemplified by the desire of President-elect Barack Obama and the Democratic Congress to push us toward government-run health care. For all his talk of allowing consumers to select their own health-care coverage, Mr. Obama's proposal, as he laid it out in his campaign, will provide strong financial incentives for employers and individuals to sign up with a new, Medicare-style government plan for working-age people and their families. This plan will almost certainly use a price-control system similar to the one in place for Medicare, allowing it to charge artificially low premiums by paying fees well below private rates. These low premiums will serve as a magnet for enrollment and will devastate the private companies trying to compete in the health-insurance market. The result will be the nationalization of the health-care sector, which today accounts for 16% of U.S. gross domestic product.
Nationalizing health care will be profoundly detrimental to the quality of American medicine. In the name of cost control, the government would make private investment in medical innovation far riskier, and thus delay the development of potentially lifesaving treatments.
It will also put America on a glide path toward European-style socialism. We need only look to Great Britain and elsewhere to see the effects of socialized health care on the broader economy. Once a large number of citizens get their health care from the state, it dramatically alters their attachment to government. Every time a tax cut is proposed, the guardians of the new medical-welfare state will argue that tax cuts would come at the expense of health care -- an argument that would resonate with middle-class families entirely dependent on the government for access to doctors and hospitals.
Of course, this health-care plan is occurring against our particular fiscal backdrop: Without major reform, our federal entitlement programs will soon double the size of government. The result will be a crushing burden of debt and taxes. In short, we may be approaching a tipping point for democratic capitalism.
While the scope of the challenge should not be underestimated, those of us worried about this fundamental reorientation of politics and economics have several things working in our favor. Among them is that a public accustomed to iTunes, Facebook, Google, eBay, Amazon and WebMD is not clamoring for centralized, bureaucratic government. The strong American instinct for individual initiative and entrepreneurship remains intact. In addition, confidence in government -- from Congress to those responsible for oversight of the financial system -- is quite low.
Our sense is that at the moment, the public is not thinking in terms of "big government" or "small government." Instead, Americans want efficient government -- one that is modern, responsive and adaptive. People want government to act as a fair referee, providing guardrails that allow individuals to rise without intrusively dictating individual decisions.
If conservatives hope to win converts to our cause, we need to understand this new moment and put forward an agenda that reforms key institutions in a way that advances individual freedom, without creating an unacceptable level of insecurity. This is no easy task, and it must begin with providing a compelling alternative to what contemporary liberalism and Mr. Obama are about to offer. This especially includes health care, where we must start by recalling that our current health-insurance system was designed to meet the needs of a 20th century economy and World War II-era employment laws. It is hopelessly outdated, yet the Obama plan would make the system even more sclerotic.
The core of our message needs to be a commitment to creating a health-care plan that meets the demands of the modern economy. We need to convince concerned citizens that we can help the uninsured find coverage in the private sector and use market incentives to contain costs. The result will be a system that makes it possible for everyone to afford health insurance, including those with pre-existing conditions. Tax credits, high-risk pools, insurance choice and regulatory reform can form the basis of a transformation from today's enormously costly and inefficient third-party system into one driven by ownership, choice and competition. And at the nucleus of this redesigned system will be the patient-doctor relationship.
If we hope to succeed in making our case, it will require a concerted education campaign that relies on hard data and facts, rigorous and accessible public arguments, and persuasive public advocates. This is quite a tall order. But if we do not succeed in resisting greater state involvement in the economy -- and health care is meant to be the beachhead of this effort -- we will move from a limited welfare state into a full-blown one. This will reshape, in deep and enduring ways, our nation's historic sensibilities. It will lead here, as it has elsewhere, to passivity and dependence on the state. Such habits, once acquired, are hard to shake. Between now and the end of this decade may be one of those rare moments in which among other things will turn decisively one way or the other. The stakes could hardly be higher for our way of life.
SOURCE
Embryo screening funding is 'postcode lottery' in Britain, researchers say
Handicapped children are a better deal, apparently. Amazingly short-sighted thinking. But that's governments for you
More than half of couples seeking embryo screening to protect their offspring from inherited genetic diseases such as breast cancer are being prevented from doing so, researchers say. Evidence from one of the country's leading gene-screening clinics suggests that local health authorities frequently refuse to fund treatment for patients who wish to avoid passing defective genes to their children.
Scientists predict an increase in demand for the technique, known as preimplantation genetic diagnosis (PGD), after the start of a pilot programme screening an entire adult community for faulty genes. The Times revealed last week that the London community of Ashkenazi Jews is being offered screening for BRCA genes that raise risks of breast, ovarian and prostate cancers. Britain's first baby screened to ensure that it was free of a genetic risk of breast cancer carried by a parent was born last week, and hailed as an important advance in the fight against genetic disease. The girl was born after embryos created through IVF treatment were screened to exclude the faulty BRCA1 gene.
PGD, which costs between 5,000 and 20,000 pounds, depending on the number of IVF cycles required, is available to dozens of selected couples each year who wish to have children but do not want to run the risk of passing on potentially fatal disorders to their offspring. It is licensed for more than 60 different conditions, including cystic fibrosis, Huntington's disease and some forms of cancer, which are triggered when a child inherits a key genetic mutation from one of its parents.
Joy Delhanty, Professor of Human Genetics at the University College London PGD centre, said that many couples were being refused NHS funding because the technique had not been considered by the National Institute for Health and Clinical Excellence (NICE), the value-for-money watchdog. "Funding for the procedure is a postcode lottery. More than 100 couples a year are referred to us from all over the country but more than 50 per cent have problems with funding in the absence of guidelines from NICE. "If local PCTs [primary care trusts] do not see this as a priority then they do not provide funding, it is as simple as that, but they do not consider the potential money they save by ensuring a child will be free of a disease."
Professor Delhanty declined to name individual trusts but said that couples living in the North of England seemed to have a greater chance of PGD applications being funded by their local PCT, while those living in London and the South East may be forced to pay thousands of pounds for private treatment.
Only a few hundred couples a year are eligible for PGD. To benefit from the technique, families must first know that they have a defective gene, usually discovered through a recurring family history of illness. Once the risk is confirmed by a clinical geneticist, embryos generated and fertilised through IVF treatment can then be screened and implanted in the womb if they are free of the faulty gene.
The Department of Health said last night: "PGD is available on the NHS but is considered on a case by case basis."
SOURCE
In both Britain and Australia, "caring" Leftist governments have a mania for closing down hospitals and shrinking the number of beds available. The pretext is that they want to combine several hospitals into one to provide bigger, better and brighter services. It is utter crap, of course. It is about cost-cutting and nothing else. Standards decline rather than rise. We see the latest iteration of this "compassionate" Leftist policy in Queensland, Australia, where the government wants to replace two childrens' hospitals with one new one. Result? Everyone is going to be shortchanged. Even the size of consulting rooms has been reduced to the point where they are too small to fit a wheelchair in. And this is a hospital?
One of Queensland's leading doctors sent a disturbing email to nearly 100 colleagues that was leaked to me last week. Dr Brent Masters, a specialist in respiratory medicine at the Royal Children's Hospital asked if anyone was happy with the planned move to the new Queensland Children's Hospital. The planning process was "truly getting out of hand", he wrote. "I recommend you all read the book On Bullshit: you can buy it at the Medical School bookshop for about $15," he said. "It points out that basing decisions on bullshit are (sic) fraught with dire consequences - indeed worse than basing decisions on lies . . .
"The complete lack of intellectual honesty has let pediatrics down badly in this state . . . "I again point out that this hospital should not be about secondary level pediatrics (the bullshit factor) but about tertiary pediatrics: You can not have a world class hospital based on secondary-level pediatrics." Then he gave an ominous warning about underfunded hospitals. "You can cross the road 100 times with your eyes closed and you will get away with it 90 times," he said.
Despite some positive announcements on the new hospital this week, Dr Masters, like many other specialists, remains sceptical. He has to be. He leads a team treating 350 young cystic fibrosis patients. "People come from all over the world to train with them," said a doctor. They are that good." He is backed up by Dr Ann Chang, a leading researcher and devout Catholic who is a world authority on respiratory disease. This week Chang is in Darwin and soon she heads to New York and Miami to present papers to international medical forums.
For Dr Masters it is a demanding clinical load. CF is an unforgiving genetic disease characterised by frequent lung infections. It is incurable. Even lung transplants have only a 50 per cent success rate. Masters and Chang fear the new hospital simply doesn't have enough space to treat existing cases, let alone the 125 new cases who will come onstream in the next five years. And hospital planners neither seem to understand nor care about necessary research. This is a common complaint among specialists, from pathology to neurology.
Gastroenterologists fear they have been sidelined by planners who "stole" some of their space for respiratory medicine. "Gastroenterology is seriously compromised at QCH, with the complete disintegration of our diagnostic unit," said Dr Looi Ee last week.
Doctors practising nuclear medicine and medical imaging fear they, too, have been short-changed, with not enough MRI scanners.
Professor Jenny Batch told colleagues she needed rooms for diabetics and growth hormone therapy and a permanent patient-family education centre. "I share the concerns that there will not be adequate rooms," she said in another email leaked to me.
Space shortages also worried Dr Jane Peake, a pediatric immunologist who deals in allergies, eczema and auto-immune deficiencies. She feared there would not even be enough space to store research papers. She thought she was looking at a "poorly designed rabbit warren" with "small and grossly inadequate consulting rooms".
Dr Kate Sinclair agrees. She says proposed, open-plan office space will be unsuitable. Privacy will be endangered and deeply personal conversations with patients will be difficult.
Several doctors also questioned plans to cut queues at the new hospital by running clinical sessions in a day starting at 7am and finishing at 8pm.
Dr Lynne McKinlay, the director of pediatric rehabilitation at the Royal, noted the apparent lack of large consulting rooms. She said rooms would be "unsuitable" for children who arrived with both parents, siblings and a stroller, "let alone children who come with wheelchairs and walkers".
The proposed research centre remains unfunded and clinicians in allied health, genetics and dentistry believe their patients, too, will suffer in the shift to South Brisbane.
SOURCE
Socialized health care fundamentally changes the relationship between citizens and state
For most of our nation's history, our approach to economics has favored enterprise, self-reliance and the free market. While the American economy has never been entirely laissez-faire, we have historically cared more about equality of opportunity than equality of results. And while Americans have embraced elements of the New Deal, the Great Society and progressive taxation, we have traditionally viewed welfare as a way to help those in dire need, not as a way of life for the middle class. We have grasped, perhaps more than any other nation, that there is a long-run cost to dependency on the state, including an aversion to risk that eventually enervates the entrepreneurial spirit necessary for innovation and prosperity.
This outlook, once assumed, is now under attack due to a recent series of political and economic events. The first is the unprecedented intervention by the federal government, in the form of a $700 billion relief package intended for our financial institutions after the credit crisis last September. This was followed by extending billions of dollars of federal assistance to America's auto makers in order to prevent their imminent bankruptcy -- the first emergency bailout that went to companies outside the financial sector. We understand why the federal government did this, and even supported legislation that, while hardly perfect, prevented an economic meltdown.
Nonetheless, the consequences of this undertaking are enormous. Not only has the size of the expenditures been staggering -- there is talk of another stimulus package worth an estimated $825 billion -- but we are witnessing a fundamental transformation of government's relationship with the polity and the economy.
The last several months are a foreshadowing of a new era of government activism, rather than an unfortunate but necessary (and anomalous) emergency action. We will soon shift from a market-based economy to a political one in which the government picks winners and losers and extends its reach and power in unprecedented ways.
This shift is exemplified by the desire of President-elect Barack Obama and the Democratic Congress to push us toward government-run health care. For all his talk of allowing consumers to select their own health-care coverage, Mr. Obama's proposal, as he laid it out in his campaign, will provide strong financial incentives for employers and individuals to sign up with a new, Medicare-style government plan for working-age people and their families. This plan will almost certainly use a price-control system similar to the one in place for Medicare, allowing it to charge artificially low premiums by paying fees well below private rates. These low premiums will serve as a magnet for enrollment and will devastate the private companies trying to compete in the health-insurance market. The result will be the nationalization of the health-care sector, which today accounts for 16% of U.S. gross domestic product.
Nationalizing health care will be profoundly detrimental to the quality of American medicine. In the name of cost control, the government would make private investment in medical innovation far riskier, and thus delay the development of potentially lifesaving treatments.
It will also put America on a glide path toward European-style socialism. We need only look to Great Britain and elsewhere to see the effects of socialized health care on the broader economy. Once a large number of citizens get their health care from the state, it dramatically alters their attachment to government. Every time a tax cut is proposed, the guardians of the new medical-welfare state will argue that tax cuts would come at the expense of health care -- an argument that would resonate with middle-class families entirely dependent on the government for access to doctors and hospitals.
Of course, this health-care plan is occurring against our particular fiscal backdrop: Without major reform, our federal entitlement programs will soon double the size of government. The result will be a crushing burden of debt and taxes. In short, we may be approaching a tipping point for democratic capitalism.
While the scope of the challenge should not be underestimated, those of us worried about this fundamental reorientation of politics and economics have several things working in our favor. Among them is that a public accustomed to iTunes, Facebook, Google, eBay, Amazon and WebMD is not clamoring for centralized, bureaucratic government. The strong American instinct for individual initiative and entrepreneurship remains intact. In addition, confidence in government -- from Congress to those responsible for oversight of the financial system -- is quite low.
Our sense is that at the moment, the public is not thinking in terms of "big government" or "small government." Instead, Americans want efficient government -- one that is modern, responsive and adaptive. People want government to act as a fair referee, providing guardrails that allow individuals to rise without intrusively dictating individual decisions.
If conservatives hope to win converts to our cause, we need to understand this new moment and put forward an agenda that reforms key institutions in a way that advances individual freedom, without creating an unacceptable level of insecurity. This is no easy task, and it must begin with providing a compelling alternative to what contemporary liberalism and Mr. Obama are about to offer. This especially includes health care, where we must start by recalling that our current health-insurance system was designed to meet the needs of a 20th century economy and World War II-era employment laws. It is hopelessly outdated, yet the Obama plan would make the system even more sclerotic.
The core of our message needs to be a commitment to creating a health-care plan that meets the demands of the modern economy. We need to convince concerned citizens that we can help the uninsured find coverage in the private sector and use market incentives to contain costs. The result will be a system that makes it possible for everyone to afford health insurance, including those with pre-existing conditions. Tax credits, high-risk pools, insurance choice and regulatory reform can form the basis of a transformation from today's enormously costly and inefficient third-party system into one driven by ownership, choice and competition. And at the nucleus of this redesigned system will be the patient-doctor relationship.
If we hope to succeed in making our case, it will require a concerted education campaign that relies on hard data and facts, rigorous and accessible public arguments, and persuasive public advocates. This is quite a tall order. But if we do not succeed in resisting greater state involvement in the economy -- and health care is meant to be the beachhead of this effort -- we will move from a limited welfare state into a full-blown one. This will reshape, in deep and enduring ways, our nation's historic sensibilities. It will lead here, as it has elsewhere, to passivity and dependence on the state. Such habits, once acquired, are hard to shake. Between now and the end of this decade may be one of those rare moments in which among other things will turn decisively one way or the other. The stakes could hardly be higher for our way of life.
SOURCE
Embryo screening funding is 'postcode lottery' in Britain, researchers say
Handicapped children are a better deal, apparently. Amazingly short-sighted thinking. But that's governments for you
More than half of couples seeking embryo screening to protect their offspring from inherited genetic diseases such as breast cancer are being prevented from doing so, researchers say. Evidence from one of the country's leading gene-screening clinics suggests that local health authorities frequently refuse to fund treatment for patients who wish to avoid passing defective genes to their children.
Scientists predict an increase in demand for the technique, known as preimplantation genetic diagnosis (PGD), after the start of a pilot programme screening an entire adult community for faulty genes. The Times revealed last week that the London community of Ashkenazi Jews is being offered screening for BRCA genes that raise risks of breast, ovarian and prostate cancers. Britain's first baby screened to ensure that it was free of a genetic risk of breast cancer carried by a parent was born last week, and hailed as an important advance in the fight against genetic disease. The girl was born after embryos created through IVF treatment were screened to exclude the faulty BRCA1 gene.
PGD, which costs between 5,000 and 20,000 pounds, depending on the number of IVF cycles required, is available to dozens of selected couples each year who wish to have children but do not want to run the risk of passing on potentially fatal disorders to their offspring. It is licensed for more than 60 different conditions, including cystic fibrosis, Huntington's disease and some forms of cancer, which are triggered when a child inherits a key genetic mutation from one of its parents.
Joy Delhanty, Professor of Human Genetics at the University College London PGD centre, said that many couples were being refused NHS funding because the technique had not been considered by the National Institute for Health and Clinical Excellence (NICE), the value-for-money watchdog. "Funding for the procedure is a postcode lottery. More than 100 couples a year are referred to us from all over the country but more than 50 per cent have problems with funding in the absence of guidelines from NICE. "If local PCTs [primary care trusts] do not see this as a priority then they do not provide funding, it is as simple as that, but they do not consider the potential money they save by ensuring a child will be free of a disease."
Professor Delhanty declined to name individual trusts but said that couples living in the North of England seemed to have a greater chance of PGD applications being funded by their local PCT, while those living in London and the South East may be forced to pay thousands of pounds for private treatment.
Only a few hundred couples a year are eligible for PGD. To benefit from the technique, families must first know that they have a defective gene, usually discovered through a recurring family history of illness. Once the risk is confirmed by a clinical geneticist, embryos generated and fertilised through IVF treatment can then be screened and implanted in the womb if they are free of the faulty gene.
The Department of Health said last night: "PGD is available on the NHS but is considered on a case by case basis."
SOURCE
Saturday, January 17, 2009
SCHIP & The States: Another Bailout Boondoggle
It’s a typical Washington elixir. When bad press for multi-billion dollar bailouts has got you down, there’s nothing quite like a government program “for the children” to put things right again – particularly when the new President needs a quick victory to get his “Era of Bigger Government” of to a successful start. Such is the drama surrounding the “reauthorization” of SCHIP, the State Children’s Health Insurance Program, which passed in 1997 ostensibly in lieu of socialized national health care and will be “re-upped” after President-elect Barack Obama takes office this month. The House just reauthorized the legislation yesterday by a vote of 289 to 139. Now, it heads to the Senate.
Never mind that the program is unsustainable. And bankrupting the states. And not insuring who it claims to be insuring – all those are things that can be worked out later, right? After all, we’re only $10 trillion dollars in the hole, with another $10 trillion pledged over the last four months alone to help us avoid an “economic Pearl Harbor.” If money grows on trees, as our leaders evidently believe that it does, why not blow billions more of it on a program that’s not only failing its mission, but doing something government shouldn’t even be doing in the first place.
Since its inception, SCHIP has been a case study in everything that’s wrong with government – another example of feel-good rhetoric and lofty promises paid for with your money, except the rhetoric never matches the reality and the promises are always too good to be true. Although its proponents are quick to throw up pictures of starving inner city children, the fact is that SCHIP has insured millions of adults, and middle class families over the past decade. In some cases, SCHIP recipients were earning 300% of the poverty level.
This was famously exposed in 2007, when Democrats selected a middle school student named Graeme Frost to deliver the rebuttal to President George W. Bush’s veto of SCHIP reauthorization, only to discover later that the boy attended a $20,000 a year school and his family lived in a 3,000 square foot home valued at over $400,000.
And who pays the most for SCHIP? A disproportionately high number of poor smokers – the very people the program is supposed to be serving. And on top of that, a recent Heritage Foundation report recently showed that 22 million people will have to take up smoking in America over the next decade or else the program will go bankrupt. How many of those people will be classified as low-income?
Then there’s the biggest fraud of them all – the fact that SCHIP is cannibalizing the private sector to the tune of 6 out of 10 beneficiary recipients. That’s right, evidence shows that only 40% of SCHIP recipients are actually uninsured – a pretty amazing number when you stop and think about it. Frankly, this defeats the whole purpose of the program, unless of course we want to start subsidizing this expense for people who can already afford it.
Not surprisingly, the 60% figure is higher than the government will admit, but not by much. Even the Congressional Budget Office acknowledges that “for every 100 children who gain coverage as a result of SCHIP, there is a corresponding reduction in private coverage of between 25 and 50 children.”
Why is this relevant now? Well, government simply can’t afford to continue unsustainably spending money on non-core functions, like providing health insurance to people who already have it. Nor can it afford to bail out the states on SCHIP to the tune of tens of billions of dollars, which is what numerous governors are currently asking for. Government must return to its core functions and get out of the business of subsidizing everything that comes along with a “for the children” sign on it.
SOURCE
Any excuse to refuse medical care to those who have paid for it
British woman with deadly virus denied free NHS care... because she moved to Turkey to retire
A grandmother who moved to Turkey when she retired was billed for NHS treatment - despite making National Insurance contributions throughout her life. Joyce McDonald, 66, almost died when she was struck down with heart and liver damage and spent her entire life savings on an emergency medical flight to Britain. She was rushed to Addenbrooke's Hospital in Cambridge where she spent two weeks undergoing treatment for a deadly virus attacking her organs.
But after she returned to Turkey, Mrs McDonald was stunned to receive a bill for 367 pounds from Cambridgeshire Primary Care Trust for her initial consultation. She was also slapped with another 800 bill for the three mile ambulance ride from the airport in Cambridge to the hospital.
Mrs McDonald, who moved to Turkey with her husband in 2004, was told she was not entitled to free state health care because she is no longer a British citizen. But her husband Ronald McDonald, 71, has blasted the NHS for its 'disgraceful' stance after the couple made more than 50 years' National Insurance contributions. He now fears they could be left financially crippled if they are forced to pay an estimated 10,000 for future treatments themselves. He said: 'It was touch and go as to whether I might lose my wife on the flight home. She was very weak. 'Then when I got to the airport in Cambridge we were taken by ambulance from the airport to the hospital - I have since been given a bill for 800 for a five minute ambulance ride.
Mrs McDonald was struck down with a deadly virus and will need more treatment in the UK 'I'm still waiting for the bill for the two week hospital stay. It's utterly disgraceful. 'My wife and I are still British citizens and have paid taxes for the best part of 50 years before we moved to Turkey. 'We only moved because our pensions didn't cover the cost of living.' The couple left their home in St Ives, Cambridgeshire, for Turkey, five years ago to enjoy their retirements in the sun.
But Mrs McDonald was struck down with a severe virus in November and the pair were forced to spend 26,000 on medical evacuation flights to the UK. She was discharged two weeks later and returned to Turkey, but was told she needed to return to the UK next month for further tests. The couple are both still British passport holders but have been told they will have to pay for all future treatments because they had been out of Britain for more than three months.
Mr McDonald, who still pays tax in Britain on a small private pension, is prepared to go to court over the issue. He said: 'I refuse to be blackmailed by the NHS. 'I don't mind having to pay for the emergency air ambulance and treatment in Turkey but it's ridiculous to have to pay for treatment in my own country. 'What have I been paying for all these years? 'I have already been given a bill of nearly 400 for the initial consultation when we arrived at the hospital and my wife still has four tests in February for her heart and her liver. 'Obviously I've spent my life savings to save my wife and now I'm totally wiped out. 'It's probably going to cost us at least 10,000.'
Mr McDonald also claims Cambridge NHS trust had threatened to contact the Foreign Office and stop him having his British visa renewed. He said: 'I don't even need a British visa - I'm a British passport holder 'We are being treated worse than immigrants who come across to Britain and get free health care and don't pay taxes.' 'Thousands of immigrants, both legal and illegal from both the EU, and the rest of the world, are entitled to free housing and medical treatment, but as British citizens, my wife and I are excluded from similar treatment.'
A spokesman from the Department of Health said the regulations on payment for services had been in place since 1989. He said: 'The NHS is first and foremost for the benefit of people who live in this country. 'People who are not ordinarily resident here are not automatically entitled to access free NHS hospital treatment. 'UK state pension holders living overseas are exempt from charges if they need treatment during their visit to the UK. This does not include pre-planned treatment.'
John Leslie, Director of Finance at NHS Cambridgeshire said: 'While NHS Cambridgeshire cannot comment on individual cases,the Department of Health gives very clear guidance on the provision of NHS services to people in Cambridgeshire. 'Anyone who is normally a resident of the UK is entitled to free NHS hospital treatment.' 'However, anyone who has been living outside of the UK for more than 3 months would not be automatically eligible for free hospital treatment.'
SOURCE
Amazing emergency room incompetence in Australian public hospital
A pensioner [senior citizen] who claims a doctor at Wynnum Hospital was unable to administer an insulin shot has become embroiled in a dispute over the emergency department's level of care. Richard Supranowicz, an insulin-dependent diabetic, said the doctor told him he would need technical advice from either the Redlands or Princess Alexandra hospitals on how to administer the insulin needle. "He also explained his experience was very limited, and his main duties were to supervise admitted patients," Mr Supranowicz said. Mr Supranowicz, directed to Wynnum after phoning a Queensland Health hotline, said he had to be transferred to Princess Alexandra Hospital to be treated for high sugar levels.
A spokeswoman for Health Minister Stephen Robertson said he had ordered a full investigation into the issues raised by Mr Supranowicz. Mr Robertson said: "Doctors at Wynnum Hospital are qualified and registered medical practitioners who can handle emergencies and provide resuscitation and stabilisation of emergencies until transfer or retrieval to a higher level service. "A doctor is rostered on and is on site at all times."
Mr Supranowicz, however, described the situation as "absolutely disgraceful". Wynnum specialist physician Dr Brian Senewiratne said Wynnum Hospital was a ``write-off''. ``It has been a write-off for a long time because it doesn't have the beds, the trained staff or the facilities, so everyone is referred to the PA which doesn't have the beds either,'' he said. ``There is the obstinate refusal of the administration to admit there is a problem.''
Queensland Health's website lists the facility's hospital services as being ``acute medical'' and ``emergency services''.
Dr Senewiratne said Wynnum deserved better because patients especially those who were elderly needed practical and emotional support from nearby family and friends.
Opposition health spokesman Mark McArdle said: ``I think it is a reasonable expectation that a hospital that is described as offering acute medical and emergency services on the Queensland Health website should actually do this.''
SOURCE
It’s a typical Washington elixir. When bad press for multi-billion dollar bailouts has got you down, there’s nothing quite like a government program “for the children” to put things right again – particularly when the new President needs a quick victory to get his “Era of Bigger Government” of to a successful start. Such is the drama surrounding the “reauthorization” of SCHIP, the State Children’s Health Insurance Program, which passed in 1997 ostensibly in lieu of socialized national health care and will be “re-upped” after President-elect Barack Obama takes office this month. The House just reauthorized the legislation yesterday by a vote of 289 to 139. Now, it heads to the Senate.
Never mind that the program is unsustainable. And bankrupting the states. And not insuring who it claims to be insuring – all those are things that can be worked out later, right? After all, we’re only $10 trillion dollars in the hole, with another $10 trillion pledged over the last four months alone to help us avoid an “economic Pearl Harbor.” If money grows on trees, as our leaders evidently believe that it does, why not blow billions more of it on a program that’s not only failing its mission, but doing something government shouldn’t even be doing in the first place.
Since its inception, SCHIP has been a case study in everything that’s wrong with government – another example of feel-good rhetoric and lofty promises paid for with your money, except the rhetoric never matches the reality and the promises are always too good to be true. Although its proponents are quick to throw up pictures of starving inner city children, the fact is that SCHIP has insured millions of adults, and middle class families over the past decade. In some cases, SCHIP recipients were earning 300% of the poverty level.
This was famously exposed in 2007, when Democrats selected a middle school student named Graeme Frost to deliver the rebuttal to President George W. Bush’s veto of SCHIP reauthorization, only to discover later that the boy attended a $20,000 a year school and his family lived in a 3,000 square foot home valued at over $400,000.
And who pays the most for SCHIP? A disproportionately high number of poor smokers – the very people the program is supposed to be serving. And on top of that, a recent Heritage Foundation report recently showed that 22 million people will have to take up smoking in America over the next decade or else the program will go bankrupt. How many of those people will be classified as low-income?
Then there’s the biggest fraud of them all – the fact that SCHIP is cannibalizing the private sector to the tune of 6 out of 10 beneficiary recipients. That’s right, evidence shows that only 40% of SCHIP recipients are actually uninsured – a pretty amazing number when you stop and think about it. Frankly, this defeats the whole purpose of the program, unless of course we want to start subsidizing this expense for people who can already afford it.
Not surprisingly, the 60% figure is higher than the government will admit, but not by much. Even the Congressional Budget Office acknowledges that “for every 100 children who gain coverage as a result of SCHIP, there is a corresponding reduction in private coverage of between 25 and 50 children.”
Why is this relevant now? Well, government simply can’t afford to continue unsustainably spending money on non-core functions, like providing health insurance to people who already have it. Nor can it afford to bail out the states on SCHIP to the tune of tens of billions of dollars, which is what numerous governors are currently asking for. Government must return to its core functions and get out of the business of subsidizing everything that comes along with a “for the children” sign on it.
SOURCE
Any excuse to refuse medical care to those who have paid for it
British woman with deadly virus denied free NHS care... because she moved to Turkey to retire
A grandmother who moved to Turkey when she retired was billed for NHS treatment - despite making National Insurance contributions throughout her life. Joyce McDonald, 66, almost died when she was struck down with heart and liver damage and spent her entire life savings on an emergency medical flight to Britain. She was rushed to Addenbrooke's Hospital in Cambridge where she spent two weeks undergoing treatment for a deadly virus attacking her organs.
But after she returned to Turkey, Mrs McDonald was stunned to receive a bill for 367 pounds from Cambridgeshire Primary Care Trust for her initial consultation. She was also slapped with another 800 bill for the three mile ambulance ride from the airport in Cambridge to the hospital.
Mrs McDonald, who moved to Turkey with her husband in 2004, was told she was not entitled to free state health care because she is no longer a British citizen. But her husband Ronald McDonald, 71, has blasted the NHS for its 'disgraceful' stance after the couple made more than 50 years' National Insurance contributions. He now fears they could be left financially crippled if they are forced to pay an estimated 10,000 for future treatments themselves. He said: 'It was touch and go as to whether I might lose my wife on the flight home. She was very weak. 'Then when I got to the airport in Cambridge we were taken by ambulance from the airport to the hospital - I have since been given a bill for 800 for a five minute ambulance ride.
Mrs McDonald was struck down with a deadly virus and will need more treatment in the UK 'I'm still waiting for the bill for the two week hospital stay. It's utterly disgraceful. 'My wife and I are still British citizens and have paid taxes for the best part of 50 years before we moved to Turkey. 'We only moved because our pensions didn't cover the cost of living.' The couple left their home in St Ives, Cambridgeshire, for Turkey, five years ago to enjoy their retirements in the sun.
But Mrs McDonald was struck down with a severe virus in November and the pair were forced to spend 26,000 on medical evacuation flights to the UK. She was discharged two weeks later and returned to Turkey, but was told she needed to return to the UK next month for further tests. The couple are both still British passport holders but have been told they will have to pay for all future treatments because they had been out of Britain for more than three months.
Mr McDonald, who still pays tax in Britain on a small private pension, is prepared to go to court over the issue. He said: 'I refuse to be blackmailed by the NHS. 'I don't mind having to pay for the emergency air ambulance and treatment in Turkey but it's ridiculous to have to pay for treatment in my own country. 'What have I been paying for all these years? 'I have already been given a bill of nearly 400 for the initial consultation when we arrived at the hospital and my wife still has four tests in February for her heart and her liver. 'Obviously I've spent my life savings to save my wife and now I'm totally wiped out. 'It's probably going to cost us at least 10,000.'
Mr McDonald also claims Cambridge NHS trust had threatened to contact the Foreign Office and stop him having his British visa renewed. He said: 'I don't even need a British visa - I'm a British passport holder 'We are being treated worse than immigrants who come across to Britain and get free health care and don't pay taxes.' 'Thousands of immigrants, both legal and illegal from both the EU, and the rest of the world, are entitled to free housing and medical treatment, but as British citizens, my wife and I are excluded from similar treatment.'
A spokesman from the Department of Health said the regulations on payment for services had been in place since 1989. He said: 'The NHS is first and foremost for the benefit of people who live in this country. 'People who are not ordinarily resident here are not automatically entitled to access free NHS hospital treatment. 'UK state pension holders living overseas are exempt from charges if they need treatment during their visit to the UK. This does not include pre-planned treatment.'
John Leslie, Director of Finance at NHS Cambridgeshire said: 'While NHS Cambridgeshire cannot comment on individual cases,the Department of Health gives very clear guidance on the provision of NHS services to people in Cambridgeshire. 'Anyone who is normally a resident of the UK is entitled to free NHS hospital treatment.' 'However, anyone who has been living outside of the UK for more than 3 months would not be automatically eligible for free hospital treatment.'
SOURCE
Amazing emergency room incompetence in Australian public hospital
A pensioner [senior citizen] who claims a doctor at Wynnum Hospital was unable to administer an insulin shot has become embroiled in a dispute over the emergency department's level of care. Richard Supranowicz, an insulin-dependent diabetic, said the doctor told him he would need technical advice from either the Redlands or Princess Alexandra hospitals on how to administer the insulin needle. "He also explained his experience was very limited, and his main duties were to supervise admitted patients," Mr Supranowicz said. Mr Supranowicz, directed to Wynnum after phoning a Queensland Health hotline, said he had to be transferred to Princess Alexandra Hospital to be treated for high sugar levels.
A spokeswoman for Health Minister Stephen Robertson said he had ordered a full investigation into the issues raised by Mr Supranowicz. Mr Robertson said: "Doctors at Wynnum Hospital are qualified and registered medical practitioners who can handle emergencies and provide resuscitation and stabilisation of emergencies until transfer or retrieval to a higher level service. "A doctor is rostered on and is on site at all times."
Mr Supranowicz, however, described the situation as "absolutely disgraceful". Wynnum specialist physician Dr Brian Senewiratne said Wynnum Hospital was a ``write-off''. ``It has been a write-off for a long time because it doesn't have the beds, the trained staff or the facilities, so everyone is referred to the PA which doesn't have the beds either,'' he said. ``There is the obstinate refusal of the administration to admit there is a problem.''
Queensland Health's website lists the facility's hospital services as being ``acute medical'' and ``emergency services''.
Dr Senewiratne said Wynnum deserved better because patients especially those who were elderly needed practical and emotional support from nearby family and friends.
Opposition health spokesman Mark McArdle said: ``I think it is a reasonable expectation that a hospital that is described as offering acute medical and emergency services on the Queensland Health website should actually do this.''
SOURCE
Friday, January 16, 2009
NHS patients face indignity of mixed-sex hospital wards
Men and women in hospital are still being treated on mixed-sex wards with little or no segregation, despite government promises to improve privacy for patients, the Conservative Party says. In April ministers claimed that they were close to abolishing mixed-sex accommodation in the National Health Service. Figures obtained by the Conservatives suggest that 15 per cent of hospitals in England still use mixed, open-plan "Nightingale" wards, while a similar proportion (16 per cent) have wards where patients are segregated only by curtains. The party said that nearly a third of trusts did not have separate bathrooms for men and women.
There were 997 complaints about lack of privacy and dignity in hospital trusts and 135 complaints in mental health trusts in the past year, a poll of 132 acute trusts and 55 mental health trusts showed.
Andrew Lansley, the Shadow Health Secretary, accused the Government of breaking its promises on the issue. "Patients have enough to worry about when they go into hospital without having to suffer the indignity of being placed in accommodation that affords them too little privacy at such a sensitive time," he said.
Alan Johnson, the Health Secretary, told a nurses' conference last year that there was a "bit of a political distinction" between the terms mixed-sex accommodation - where men and women are in separate rooms or bays and have their own bathrooms and lavatories - and the larger, mixed-sex wards.
The Department of Health responded: "We are reducing mixed-sex accommodation to an absolute minimum and have made significant progress. Some hospitals and local NHS areas still have more to do and they are now required to publish and implement ambitious plans to improve." A spokesman added that only 2 per cent of patients complained about lack of privacy in the latest official audit.
Source
Midwives' workload surges under Labour - putting mothers and babies at risk
The decline of maternity care under Labour was highlighted last night by figures showing that midwives are more overworked than they have been for at least a decade. NHS midwives are delivering far more babies per year than stipulated by safety guidelines - putting mothers and babies at risk. For the sixth year running, the number of births each midwife handles has risen, and it is now higher than at any time since records began in 1997.
The workload being heaped on maternity wards was blamed for the recent doubling in the number of payouts for medical blunders - and for the fact that rising numbers of women are being left alone and terrified during labour. Experts believe up to 1,000 babies a year die needlessly because doctors and midwives are too overstretched or poorly-trained to detect warning signs.
Safety guidelines, laid down by the Royal College of Midwives, say that midwives should deliver an average of 27.5 babies a year - one every 13 days or so - to ensure mother and child have the best quality of care. But figures obtained by the Liberal Democrats from a parliamentary question show that in 2007, the average midwife in England delivered 34.0 babies - one every ten or 11 days, and almost 25 per cent more than they should under the safety standard. This was up on 2006, when the midwife to baby ratio was 33.7, despite the launch of a major maternity strategy designed to turn things round and even offer all women onetoone care with a midwife. The number of babies delivered is 10 per cent higher than in 2001, and is higher than at any time since records began in 1997, when the ratio was 33.7.
Critics blame a continuing shortage of midwives and ministers' failure to anticipate a soaring birthrate. More babies are now born in England than at any time in the past 26 years; largely the result of immigration. They say the figures prove the Government has no chance of honouring its pledge that all women should have one to one care from a named midwife during the entire pregnancy by the end of this year. The number of babies a midwife is expected to deliver is less than one a week because the job is much wider than dealing with the birth: they look after women over the whole pregnancy and afterwards.
Liberal Democrat health spokesman Norman Lamb said: 'After 12 years of empty promises the Labour party will have left maternity care in a state of near crisis. 'Last year it was revealed that hundreds of thousands of women are being left alone during their labour causing worry and distress to many. We also know that the number of safety incidents is on the rise and that millions are being paid out in compensation for medical blunders. 'To find now that midwives are at their most over-stretched since records began, adds to the shameful failure of the Government. 'We must increase the number of midwives and cut back on managers so the health service can cope, especially with a birth rate set to rise.'
Last year, the Healthcare Commission watchdog found that more than a quarter of women were left worried and alone during labour or shortly after birth. Other figures showed that the numbers of medical blunders on NHS maternity wards has doubled in two years. In 2007, 70,108 cases of blunders or abuse of mothers on neonatal units were passed to the National Patient Safety Agency, compared with 35,428 in 2005.
A spokesman for the Department of Health said: 'The UK is one of the safest countries in the world to have a baby. 'There is no evidence to suggest a lower ratio of births to midwives is needed. The number of midwives is actually increasing.'
SOURCE
Maggots in Australian public hospital ICU
This must be about as charming as it gets. Maggots breed in garbage or dead bodies. But the NHS got there before us, of course
Maggots have been found falling from the ceiling of the Royal Hobart Hospital's intensive care unit. The maggots were discovered on Tuesday in a male staff toilet not accessible to the general public. The hospital attempted to play down the grubby find yesterday, saying only a small number of larvae were found by a staff member, who reported them immediately.
Spokeswoman Pene Snashall said patient hygiene was never at risk. "The Environmental Services Team and the Infection and Prevention Control Team responded immediately with a thorough clean-up and investigation," Ms Snashall said. "Patient safety and care was always our top priority." But even after virtually gutting the toilet block, the source of the infestation remains a mystery. The hygiene team ripped out ceiling tiles looking for possible sources of the maggots, including dead rodents in the air-conditioning vents, but found nothing. "There have not been any further discoveries [of maggots] as of today and we are confident we have eliminated the problem," Ms Snashall said.
Maggots are sometimes used in medicine to eat dead flesh and speed up the healing of wounds -- but not in this case. Ms Snashall said the hospital had a year-round pest control program to control spiders, ants and cockroaches.
Australian Nursing Federation Neroli Ellis said the incident showed the ageing hospital was virtually rotting. "I do think it is a one-off -- the cleaning staff are vigilant," she said. "But it is reflective of the state of the building and the age of the building that these issues are occurring and there needs to be strong monitoring and a review of maintenance to ensure this situation doesn't happen again." Ms Ellis said building a new hospital would not fix the problems at the old facility in the short term. "Whatever is decided politically about building a new hospital, there must be an ongoing upgrade of the current building in the meantime because it is falling down around them," she said.
SOURCE
Men and women in hospital are still being treated on mixed-sex wards with little or no segregation, despite government promises to improve privacy for patients, the Conservative Party says. In April ministers claimed that they were close to abolishing mixed-sex accommodation in the National Health Service. Figures obtained by the Conservatives suggest that 15 per cent of hospitals in England still use mixed, open-plan "Nightingale" wards, while a similar proportion (16 per cent) have wards where patients are segregated only by curtains. The party said that nearly a third of trusts did not have separate bathrooms for men and women.
There were 997 complaints about lack of privacy and dignity in hospital trusts and 135 complaints in mental health trusts in the past year, a poll of 132 acute trusts and 55 mental health trusts showed.
Andrew Lansley, the Shadow Health Secretary, accused the Government of breaking its promises on the issue. "Patients have enough to worry about when they go into hospital without having to suffer the indignity of being placed in accommodation that affords them too little privacy at such a sensitive time," he said.
Alan Johnson, the Health Secretary, told a nurses' conference last year that there was a "bit of a political distinction" between the terms mixed-sex accommodation - where men and women are in separate rooms or bays and have their own bathrooms and lavatories - and the larger, mixed-sex wards.
The Department of Health responded: "We are reducing mixed-sex accommodation to an absolute minimum and have made significant progress. Some hospitals and local NHS areas still have more to do and they are now required to publish and implement ambitious plans to improve." A spokesman added that only 2 per cent of patients complained about lack of privacy in the latest official audit.
Source
Midwives' workload surges under Labour - putting mothers and babies at risk
The decline of maternity care under Labour was highlighted last night by figures showing that midwives are more overworked than they have been for at least a decade. NHS midwives are delivering far more babies per year than stipulated by safety guidelines - putting mothers and babies at risk. For the sixth year running, the number of births each midwife handles has risen, and it is now higher than at any time since records began in 1997.
The workload being heaped on maternity wards was blamed for the recent doubling in the number of payouts for medical blunders - and for the fact that rising numbers of women are being left alone and terrified during labour. Experts believe up to 1,000 babies a year die needlessly because doctors and midwives are too overstretched or poorly-trained to detect warning signs.
Safety guidelines, laid down by the Royal College of Midwives, say that midwives should deliver an average of 27.5 babies a year - one every 13 days or so - to ensure mother and child have the best quality of care. But figures obtained by the Liberal Democrats from a parliamentary question show that in 2007, the average midwife in England delivered 34.0 babies - one every ten or 11 days, and almost 25 per cent more than they should under the safety standard. This was up on 2006, when the midwife to baby ratio was 33.7, despite the launch of a major maternity strategy designed to turn things round and even offer all women onetoone care with a midwife. The number of babies delivered is 10 per cent higher than in 2001, and is higher than at any time since records began in 1997, when the ratio was 33.7.
Critics blame a continuing shortage of midwives and ministers' failure to anticipate a soaring birthrate. More babies are now born in England than at any time in the past 26 years; largely the result of immigration. They say the figures prove the Government has no chance of honouring its pledge that all women should have one to one care from a named midwife during the entire pregnancy by the end of this year. The number of babies a midwife is expected to deliver is less than one a week because the job is much wider than dealing with the birth: they look after women over the whole pregnancy and afterwards.
Liberal Democrat health spokesman Norman Lamb said: 'After 12 years of empty promises the Labour party will have left maternity care in a state of near crisis. 'Last year it was revealed that hundreds of thousands of women are being left alone during their labour causing worry and distress to many. We also know that the number of safety incidents is on the rise and that millions are being paid out in compensation for medical blunders. 'To find now that midwives are at their most over-stretched since records began, adds to the shameful failure of the Government. 'We must increase the number of midwives and cut back on managers so the health service can cope, especially with a birth rate set to rise.'
Last year, the Healthcare Commission watchdog found that more than a quarter of women were left worried and alone during labour or shortly after birth. Other figures showed that the numbers of medical blunders on NHS maternity wards has doubled in two years. In 2007, 70,108 cases of blunders or abuse of mothers on neonatal units were passed to the National Patient Safety Agency, compared with 35,428 in 2005.
A spokesman for the Department of Health said: 'The UK is one of the safest countries in the world to have a baby. 'There is no evidence to suggest a lower ratio of births to midwives is needed. The number of midwives is actually increasing.'
SOURCE
Maggots in Australian public hospital ICU
This must be about as charming as it gets. Maggots breed in garbage or dead bodies. But the NHS got there before us, of course
Maggots have been found falling from the ceiling of the Royal Hobart Hospital's intensive care unit. The maggots were discovered on Tuesday in a male staff toilet not accessible to the general public. The hospital attempted to play down the grubby find yesterday, saying only a small number of larvae were found by a staff member, who reported them immediately.
Spokeswoman Pene Snashall said patient hygiene was never at risk. "The Environmental Services Team and the Infection and Prevention Control Team responded immediately with a thorough clean-up and investigation," Ms Snashall said. "Patient safety and care was always our top priority." But even after virtually gutting the toilet block, the source of the infestation remains a mystery. The hygiene team ripped out ceiling tiles looking for possible sources of the maggots, including dead rodents in the air-conditioning vents, but found nothing. "There have not been any further discoveries [of maggots] as of today and we are confident we have eliminated the problem," Ms Snashall said.
Maggots are sometimes used in medicine to eat dead flesh and speed up the healing of wounds -- but not in this case. Ms Snashall said the hospital had a year-round pest control program to control spiders, ants and cockroaches.
Australian Nursing Federation Neroli Ellis said the incident showed the ageing hospital was virtually rotting. "I do think it is a one-off -- the cleaning staff are vigilant," she said. "But it is reflective of the state of the building and the age of the building that these issues are occurring and there needs to be strong monitoring and a review of maintenance to ensure this situation doesn't happen again." Ms Ellis said building a new hospital would not fix the problems at the old facility in the short term. "Whatever is decided politically about building a new hospital, there must be an ongoing upgrade of the current building in the meantime because it is falling down around them," she said.
SOURCE
Thursday, January 15, 2009
Incompetent Indian doctor kills woman in NHS hospital
A doctor killed a patient being treated for an infected bunion by injecting her with adrenaline against the advice of colleagues, a court heard yesterday. Priya Ramnath ignored two doctors' and a nursing sister's express instructions and failed to speak to a consultant anaesthetist before administering the fatal dose to 51-year-old Patricia Leighton in 1998, a jury was told. Mother-of-two Ramnath moved to America soon after. She denies the manslaughter of Mrs Leighton by gross negligence.
Ramnath, now 40, was working as a registrar in the intensive therapy unit at Stafford District General Hospital where Mrs Leighton was being treated for septic shock from the infection on her left foot. Ramnath, who was on a seven-week placement at the hospital, became concerned about Mrs Leighton's weak pulse and low blood pressure. She says she thought adrenaline was necessary because she believed the patient was about to go into cardiac arrest, the court heard.
Her colleagues advised her not to use adrenaline as they believed Mrs Leighton's condition could have been controlled without it. But Ramnath gave her a 3ml injection of it, Birmingham Crown Court was told. Prosecutor Michael Burrows QC, said: 'The effects of adrenaline are unpredictable and can be fatal. In the case of Mrs Leighton, they were fatal. 'Within moments of the injection, Mrs Leighton jerked forward and sat bolt upright in her bed. She shouted out "What's happening to me? I am going to die".' Mrs Leighton, of Burntwood, Staffordshire, then lost consciousness, her heart stopped and she died despite attempts to resucitate her.
Mr Burrows said: 'Mrs Leighton was not in cardiac arrest, the injection of a bolus of adrenaline was not necessary and should not have been given. 'She owed Mrs Leighton a duty of care, that duty was breached by giving her the adrenaline. There was no clinical indication that such treatment was necessary.' Mr Burrows said the Crown would call an expert witness who believed that Ramnath's alleged decision to ignore advice was arrogant and reckless.
He added that when writing up her notes Ramnath said she injected the adrenaline after Mrs Leighton went into cardiac arrest. He said: 'When someone does something wrong they may seek to conceal what they have done wrong. 'This is a case where you will have to consider whether Dr Ramnath sought to conceal what she has done and whether others helped her.'
Ramnath handed in her resignation less than a week after Mrs Leighton's death stating she had been planning to move to the US with her husband. Mr Burrows told the jury: 'You will have to consider whether she fled the country in order to hinder or escape the investigation into Mrs Leighton's death.' Ramnath, whose address cannot be published for legal reasons, came back to Britain in February last year after dropping her opposition to extradition proceedings.
SOURCE
Britain worse off for hospital beds than Macedonia
The provision of hospital beds in Britain has plunged in the past eight years to one of the lowest levels in Europe. The number of beds per person has dropped 14 per cent since 2000 - to below the rate for Latvia, Estonia and Macedonia. The UK has only 389 hospital beds per 100,000 inhabitants, even when taking into account both private and NHS beds. This is well below the EU average of 590 beds per 100,000 inhabitants.
The UK is ranked 25th out of 32 European countries. Only Cyprus, Portugal, Denmark, Spain, Sweden, Turkey and Malta perform worse. In 2000/01 the NHS had 186,091 beds, falling to 160,297 in 2007/08. Maternity beds have almost halved in number in some parts of the UK. In 2000/01 the NHS had 186,091 beds, falling to 160,297 in 2007/08. Maternity beds have almost halved in number in some parts of the UK.
Tory health spokesman Andrew Lansley, who obtained the figures from the European Commission, said: 'The objective of the NHS is to deliver world-class healthcare, not to maintain a certain number of hospital beds. 'It is madness to cut beds when wards are overcrowded, there aren't enough isolation rooms to control hospital infections and patients are still in mixed-sex accommodation. 'In 2000 Labour said that bed numbers needed to increase but these figures demonstrate again how badly they have failed.'
Health Minister Ben Bradshaw said: 'Given that the Conservatives are pledged to cut NHS funding, we await with interest a commitment by Andrew Lansley to increase expenditure on this or any other aspect of the work of the NHS that he frequently criticises.'
A Department of Health spokesman said: 'Bed numbers have fallen because people are being treated much more quickly - spending less time in hospital - and for many conditions medical advances mean they do not need to go to hospital at all. 'Detailed analysis of the past three years' MRSA and bed occupancy rates has shown no correlation between the two.'
SOURCE
US Surgeon Shortage Pushes Hospitals to Hire Temps
With miserly Medicare payments being a big part of the problem
When someone doubles over from stomach pain, the general surgeon is the one who performs an appendectomy. Gallstones? The general surgeon removes the gallbladder. Breast and colon tumors and hernias are also matters for the surgeon's scalpel. Now the economic and cultural forces reshaping U.S. medicine are prompting an exodus from this once venerable field, creating a growing market for temporary surgeons-for-hire.
As a general surgeon in her hometown of Franklin, Tenn., Jennifer Peppers could no longer keep her practice going after eight years in business. Faced with rising overhead costs and declines in reimbursements, she and her partners stopped drawing salaries last winter. To pay her home mortgage, Dr. Peppers had to borrow from a credit line.
So the surgeons shuttered their practice, and Dr. Peppers, 42 years old, hit the road. Her typical month might now include a weekend in Springfield, Ore., removing ruptured spleens or repairing obstructed bowels, followed by two weeks at a rural Kentucky or New Hampshire hospital. Though she misses her husband, she earns double her old salary and has paid off a big chunk of her medical-school debt. "I'd much prefer to be in my hospital in my little town," says Dr. Peppers, who is now licensed in five states. "But I don't see how that's possible."
The shift toward temporary assignments comes as the traditional way of practicing general surgery is fading in many parts of the country. For decades, general surgeons have been the backbone and economic engine of the community hospital. While maintaining their own private practices, they staff trauma and critical-care units and perform most common abdominal procedures. Without them, hospitals couldn't provide many emergency-room services. In rural areas, their backup is necessary for everything from complicated births to inserting chest tubes.
But the increasingly grueling schedules, shrinking payments and the temptation of more profitable surgical niches have made the field less attractive. Over the past 25 years, the number of general surgeons per capita has declined 25%, according to a study published in the Archives of Surgery earlier this year. Other specialties are also seeing shortages as their ranks grow more slowly than the overall population, but the decline in general surgery is steeper than most. And while the number of physicians overall isn't in decline, general surgery is one of the few fields where the absolute number of surgeons is actually shrinking.
It's possible that the implosion of Wall Street will rekindle an interest in medicine as a career, but future medical-school graduates could continue to flock to specialties that pay more than general surgery. Nearly three-quarters of surgeons-in-training already are opting for lucrative subspecialties with more predictable hours, such as cardiovascular surgery and neurosurgery, the American College of Surgeons says. That's left community hospitals around the U.S. struggling to provide some of their most basic services.
Some are turning to temporary physicians to fill the void. General surgery is now among the fastest-growing areas of a temporary-medical-staffing industry that's expected to double to $2.1 billion in 2009 from five years ago, according to Locumtenens.com, a staffing agency. The company, which takes its name from the Latin phrase meaning "to stand in another's place," matches hospitals with what the medical field calls locum tenens doctors. Rising demand for these services, in turn, is prompting more of the remaining general surgeons to choose a life on the road and in hotels.
Staffing agencies estimate that at least 1 in 20 of America's 17,000 general surgeons now work on a temporary basis some or all of the time. Full-time temporary surgeons can earn $250,000 or more a year, in some cases nearly twice as much as in private practice. That's largely because they don't have to pay overhead costs anymore.
Critics of the practice worry that it carries potential safety risks. A new surgeon arriving in town may not be familiar with a hospital's staff, for example, or with surgical patients coming in for follow-up visits. "That continuity of care in surgical diseases is really important," says Phillip Burns, chairman of the University of Tennessee's surgical department. As the one who performs the surgery, "you are the best one to handle [any problems] because you were the one inside."
Some who've switched to temporary work say patients often fare better with a surgeon who can focus entirely on providing care instead of the administrative hassles of a private practice. "I don't pay a penny of overhead now and I feel better than I have in years," says Kenneth Lawson, 55. Dr. Lawson left his practice in Roseburg, Ore., in 2005 to travel as a temporary surgeon.
While in private practice, Dr. Lawson says he would often spend five nights in a row on call, "bleary eyed," performing emergency surgeries. Increasingly, he says, these patients had no insurance. Hospitals typically have the means to pursue debts from patients or write the losses off as charity care, but doctors don't always have the manpower to collect on their portion of the bill. "We got to the point we wouldn't waste a stamp trying to get that money," says Dr. Lawson.
Locum tenens isn't a bargain for hospitals or a health-care system that is already the world's costliest and accounts for nearly 17% of the U.S. economy, according to federal government data. A temporary surgeon who comes in to perform scheduled procedures and emergency operations can cost a hospital about $1,500 a day -- between $650 and $900 for the physician and about the same for the staffing agency, according to Staff Care, a temporary-medical-placement firm. That's in addition to travel and lodging expenses. In traditional practice, hospitals don't pay surgeons directly: They give them "privileges" to use their operating rooms in exchange for sharing in emergency-call duty.
Yet, without the ability to perform surgeries, "we lose the business," says Karen Hendren, chief operating officer of Stillwater Medical Center in Oklahoma. The hospital plans to hire temporary surgeons this spring, when one of its three local general surgeons leaves. Ms. Hendren is bracing for a hit to the bottom line. In 2007, it cost the hospital $1.2 million to cover the departure of a few anesthesiologists by hiring temporary replacements, contributing to a $4 million drop in operating income. Hiring temporary doctors adds "a lot of cost to the health-care system, and it's almost certainly going to get worse," says Richard Reynolds, president of MidMichigan Health, which operates four hospitals in the heart of the state. He estimates it costs the company twice as much to hire a temporary doctor than a permanent one. MidMichigan tries to pass on some of these costs in contract negotiations with insurers, says Mr. Reynolds, but it doesn't always succeed.
Steven Bengelsdorf, a 41-year-old doctor from Nashville, formed his own group of temporary surgeons to contract directly with hospitals so they avoid the extra cost of a staffing agency. Spending days or a week at a time away from his wife and three children is tough, Dr. Bengelsdorf says, but, "when I'm home, I'm home. I can participate in their lives and take them to birthday parties." If he were in traditional practice working 12- to 14-hour days, he adds, "I wouldn't get to see my kids."
The American College of Surgeons has long condemned the practice of "itinerant surgery," where doctors operate on patients and leave follow-up care to a family physician. But it has refrained from issuing guidelines on locum tenens. Paul Collicott, a director of the ACS, says it's "a necessary part of surgical practice today," given the overall shortage in the field. He says it's the responsibility of each temporary surgeon to make sure patients are handed off to another surgeon for postoperative care. The ACS also advises doctors who primarily work in urban hospitals, where the work is more specialized, not to do stints in small, rural hospitals, where they typically need to be jacks-of-all-trades.
In 2007, Marlene Tymchuk of Reedsport, Ore., learned she needed a large pool of blood called a hematoma removed from her groin. The hospital in her small coastal town was staffed by a temporary surgeon; the nearest hospital with a full-time surgeon was 45 minutes away. "I talked it over with my family," she says, debating whether it would be smarter to go to the bigger hospital and have consistent care. She decided to stay in Reedsport, in the hospital she knew well and near her family doctor. Though she saw another surgeon for her follow-up care, she says it felt better to be close to home.
Temporary surgeons used to be mostly older physicians who wanted a lighter workload, or those fresh out of training, still deciding where to put down roots. But today, more are midcareer people like Dr. Peppers, who had originally mapped out a more traditional path. Born in the same Franklin hospital she later operated in, she knew by age 10 she wanted to be a surgeon. She told her future husband -- a childhood friend -- she wanted to marry him so she could take his name and be "Dr. Peppers." After medical school, residency and a fellowship in laparoscopic surgery, she came back to her hometown to practice in 2000, saddled with $250,000 in debt. Paying it back turned out to be harder than she thought.
While Dr. Peppers was in training during the 1990s, the federal Medicare program was cutting back what it pays surgeons for many common procedures. For instance, in 2008, Medicare paid a general surgeon $562 for an appendectomy, compared with $580 in 1997. For a complex hemorrhoid removal, a general surgeon got $390 in 2008, compared with $574 in 1997. Private insurers followed suit.
Meanwhile, higher-priced procedures increasingly fell under the purview of more specialized fields. And, reflecting a steady rise in the number of uninsured and underinsured Americans, more of the patients whom surgeons would operate on in the emergency room had limited means to pay for treatment.
By 2007, Dr. Peppers says, she was making roughly $135,000 annually and her practice was struggling to pay its overhead and malpractice insurance. Since shuttering her practice last spring and becoming a full-time surgeon-for-hire, Dr. Peppers says she's earned enough money to whittle her medical-school debt to below $100,000. For the first time, she adds, she can focus exclusively on surgery and patients. "When I had a practice, it was like running a small business," she says. "It's like a huge weight has been lifted."
Dr. Peppers says she is careful to take assignments where she knows the surgeon she'll be handing cases off to and often follows up with a phone call. "I'm very conscientious about telling the patient, 'I'm here until 7 o'clock Monday morning. If there are any problems, after that you need to talk to Dr. so-and-so,'" she says. "I put a lot of responsibility onto patients."
SOURCE
A doctor killed a patient being treated for an infected bunion by injecting her with adrenaline against the advice of colleagues, a court heard yesterday. Priya Ramnath ignored two doctors' and a nursing sister's express instructions and failed to speak to a consultant anaesthetist before administering the fatal dose to 51-year-old Patricia Leighton in 1998, a jury was told. Mother-of-two Ramnath moved to America soon after. She denies the manslaughter of Mrs Leighton by gross negligence.
Ramnath, now 40, was working as a registrar in the intensive therapy unit at Stafford District General Hospital where Mrs Leighton was being treated for septic shock from the infection on her left foot. Ramnath, who was on a seven-week placement at the hospital, became concerned about Mrs Leighton's weak pulse and low blood pressure. She says she thought adrenaline was necessary because she believed the patient was about to go into cardiac arrest, the court heard.
Her colleagues advised her not to use adrenaline as they believed Mrs Leighton's condition could have been controlled without it. But Ramnath gave her a 3ml injection of it, Birmingham Crown Court was told. Prosecutor Michael Burrows QC, said: 'The effects of adrenaline are unpredictable and can be fatal. In the case of Mrs Leighton, they were fatal. 'Within moments of the injection, Mrs Leighton jerked forward and sat bolt upright in her bed. She shouted out "What's happening to me? I am going to die".' Mrs Leighton, of Burntwood, Staffordshire, then lost consciousness, her heart stopped and she died despite attempts to resucitate her.
Mr Burrows said: 'Mrs Leighton was not in cardiac arrest, the injection of a bolus of adrenaline was not necessary and should not have been given. 'She owed Mrs Leighton a duty of care, that duty was breached by giving her the adrenaline. There was no clinical indication that such treatment was necessary.' Mr Burrows said the Crown would call an expert witness who believed that Ramnath's alleged decision to ignore advice was arrogant and reckless.
He added that when writing up her notes Ramnath said she injected the adrenaline after Mrs Leighton went into cardiac arrest. He said: 'When someone does something wrong they may seek to conceal what they have done wrong. 'This is a case where you will have to consider whether Dr Ramnath sought to conceal what she has done and whether others helped her.'
Ramnath handed in her resignation less than a week after Mrs Leighton's death stating she had been planning to move to the US with her husband. Mr Burrows told the jury: 'You will have to consider whether she fled the country in order to hinder or escape the investigation into Mrs Leighton's death.' Ramnath, whose address cannot be published for legal reasons, came back to Britain in February last year after dropping her opposition to extradition proceedings.
SOURCE
Britain worse off for hospital beds than Macedonia
The provision of hospital beds in Britain has plunged in the past eight years to one of the lowest levels in Europe. The number of beds per person has dropped 14 per cent since 2000 - to below the rate for Latvia, Estonia and Macedonia. The UK has only 389 hospital beds per 100,000 inhabitants, even when taking into account both private and NHS beds. This is well below the EU average of 590 beds per 100,000 inhabitants.
The UK is ranked 25th out of 32 European countries. Only Cyprus, Portugal, Denmark, Spain, Sweden, Turkey and Malta perform worse. In 2000/01 the NHS had 186,091 beds, falling to 160,297 in 2007/08. Maternity beds have almost halved in number in some parts of the UK. In 2000/01 the NHS had 186,091 beds, falling to 160,297 in 2007/08. Maternity beds have almost halved in number in some parts of the UK.
Tory health spokesman Andrew Lansley, who obtained the figures from the European Commission, said: 'The objective of the NHS is to deliver world-class healthcare, not to maintain a certain number of hospital beds. 'It is madness to cut beds when wards are overcrowded, there aren't enough isolation rooms to control hospital infections and patients are still in mixed-sex accommodation. 'In 2000 Labour said that bed numbers needed to increase but these figures demonstrate again how badly they have failed.'
Health Minister Ben Bradshaw said: 'Given that the Conservatives are pledged to cut NHS funding, we await with interest a commitment by Andrew Lansley to increase expenditure on this or any other aspect of the work of the NHS that he frequently criticises.'
A Department of Health spokesman said: 'Bed numbers have fallen because people are being treated much more quickly - spending less time in hospital - and for many conditions medical advances mean they do not need to go to hospital at all. 'Detailed analysis of the past three years' MRSA and bed occupancy rates has shown no correlation between the two.'
SOURCE
US Surgeon Shortage Pushes Hospitals to Hire Temps
With miserly Medicare payments being a big part of the problem
When someone doubles over from stomach pain, the general surgeon is the one who performs an appendectomy. Gallstones? The general surgeon removes the gallbladder. Breast and colon tumors and hernias are also matters for the surgeon's scalpel. Now the economic and cultural forces reshaping U.S. medicine are prompting an exodus from this once venerable field, creating a growing market for temporary surgeons-for-hire.
As a general surgeon in her hometown of Franklin, Tenn., Jennifer Peppers could no longer keep her practice going after eight years in business. Faced with rising overhead costs and declines in reimbursements, she and her partners stopped drawing salaries last winter. To pay her home mortgage, Dr. Peppers had to borrow from a credit line.
So the surgeons shuttered their practice, and Dr. Peppers, 42 years old, hit the road. Her typical month might now include a weekend in Springfield, Ore., removing ruptured spleens or repairing obstructed bowels, followed by two weeks at a rural Kentucky or New Hampshire hospital. Though she misses her husband, she earns double her old salary and has paid off a big chunk of her medical-school debt. "I'd much prefer to be in my hospital in my little town," says Dr. Peppers, who is now licensed in five states. "But I don't see how that's possible."
The shift toward temporary assignments comes as the traditional way of practicing general surgery is fading in many parts of the country. For decades, general surgeons have been the backbone and economic engine of the community hospital. While maintaining their own private practices, they staff trauma and critical-care units and perform most common abdominal procedures. Without them, hospitals couldn't provide many emergency-room services. In rural areas, their backup is necessary for everything from complicated births to inserting chest tubes.
But the increasingly grueling schedules, shrinking payments and the temptation of more profitable surgical niches have made the field less attractive. Over the past 25 years, the number of general surgeons per capita has declined 25%, according to a study published in the Archives of Surgery earlier this year. Other specialties are also seeing shortages as their ranks grow more slowly than the overall population, but the decline in general surgery is steeper than most. And while the number of physicians overall isn't in decline, general surgery is one of the few fields where the absolute number of surgeons is actually shrinking.
It's possible that the implosion of Wall Street will rekindle an interest in medicine as a career, but future medical-school graduates could continue to flock to specialties that pay more than general surgery. Nearly three-quarters of surgeons-in-training already are opting for lucrative subspecialties with more predictable hours, such as cardiovascular surgery and neurosurgery, the American College of Surgeons says. That's left community hospitals around the U.S. struggling to provide some of their most basic services.
Some are turning to temporary physicians to fill the void. General surgery is now among the fastest-growing areas of a temporary-medical-staffing industry that's expected to double to $2.1 billion in 2009 from five years ago, according to Locumtenens.com, a staffing agency. The company, which takes its name from the Latin phrase meaning "to stand in another's place," matches hospitals with what the medical field calls locum tenens doctors. Rising demand for these services, in turn, is prompting more of the remaining general surgeons to choose a life on the road and in hotels.
Staffing agencies estimate that at least 1 in 20 of America's 17,000 general surgeons now work on a temporary basis some or all of the time. Full-time temporary surgeons can earn $250,000 or more a year, in some cases nearly twice as much as in private practice. That's largely because they don't have to pay overhead costs anymore.
Critics of the practice worry that it carries potential safety risks. A new surgeon arriving in town may not be familiar with a hospital's staff, for example, or with surgical patients coming in for follow-up visits. "That continuity of care in surgical diseases is really important," says Phillip Burns, chairman of the University of Tennessee's surgical department. As the one who performs the surgery, "you are the best one to handle [any problems] because you were the one inside."
Some who've switched to temporary work say patients often fare better with a surgeon who can focus entirely on providing care instead of the administrative hassles of a private practice. "I don't pay a penny of overhead now and I feel better than I have in years," says Kenneth Lawson, 55. Dr. Lawson left his practice in Roseburg, Ore., in 2005 to travel as a temporary surgeon.
While in private practice, Dr. Lawson says he would often spend five nights in a row on call, "bleary eyed," performing emergency surgeries. Increasingly, he says, these patients had no insurance. Hospitals typically have the means to pursue debts from patients or write the losses off as charity care, but doctors don't always have the manpower to collect on their portion of the bill. "We got to the point we wouldn't waste a stamp trying to get that money," says Dr. Lawson.
Locum tenens isn't a bargain for hospitals or a health-care system that is already the world's costliest and accounts for nearly 17% of the U.S. economy, according to federal government data. A temporary surgeon who comes in to perform scheduled procedures and emergency operations can cost a hospital about $1,500 a day -- between $650 and $900 for the physician and about the same for the staffing agency, according to Staff Care, a temporary-medical-placement firm. That's in addition to travel and lodging expenses. In traditional practice, hospitals don't pay surgeons directly: They give them "privileges" to use their operating rooms in exchange for sharing in emergency-call duty.
Yet, without the ability to perform surgeries, "we lose the business," says Karen Hendren, chief operating officer of Stillwater Medical Center in Oklahoma. The hospital plans to hire temporary surgeons this spring, when one of its three local general surgeons leaves. Ms. Hendren is bracing for a hit to the bottom line. In 2007, it cost the hospital $1.2 million to cover the departure of a few anesthesiologists by hiring temporary replacements, contributing to a $4 million drop in operating income. Hiring temporary doctors adds "a lot of cost to the health-care system, and it's almost certainly going to get worse," says Richard Reynolds, president of MidMichigan Health, which operates four hospitals in the heart of the state. He estimates it costs the company twice as much to hire a temporary doctor than a permanent one. MidMichigan tries to pass on some of these costs in contract negotiations with insurers, says Mr. Reynolds, but it doesn't always succeed.
Steven Bengelsdorf, a 41-year-old doctor from Nashville, formed his own group of temporary surgeons to contract directly with hospitals so they avoid the extra cost of a staffing agency. Spending days or a week at a time away from his wife and three children is tough, Dr. Bengelsdorf says, but, "when I'm home, I'm home. I can participate in their lives and take them to birthday parties." If he were in traditional practice working 12- to 14-hour days, he adds, "I wouldn't get to see my kids."
The American College of Surgeons has long condemned the practice of "itinerant surgery," where doctors operate on patients and leave follow-up care to a family physician. But it has refrained from issuing guidelines on locum tenens. Paul Collicott, a director of the ACS, says it's "a necessary part of surgical practice today," given the overall shortage in the field. He says it's the responsibility of each temporary surgeon to make sure patients are handed off to another surgeon for postoperative care. The ACS also advises doctors who primarily work in urban hospitals, where the work is more specialized, not to do stints in small, rural hospitals, where they typically need to be jacks-of-all-trades.
In 2007, Marlene Tymchuk of Reedsport, Ore., learned she needed a large pool of blood called a hematoma removed from her groin. The hospital in her small coastal town was staffed by a temporary surgeon; the nearest hospital with a full-time surgeon was 45 minutes away. "I talked it over with my family," she says, debating whether it would be smarter to go to the bigger hospital and have consistent care. She decided to stay in Reedsport, in the hospital she knew well and near her family doctor. Though she saw another surgeon for her follow-up care, she says it felt better to be close to home.
Temporary surgeons used to be mostly older physicians who wanted a lighter workload, or those fresh out of training, still deciding where to put down roots. But today, more are midcareer people like Dr. Peppers, who had originally mapped out a more traditional path. Born in the same Franklin hospital she later operated in, she knew by age 10 she wanted to be a surgeon. She told her future husband -- a childhood friend -- she wanted to marry him so she could take his name and be "Dr. Peppers." After medical school, residency and a fellowship in laparoscopic surgery, she came back to her hometown to practice in 2000, saddled with $250,000 in debt. Paying it back turned out to be harder than she thought.
While Dr. Peppers was in training during the 1990s, the federal Medicare program was cutting back what it pays surgeons for many common procedures. For instance, in 2008, Medicare paid a general surgeon $562 for an appendectomy, compared with $580 in 1997. For a complex hemorrhoid removal, a general surgeon got $390 in 2008, compared with $574 in 1997. Private insurers followed suit.
Meanwhile, higher-priced procedures increasingly fell under the purview of more specialized fields. And, reflecting a steady rise in the number of uninsured and underinsured Americans, more of the patients whom surgeons would operate on in the emergency room had limited means to pay for treatment.
By 2007, Dr. Peppers says, she was making roughly $135,000 annually and her practice was struggling to pay its overhead and malpractice insurance. Since shuttering her practice last spring and becoming a full-time surgeon-for-hire, Dr. Peppers says she's earned enough money to whittle her medical-school debt to below $100,000. For the first time, she adds, she can focus exclusively on surgery and patients. "When I had a practice, it was like running a small business," she says. "It's like a huge weight has been lifted."
Dr. Peppers says she is careful to take assignments where she knows the surgeon she'll be handing cases off to and often follows up with a phone call. "I'm very conscientious about telling the patient, 'I'm here until 7 o'clock Monday morning. If there are any problems, after that you need to talk to Dr. so-and-so,'" she says. "I put a lot of responsibility onto patients."
SOURCE
Wednesday, January 14, 2009
NHS squanders millions on agency staff - with some nurses earning up to $200 an HOUR
Millions of pounds of health service funds are being wasted employing agency nurses on up to 128 pounds an hour. This is almost ten times the amount paid to an experienced staff nurse - and equates to a salary of 250,000. Overall, the health service spent almost 800million on agency doctors, nurses and consultants in 2006-07, according to the figures uncovered in a Freedom of Information request. That could fund around ten hospitals or employ 30,000 full- time experienced nurses. Agency staff are plugging the holes left by the 11,000 nurses who left to work overseas last year, seeking better pay and conditions.
The yawning gap between rates for NHS workers and agency locums exists at every level including managers and even prison GPs, who have been paid up to 158 an hour. The figures also show that much of the money goes into the pockets of agency bosses rather than to the workers, who can earn less than two-thirds of what the NHS pays out.
The Department of Health insists that the amount spent on agency staff is falling, year on year. But critics say it must do more to prevent agencies 'creaming off' millions meant to improve the standards of care. Dr Peter Carter, the chief executive and general secretary of the Royal College of Nursing, said: 'We are concerned and we want the Government to tackle this as a matter of urgency. 'If the NHS made more effort attracting and retaining permanent staff, it would obviate the need for many agency nurses. 'It's understandable that members of the public seeing these huge rates wonder whether nurses really are underpaid, but the reality is that individuals working for agencies get much less than the NHS is charged. There are private companies that are making a killing out of the NHS.'
He said many nurses were emigrating, partly because the NHS could not help with high housing costs in many areas. He said: 'There has been a huge surge in UK nurses wanting to work abroad and they have employment opportunities in the U.S., Australia, South Africa and other countries. Almost 11,000 went last year.'
Tory health spokesman Andrew Lansley, who obtained the figures, said: 'For years the Government have been telling us how many extra staff they have hired for the NHS. So surely we should have reached a situation by now where we no longer need to keep paying out millions each year to agencies and their staff? 'It is a dreadful waste of taxpayers' money at a time when we can least afford it.'
All NHS trusts were asked to provide details of the highest amount they paid to an agency worker between May and October 2008 and there was a response rate of more than 70 per cent. An agency nurse employed at Great Western Hospitals NHS Foundation Trust in Swindon was paid 128 an hour. An experienced nurse on Band 5 pay in the NHS gets 13 an hour or 26,000 a year - almost ten times less. Whipps Cross University Hospitals NHS Trust said it paid 188 an hour for an anaesthetics medical consultant, equivalent to a salary of 366,000.
The resulting data did not show whether the workers came from privately-run agencies or from NHS Professionals, a non-profit agency set up by the Government to provide flexible staff. Some agencies-were taking large cuts. Somerset Partnership NHS Foundation Trust paid 116 per hour for a nurse but the agency took 50 (43 per cent).
Matthew Elliott of the TaxPayers' Alliance said: 'Agencies have creamed off millions of pounds of taxpayers' money, whilst patients continue to receive below-par care.' A Department of Health spokesman said: 'Temporary staff have, and continue to have, a key role in helping the NHS to respond to fluctuations in demand for services and in staff availability. 'The total pay bill spent on agency staff has reduced from 5.5 per cent in 2003-04, to 4.2 per cent in 2004-05 to 3.5 per cent in 2005-06, 2.7 per cent in 2006-07 and 3.2 per cent in 2007-08.'
Source
Australia: More "caring" socialist medicine
Mother charged $500 to park at hospital but media exposure brings a backdown
THE Children's Hospital, Westmead has told a mother about to donate a kidney to her daughter she will have to pay $500 in parking fees. The case of South Granville mother Kristy Hite has exposed the confusion and heartlessness of the hospital's new parking policy. The Daily Telegraph this week revealed the State Government's plan to privatise hospital car parks and Westmead's proposal to increase fees at its car park.
Ms Hite's daughter Lily, 4, has been sick since she was born and the struggling family was entitled to free parking. Last month a hospital social worker said the free parking would be revoked and Ms Hite would have to pay for parking for at least two months until the hospital could consider her case. If Ms Hite parks at the hospital - which is now charging $16 a day, up from $12 - during visits before and after her daughter's operation she would pay about $512.
When The Daily Telegraph alerted the hospital to Ms Hite's plight yesterday, a spokeswoman said there had been a miscommunication and the family would continue to be allowed to park free. "She (the social worker) said she was looking into what we could do further down the track," Ms Hite said yesterday. "She said I would have to pay for a couple of months until they worked something out, it was a very vague conversation we had. "It is the worst time for them to cancel that card, we're going to live here for at least a month."
Ms Hite has moved from Nowra to South Granville and borrowed money to stay afloat. Before the hospital returned her parking privileges, she said she would have to park blocks from the hospital and walk to see her daughter despite undergoing serious surgery to have her kidney removed. "That cost isn't even an option . . . I am in debt up to my eyeballs," she said. "I am amazed you have to pay at all and the price is ridiculous."
Health Minister John Della Bosca said yesterday he had called the hospital to ensure families were given proper consideration. A spokeswoman for the hospital said Ms Hite would be provided with free parking.
SOURCE
Millions of pounds of health service funds are being wasted employing agency nurses on up to 128 pounds an hour. This is almost ten times the amount paid to an experienced staff nurse - and equates to a salary of 250,000. Overall, the health service spent almost 800million on agency doctors, nurses and consultants in 2006-07, according to the figures uncovered in a Freedom of Information request. That could fund around ten hospitals or employ 30,000 full- time experienced nurses. Agency staff are plugging the holes left by the 11,000 nurses who left to work overseas last year, seeking better pay and conditions.
The yawning gap between rates for NHS workers and agency locums exists at every level including managers and even prison GPs, who have been paid up to 158 an hour. The figures also show that much of the money goes into the pockets of agency bosses rather than to the workers, who can earn less than two-thirds of what the NHS pays out.
The Department of Health insists that the amount spent on agency staff is falling, year on year. But critics say it must do more to prevent agencies 'creaming off' millions meant to improve the standards of care. Dr Peter Carter, the chief executive and general secretary of the Royal College of Nursing, said: 'We are concerned and we want the Government to tackle this as a matter of urgency. 'If the NHS made more effort attracting and retaining permanent staff, it would obviate the need for many agency nurses. 'It's understandable that members of the public seeing these huge rates wonder whether nurses really are underpaid, but the reality is that individuals working for agencies get much less than the NHS is charged. There are private companies that are making a killing out of the NHS.'
He said many nurses were emigrating, partly because the NHS could not help with high housing costs in many areas. He said: 'There has been a huge surge in UK nurses wanting to work abroad and they have employment opportunities in the U.S., Australia, South Africa and other countries. Almost 11,000 went last year.'
Tory health spokesman Andrew Lansley, who obtained the figures, said: 'For years the Government have been telling us how many extra staff they have hired for the NHS. So surely we should have reached a situation by now where we no longer need to keep paying out millions each year to agencies and their staff? 'It is a dreadful waste of taxpayers' money at a time when we can least afford it.'
All NHS trusts were asked to provide details of the highest amount they paid to an agency worker between May and October 2008 and there was a response rate of more than 70 per cent. An agency nurse employed at Great Western Hospitals NHS Foundation Trust in Swindon was paid 128 an hour. An experienced nurse on Band 5 pay in the NHS gets 13 an hour or 26,000 a year - almost ten times less. Whipps Cross University Hospitals NHS Trust said it paid 188 an hour for an anaesthetics medical consultant, equivalent to a salary of 366,000.
The resulting data did not show whether the workers came from privately-run agencies or from NHS Professionals, a non-profit agency set up by the Government to provide flexible staff. Some agencies-were taking large cuts. Somerset Partnership NHS Foundation Trust paid 116 per hour for a nurse but the agency took 50 (43 per cent).
Matthew Elliott of the TaxPayers' Alliance said: 'Agencies have creamed off millions of pounds of taxpayers' money, whilst patients continue to receive below-par care.' A Department of Health spokesman said: 'Temporary staff have, and continue to have, a key role in helping the NHS to respond to fluctuations in demand for services and in staff availability. 'The total pay bill spent on agency staff has reduced from 5.5 per cent in 2003-04, to 4.2 per cent in 2004-05 to 3.5 per cent in 2005-06, 2.7 per cent in 2006-07 and 3.2 per cent in 2007-08.'
Source
Australia: More "caring" socialist medicine
Mother charged $500 to park at hospital but media exposure brings a backdown
THE Children's Hospital, Westmead has told a mother about to donate a kidney to her daughter she will have to pay $500 in parking fees. The case of South Granville mother Kristy Hite has exposed the confusion and heartlessness of the hospital's new parking policy. The Daily Telegraph this week revealed the State Government's plan to privatise hospital car parks and Westmead's proposal to increase fees at its car park.
Ms Hite's daughter Lily, 4, has been sick since she was born and the struggling family was entitled to free parking. Last month a hospital social worker said the free parking would be revoked and Ms Hite would have to pay for parking for at least two months until the hospital could consider her case. If Ms Hite parks at the hospital - which is now charging $16 a day, up from $12 - during visits before and after her daughter's operation she would pay about $512.
When The Daily Telegraph alerted the hospital to Ms Hite's plight yesterday, a spokeswoman said there had been a miscommunication and the family would continue to be allowed to park free. "She (the social worker) said she was looking into what we could do further down the track," Ms Hite said yesterday. "She said I would have to pay for a couple of months until they worked something out, it was a very vague conversation we had. "It is the worst time for them to cancel that card, we're going to live here for at least a month."
Ms Hite has moved from Nowra to South Granville and borrowed money to stay afloat. Before the hospital returned her parking privileges, she said she would have to park blocks from the hospital and walk to see her daughter despite undergoing serious surgery to have her kidney removed. "That cost isn't even an option . . . I am in debt up to my eyeballs," she said. "I am amazed you have to pay at all and the price is ridiculous."
Health Minister John Della Bosca said yesterday he had called the hospital to ensure families were given proper consideration. A spokeswoman for the hospital said Ms Hite would be provided with free parking.
SOURCE
Tuesday, January 13, 2009
The GOP Should Fight Health-Care Rationing
Obama's HMO deserves principled opposition
Perhaps the greatest missed opportunity of the past eight years was the chance for Republicans to fundamentally reform the terribly broken American health-care system. Access to quality health care has long been a professed priority, yet Republicans have been reluctant to tackle the issue.
As a physician, this is deeply disappointing to me because patient-centered health care is, at its core, conservative. Health care is fundamentally a personal relationship between patients and doctors. To honor this relationship -- consistent with Republican ideals -- our goal should be to provide a system that allows access to affordable, quality health care for all Americans, in a way that ensures medical decisions are made in doctors' offices, not Washington.
Republican unwillingness to address the issue, however, has left us facing an emboldened Democratic Party well equipped to push a government-centered health-care agenda. While Democrats are still dangerously misguided in their policies, this time they are prepared to avoid the political mistakes of the Clinton administration.
For a preview, look no further than "What We Can Do About the Health-Care Crisis," a book published this year by former Sen. Tom Daschle, President-elect Barack Obama's choice for secretary of Health and Human Services. Atop the list of worrisome ideas proposed by Mr. Daschle is the creation of an innocently termed "Federal Health Advisory Board."
This board would offer recommendations to private insurers and create a single standard of care for all public programs, including which procedures doctors may perform, which drugs patients may take, and how many diagnostic machines hospitals really need. As with Medicare, for any care provided outside the board's guidelines, patients and physicians would not be reimbursed.
Mr. Daschle is quick to note the board's standards would serve only as a suggestion to the private market. Yet to ensure that there are no rogue private insurers, he has proposed making the employer tax deduction for providing health insurance dependent on compliance with the board's standards. In an overtly political ruse, Democrats will claim they are dictating nothing to private providers, while whipping noncompliant insurers in place through the tax code.
To be sure, this strategy seeks to eliminate private providers completely. Forced into accepting rigid Washington rules and unsustainable financing mechanisms under Mr. Daschle's plan, most private insurers would be quickly eradicated. Or, as Mr. Daschle soberly predicts in his book, "the health-care industry would have to reconsider its business plan."
If we fail to recognize the scope and scale of Democratic ambition on this issue, we will find ourselves with a permanent Washington bureaucracy prescribing patient care. Our goal, however, must not be confined to defeating a Democratic proposal. Instead, we must advocate for a positive approach to health-care reform that does not sacrifice patient care to achieve its goals. This patient-centered approach must be built upon two pillars: access to coverage for all Americans and coverage that is truly owned by patients.
First, we must fundamentally reform the tax code so that it makes sense for all people to have health insurance. This may be readily accomplished through the adoption of tax equity for the purchase of insurance, active pooling mechanisms for increased purchasing power, and focused use of tax deductions and credits. Through positive changes in the tax code we can make health-care cost effective and create incentives so there is no reason to be uninsured. This way, care is purchased without government interference between you and your doctor.
Secondly, we must transform our health-care model to one that is owned and controlled by patients. Currently, most Americans receive coverage through a third party, leaving health-care decisions to an employer or the government. By creating a new system in which Americans are provided the opportunity to purchase whichever health-coverage product fits their personal needs, insurers would be forced to focus on patients. Not until patients truly own their own health plans will we see the accountability and flexibility needed to ensure quality care and necessary cost-lowering efficiencies.
A historic debate about American health care is fast approaching. We are not doomed to a Washington-run bureaucratic health-care system, so long as Republicans push for the right remedy for health care and return to being the party of solutions.
Source
Four-hour wait for a lifesaving British ambulance trip
They actually keep ambulances out of action for bureaucratic reasons!
Patients with life --threatening conditions are waiting up to four hours for an ambulance. One man with suspected poisoning had to wait three hours 47 minutes for an ambulance to drive less than a mile to treat him. Others suffering from severe breathing difficulties have had to wait two hours for medical help to arrive. Government targets say ambulance trusts should reach such 'category-A' patients within eight minutes in 75 per cent of cases. But the lack of a maximum time means some are waiting hours.
The cases were uncovered in Freedom of Information requests. The figures, from 2007/08, also showed that some 'category-B' patients - those with illnesses that need urgent hospital treatment but are not life-threatening - are waiting as long as nine hours before help arrives, even though trusts are supposed to attend 95 per cent of such calls within 19 minutes.
A patient with severe back pain waited nine hours 11 minutes for paramedics to show up in London. The ambulance trust blamed a lack of vehicles. Many of the slowest responses occurred over the 2007/08 New Year period, when paramedics had to deal with thousands of drunken revellers and an upsurge in flu and breathing problems.
There was massive variation across the country in the slowest response time for a category-A case. In the North West it was just 38 minutes, but in the East Midlands, the longest response took two hours and 34 minutes, and in Wales, three hours 47 minutes - the suspected poisoning case.
Critics blamed the failures on Labour's strict four-hour maximum waiting time for hospital accident and emergency units. As this is only counted from when the patient steps through the casualty department doors, ambulances often queue outside hospitals, dropping off patients only when they are certain to be seen within the allotted time.
A Department of Health spokesman said: 'We often see an increase in demand for ambulances during the winter season and this year is no different. 'The NHS is coping well with this increased demand. We have done a lot of work in recent years across the country to share best practice. Our staff are working hard and doing great work to respond to the extra demand.'
SOURCE
Obama's HMO deserves principled opposition
Perhaps the greatest missed opportunity of the past eight years was the chance for Republicans to fundamentally reform the terribly broken American health-care system. Access to quality health care has long been a professed priority, yet Republicans have been reluctant to tackle the issue.
As a physician, this is deeply disappointing to me because patient-centered health care is, at its core, conservative. Health care is fundamentally a personal relationship between patients and doctors. To honor this relationship -- consistent with Republican ideals -- our goal should be to provide a system that allows access to affordable, quality health care for all Americans, in a way that ensures medical decisions are made in doctors' offices, not Washington.
Republican unwillingness to address the issue, however, has left us facing an emboldened Democratic Party well equipped to push a government-centered health-care agenda. While Democrats are still dangerously misguided in their policies, this time they are prepared to avoid the political mistakes of the Clinton administration.
For a preview, look no further than "What We Can Do About the Health-Care Crisis," a book published this year by former Sen. Tom Daschle, President-elect Barack Obama's choice for secretary of Health and Human Services. Atop the list of worrisome ideas proposed by Mr. Daschle is the creation of an innocently termed "Federal Health Advisory Board."
This board would offer recommendations to private insurers and create a single standard of care for all public programs, including which procedures doctors may perform, which drugs patients may take, and how many diagnostic machines hospitals really need. As with Medicare, for any care provided outside the board's guidelines, patients and physicians would not be reimbursed.
Mr. Daschle is quick to note the board's standards would serve only as a suggestion to the private market. Yet to ensure that there are no rogue private insurers, he has proposed making the employer tax deduction for providing health insurance dependent on compliance with the board's standards. In an overtly political ruse, Democrats will claim they are dictating nothing to private providers, while whipping noncompliant insurers in place through the tax code.
To be sure, this strategy seeks to eliminate private providers completely. Forced into accepting rigid Washington rules and unsustainable financing mechanisms under Mr. Daschle's plan, most private insurers would be quickly eradicated. Or, as Mr. Daschle soberly predicts in his book, "the health-care industry would have to reconsider its business plan."
If we fail to recognize the scope and scale of Democratic ambition on this issue, we will find ourselves with a permanent Washington bureaucracy prescribing patient care. Our goal, however, must not be confined to defeating a Democratic proposal. Instead, we must advocate for a positive approach to health-care reform that does not sacrifice patient care to achieve its goals. This patient-centered approach must be built upon two pillars: access to coverage for all Americans and coverage that is truly owned by patients.
First, we must fundamentally reform the tax code so that it makes sense for all people to have health insurance. This may be readily accomplished through the adoption of tax equity for the purchase of insurance, active pooling mechanisms for increased purchasing power, and focused use of tax deductions and credits. Through positive changes in the tax code we can make health-care cost effective and create incentives so there is no reason to be uninsured. This way, care is purchased without government interference between you and your doctor.
Secondly, we must transform our health-care model to one that is owned and controlled by patients. Currently, most Americans receive coverage through a third party, leaving health-care decisions to an employer or the government. By creating a new system in which Americans are provided the opportunity to purchase whichever health-coverage product fits their personal needs, insurers would be forced to focus on patients. Not until patients truly own their own health plans will we see the accountability and flexibility needed to ensure quality care and necessary cost-lowering efficiencies.
A historic debate about American health care is fast approaching. We are not doomed to a Washington-run bureaucratic health-care system, so long as Republicans push for the right remedy for health care and return to being the party of solutions.
Source
Four-hour wait for a lifesaving British ambulance trip
They actually keep ambulances out of action for bureaucratic reasons!
Patients with life --threatening conditions are waiting up to four hours for an ambulance. One man with suspected poisoning had to wait three hours 47 minutes for an ambulance to drive less than a mile to treat him. Others suffering from severe breathing difficulties have had to wait two hours for medical help to arrive. Government targets say ambulance trusts should reach such 'category-A' patients within eight minutes in 75 per cent of cases. But the lack of a maximum time means some are waiting hours.
The cases were uncovered in Freedom of Information requests. The figures, from 2007/08, also showed that some 'category-B' patients - those with illnesses that need urgent hospital treatment but are not life-threatening - are waiting as long as nine hours before help arrives, even though trusts are supposed to attend 95 per cent of such calls within 19 minutes.
A patient with severe back pain waited nine hours 11 minutes for paramedics to show up in London. The ambulance trust blamed a lack of vehicles. Many of the slowest responses occurred over the 2007/08 New Year period, when paramedics had to deal with thousands of drunken revellers and an upsurge in flu and breathing problems.
There was massive variation across the country in the slowest response time for a category-A case. In the North West it was just 38 minutes, but in the East Midlands, the longest response took two hours and 34 minutes, and in Wales, three hours 47 minutes - the suspected poisoning case.
Critics blamed the failures on Labour's strict four-hour maximum waiting time for hospital accident and emergency units. As this is only counted from when the patient steps through the casualty department doors, ambulances often queue outside hospitals, dropping off patients only when they are certain to be seen within the allotted time.
A Department of Health spokesman said: 'We often see an increase in demand for ambulances during the winter season and this year is no different. 'The NHS is coping well with this increased demand. We have done a lot of work in recent years across the country to share best practice. Our staff are working hard and doing great work to respond to the extra demand.'
SOURCE
Monday, January 12, 2009
NHS Trust where 270 died of superbug STILL making 'serious' hygiene breaches
Undercover inspectors have found continued hygiene failings at the NHS trust where 270 people died of the superbug C. diff. Spot checks revealed evidence of 'serious' breaches of hygiene on a specialist ward where internal body cameras were not being properly decontaminated before being inserted into another patient. The Healthcare Commission said there was still a shortage of nurses at the trust and on one ward staff could not wash their hands because there was no accessible basin.
At least 90 people died as a direct result of C. diff, and a further 180 deaths were hastened by two outbreaks at three hospitals covered by the Maidstone and Tunbridge Wells trust in 2006 and 2007. The trust's chief executive, Rose Gibb, resigned after being offered a 250,000 payout. It was later reduced to 75,000 - half her annual salary. Miss Gibb is appealing the reduced payoff through the High Court.
Now a follow-up investigation by the Healthcare Commission has said the trust - which runs the Kent and Sussex Hospital, Pembury Hospital and Maidstone Hospital - still needs to do better. A spot check in October found several breaches of the Government's-hygiene code.
The most serious related to decontamination of equipment in the endoscopy unit at Kent and Sussex Hospital in Tunbridge Wells. A special double sink for washing the internal camera equipment has now been ordered.
It was also found that although regular audits were being carried out on the effectiveness of infection control facilities, the recommendations were not being followed up across the trust. But specific wards have been allocated for the isolation of infected patients and there are better standards of cleaning and improved staff training. The latest C. diff figures were the lowest for three years.
Healthcare Commission head of investigations Nigel Ellis said: 'The trust's infection control system still needs further improvement.' Inspectors will visit the trust in July to check on progress. Geoff Martin of pressure group Health Emergency said: 'This was the biggest corporate failure in the history of the NHS. It is shocking that there are still problems this far on.'
Source
Australia: Public hospital delays killing cancer patients
CANCER campaigners are developing a hospital waiting lists shame file in an attempt to cut treatment delays they say could be killing patients. People who have faced hold-ups in the state's health system are being urged to contact Cancer Council Queensland's hotline, from tomorrow, to report their experiences. Chief executive officer Professor Jeff Dunn said the calls would be logged and presented to Health Minister Stephen Robertson.
The move follows the release of Queensland Health figures showing more than 250 Category 2 patients had been waiting more than two years for elective surgery. People in that group - including cancer and heart disease patients - should be operated on within 90 days, according to State Government guidelines.
"We are very concerned that some cancer patients might have experienced a two-year wait for treatment," said Prof Dunn. "We have a moral responsibility to ensure that Queenslanders with cancer are receiving timely treatment."
The Cancer Council says hold-ups in getting access to treatment could cost lives. "A two-year delay in treatment for most types of cancer is too long and could have an impact on patient survival and quality of life. "With timely treatment, effective care and support, people have a much better chance of surviving and thriving after a cancer diagnosis," Prof Dunn said.
Long waits could also cause additional pain and distress for patients and their loved ones, he said. "The diagnosis and treatment of cancer is a major life stress for most people and brings with it a range of psychological challenges, including anxiety, depression and - for some - feelings of loneliness, confusion and fear of the future. "Over one-third of people diagnosed with cancer experience persistent, clinically significant distress, and carers often experience even higher distress than patients.
"A two-year waiting time could significantly exacerbate their distress, with adverse effects on the patient's treatment and recovery process."
Source
Undercover inspectors have found continued hygiene failings at the NHS trust where 270 people died of the superbug C. diff. Spot checks revealed evidence of 'serious' breaches of hygiene on a specialist ward where internal body cameras were not being properly decontaminated before being inserted into another patient. The Healthcare Commission said there was still a shortage of nurses at the trust and on one ward staff could not wash their hands because there was no accessible basin.
At least 90 people died as a direct result of C. diff, and a further 180 deaths were hastened by two outbreaks at three hospitals covered by the Maidstone and Tunbridge Wells trust in 2006 and 2007. The trust's chief executive, Rose Gibb, resigned after being offered a 250,000 payout. It was later reduced to 75,000 - half her annual salary. Miss Gibb is appealing the reduced payoff through the High Court.
Now a follow-up investigation by the Healthcare Commission has said the trust - which runs the Kent and Sussex Hospital, Pembury Hospital and Maidstone Hospital - still needs to do better. A spot check in October found several breaches of the Government's-hygiene code.
The most serious related to decontamination of equipment in the endoscopy unit at Kent and Sussex Hospital in Tunbridge Wells. A special double sink for washing the internal camera equipment has now been ordered.
It was also found that although regular audits were being carried out on the effectiveness of infection control facilities, the recommendations were not being followed up across the trust. But specific wards have been allocated for the isolation of infected patients and there are better standards of cleaning and improved staff training. The latest C. diff figures were the lowest for three years.
Healthcare Commission head of investigations Nigel Ellis said: 'The trust's infection control system still needs further improvement.' Inspectors will visit the trust in July to check on progress. Geoff Martin of pressure group Health Emergency said: 'This was the biggest corporate failure in the history of the NHS. It is shocking that there are still problems this far on.'
Source
Australia: Public hospital delays killing cancer patients
CANCER campaigners are developing a hospital waiting lists shame file in an attempt to cut treatment delays they say could be killing patients. People who have faced hold-ups in the state's health system are being urged to contact Cancer Council Queensland's hotline, from tomorrow, to report their experiences. Chief executive officer Professor Jeff Dunn said the calls would be logged and presented to Health Minister Stephen Robertson.
The move follows the release of Queensland Health figures showing more than 250 Category 2 patients had been waiting more than two years for elective surgery. People in that group - including cancer and heart disease patients - should be operated on within 90 days, according to State Government guidelines.
"We are very concerned that some cancer patients might have experienced a two-year wait for treatment," said Prof Dunn. "We have a moral responsibility to ensure that Queenslanders with cancer are receiving timely treatment."
The Cancer Council says hold-ups in getting access to treatment could cost lives. "A two-year delay in treatment for most types of cancer is too long and could have an impact on patient survival and quality of life. "With timely treatment, effective care and support, people have a much better chance of surviving and thriving after a cancer diagnosis," Prof Dunn said.
Long waits could also cause additional pain and distress for patients and their loved ones, he said. "The diagnosis and treatment of cancer is a major life stress for most people and brings with it a range of psychological challenges, including anxiety, depression and - for some - feelings of loneliness, confusion and fear of the future. "Over one-third of people diagnosed with cancer experience persistent, clinically significant distress, and carers often experience even higher distress than patients.
"A two-year waiting time could significantly exacerbate their distress, with adverse effects on the patient's treatment and recovery process."
Source
Saturday, January 10, 2009
Starved to death in an NHS hospital: Damning inquiry highlights case of patient left without food for 26 days
Nobody gives a stuff when you are in the hands of the government
A vulnerable patient starved to death in an NHS hospital after 26 days without proper nourishment. Martin Ryan, 43, had suffered a stroke which left him unable to swallow. But a 'total breakdown in communication' meant he was never fitted with a feeding tube. It was one of a number of horrific cases where the NHS fatally failed patients with learning difficulties, a health watchdog is expected to rule later this month.
Emma Kemp, 26, was denied cancer treatment that could have saved her life, while 30-year-old Mark Cannon died two months after being admitted to hospital with a broken leg. Three other cases followed similar patterns, with warnings ignored or problems missed until it was too late, often because the patients had difficulty communicating.
Ann Abraham, the Parliamentary and Health Service Ombudsman, is expected to deliver a withering verdict in her report. Sources said the overall picture of neglect that it paints is devastating. Campaigners will seize on the findings as evidence of a wider problem of institutional discrimination in the health service.
The father of one man who died, who was just 20, said: 'People like my son are treated as less than human'. The six cases were first highlighted by the disability charity Mencap in a report entitled Death By Indifference. The charity, which has complained of 'widespread ignorance' in the NHS, says many more cases have emerged since then.
Sources close to the Ombudsman's inquiry said its findings will vindicate Mencap's attack almost totally. One said: 'The Ombudsman will issue a damning verdict in most, though not all, of the cases. 'In some cases the NHS's treatment of vulnerable people was quite shocking - a patient effectively being starved to death is indefensible. 'There will be a lot for NHS trusts and politicians to chew over.'
The report will intensify pressure on ministers to rapidly ensure tighter procedures for the care of such vulnerable patients. Tory spokesman Anne Milton said: 'Unfortunately we are still seeing some pretty shocking cases where people's needs have been neglected and they are not gaining equal access to the NHS. 'Although these might be isolated incidents, every case like this is one too many. 'This is another deeply worrying example of how the Government has yet to get to grips with providing first-class care for everyone, including people with disabilities.'
Mr Ryan, who had Down's syndrome, died in hospital in Kingston-upon-Thames. An internal inquiry by the hospital found that doctors had thought nurses were feeding him through a tube in his nose. By the time they found out this was not happening, he was too weak for an operation to insert a tube into his stomach. He died in agony five days later.
Mr Ryan's distraught family, from Richmond, South-west London, are convinced he could have been saved by the correct treatment. One relative said of him: 'Martin will always be the light of my life. He had a quirky sense of humour and oodles of charm. He was often smiling - he loved to go out, liked the movement of the coach and listening to the music.'
Death by Indifference was published in 2007 as part of Mencap's long-running Treat Me Right! campaign for better healthcare for people with learning disabilities. Mark Goldring, Mencap's chief executive, said: 'Our report exposed the horrific deaths of six people with a learning disability who died unnecessarily in NHS care. 'We have fought and will continue our fight for justice for their families. 'The Ombudsman's reports must condemn the appalling failings of the NHS in these six cases. 'They need to make it impossible for people with a learning disability to continue to die unnecessarily. A failure to do this would be irrational and perverse. 'The reports have a duty to challenge complacency, where it has been shown to exist within the health service, when treating people with a learning disability and must hold individuals to account for their actions.'
The Ombudsman's inquiry, which covers just the six cases, will mirror the findings of a wider investigation into the treatment of vulnerable patients which was ordered by the Government after Mencap's report came out. Chaired by Sir Jonathan Michael, a former chief executive of Guy's and St Thomas' NHS Foundation Trust, it found that the deaths highlighted by the charity were 'not isolated' incidents. A spokesman for the Ombudsman declined to comment before the report is published.
There are 1.5million people with a learning disability in the UK. Mencap says most are treated as ' different' and do not have the same control over their own lives as the rest of society.
Earlier this week the Mail revealed the growing scandal of 'avoidable deaths' in the NHS. Figures showed that the number of patients killed by hospital blunders has soared by 60 per cent in two years to a frightening 3,645.
Source
Australia: Another birth in a public hospital toilet
Aint government medicine wonderful?
A WOMAN has told how she miscarried "in a blur" in a hospital toilet then cleaned up the area herself. Mother-of-two Jodie Whiteside was 14 weeks pregnant when she felt something was "wrong". After believing her waters had broken, and able to see the leg of her child, Ms Whiteside headed to Maitland Hospital, about 30 minutes drive from her home in the New South Wales Hunter region. "En route my husband phoned up the Maitland Hospital emergency department to say what had happened and that I was on my way," Ms Whiteside said on the Fairfax Radio Network. "It was a blase response, basically that I have to be processed like everyone else and wait to see the triage nurse."
On arrival at the hospital, Ms Whiteside said she was "in a lot of pain, cowering over the counter" while she was being asked for her personal details. A triage nurse then asked Ms Whiteside a series of questions. "I said that I saw the baby coming away and she proceeded to take my blood pressure, I think that she took my temperature and she gave me a plastic pot and said 'I need a urine sample'," she said. "I told her that I was 14 weeks pregnant ... I asked her 'if I'm miscarrying what do I do?' She said there is nothing they can do and instructed me to go to the toilet."
After making her way through a crowded emergency department waiting room, Ms Whiteside reached the women's public toilet. "It's a bit of a blur to me, all I know is I gave birth to the child, I had it in my hands, I was given no other option, I just didn't know what to do ... I put it in the toilet and I had what they call afterbirth everywhere and I was thinking what poor woman wants to come into the cubicle after me," she said. "I tried to tidy it up a bit because it was just a mess."
A short time later Ms Whiteside was found a bed, was given an ultrasound and saw a doctor. She was offered surgery or told she could go home, and was then told that thousands of women had gone through what she had just experienced. Ms Whiteside chose to go home and has since written letters of complaint to the hospital and NSW Health Minister.
Chief executive of the Hunter New England Area Health Service, Nigel Lyons publicly apologised to Ms Whiteside today. "Let me say I'm very distressed to hear about the circumstances of Jodie's care," he said on Fairfax Radio Network. "It's clear that the distress that was caused by Jodie's experience at the hospital is something that we deeply regret and apologise for. "We'll fully investigate this and find out what's occurred and why and what we can do better. But the aspects that come through to me is that it is about the care that we've provided in terms of sensitivity."
Her experience is similar to that of Jana Horska, who miscarried in a Sydney hospital toilet in September 2007 after waiting two hours in the emergency department.
Source
Nobody gives a stuff when you are in the hands of the government
A vulnerable patient starved to death in an NHS hospital after 26 days without proper nourishment. Martin Ryan, 43, had suffered a stroke which left him unable to swallow. But a 'total breakdown in communication' meant he was never fitted with a feeding tube. It was one of a number of horrific cases where the NHS fatally failed patients with learning difficulties, a health watchdog is expected to rule later this month.
Emma Kemp, 26, was denied cancer treatment that could have saved her life, while 30-year-old Mark Cannon died two months after being admitted to hospital with a broken leg. Three other cases followed similar patterns, with warnings ignored or problems missed until it was too late, often because the patients had difficulty communicating.
Ann Abraham, the Parliamentary and Health Service Ombudsman, is expected to deliver a withering verdict in her report. Sources said the overall picture of neglect that it paints is devastating. Campaigners will seize on the findings as evidence of a wider problem of institutional discrimination in the health service.
The father of one man who died, who was just 20, said: 'People like my son are treated as less than human'. The six cases were first highlighted by the disability charity Mencap in a report entitled Death By Indifference. The charity, which has complained of 'widespread ignorance' in the NHS, says many more cases have emerged since then.
Sources close to the Ombudsman's inquiry said its findings will vindicate Mencap's attack almost totally. One said: 'The Ombudsman will issue a damning verdict in most, though not all, of the cases. 'In some cases the NHS's treatment of vulnerable people was quite shocking - a patient effectively being starved to death is indefensible. 'There will be a lot for NHS trusts and politicians to chew over.'
The report will intensify pressure on ministers to rapidly ensure tighter procedures for the care of such vulnerable patients. Tory spokesman Anne Milton said: 'Unfortunately we are still seeing some pretty shocking cases where people's needs have been neglected and they are not gaining equal access to the NHS. 'Although these might be isolated incidents, every case like this is one too many. 'This is another deeply worrying example of how the Government has yet to get to grips with providing first-class care for everyone, including people with disabilities.'
Mr Ryan, who had Down's syndrome, died in hospital in Kingston-upon-Thames. An internal inquiry by the hospital found that doctors had thought nurses were feeding him through a tube in his nose. By the time they found out this was not happening, he was too weak for an operation to insert a tube into his stomach. He died in agony five days later.
Mr Ryan's distraught family, from Richmond, South-west London, are convinced he could have been saved by the correct treatment. One relative said of him: 'Martin will always be the light of my life. He had a quirky sense of humour and oodles of charm. He was often smiling - he loved to go out, liked the movement of the coach and listening to the music.'
Death by Indifference was published in 2007 as part of Mencap's long-running Treat Me Right! campaign for better healthcare for people with learning disabilities. Mark Goldring, Mencap's chief executive, said: 'Our report exposed the horrific deaths of six people with a learning disability who died unnecessarily in NHS care. 'We have fought and will continue our fight for justice for their families. 'The Ombudsman's reports must condemn the appalling failings of the NHS in these six cases. 'They need to make it impossible for people with a learning disability to continue to die unnecessarily. A failure to do this would be irrational and perverse. 'The reports have a duty to challenge complacency, where it has been shown to exist within the health service, when treating people with a learning disability and must hold individuals to account for their actions.'
The Ombudsman's inquiry, which covers just the six cases, will mirror the findings of a wider investigation into the treatment of vulnerable patients which was ordered by the Government after Mencap's report came out. Chaired by Sir Jonathan Michael, a former chief executive of Guy's and St Thomas' NHS Foundation Trust, it found that the deaths highlighted by the charity were 'not isolated' incidents. A spokesman for the Ombudsman declined to comment before the report is published.
There are 1.5million people with a learning disability in the UK. Mencap says most are treated as ' different' and do not have the same control over their own lives as the rest of society.
Earlier this week the Mail revealed the growing scandal of 'avoidable deaths' in the NHS. Figures showed that the number of patients killed by hospital blunders has soared by 60 per cent in two years to a frightening 3,645.
Source
Australia: Another birth in a public hospital toilet
Aint government medicine wonderful?
A WOMAN has told how she miscarried "in a blur" in a hospital toilet then cleaned up the area herself. Mother-of-two Jodie Whiteside was 14 weeks pregnant when she felt something was "wrong". After believing her waters had broken, and able to see the leg of her child, Ms Whiteside headed to Maitland Hospital, about 30 minutes drive from her home in the New South Wales Hunter region. "En route my husband phoned up the Maitland Hospital emergency department to say what had happened and that I was on my way," Ms Whiteside said on the Fairfax Radio Network. "It was a blase response, basically that I have to be processed like everyone else and wait to see the triage nurse."
On arrival at the hospital, Ms Whiteside said she was "in a lot of pain, cowering over the counter" while she was being asked for her personal details. A triage nurse then asked Ms Whiteside a series of questions. "I said that I saw the baby coming away and she proceeded to take my blood pressure, I think that she took my temperature and she gave me a plastic pot and said 'I need a urine sample'," she said. "I told her that I was 14 weeks pregnant ... I asked her 'if I'm miscarrying what do I do?' She said there is nothing they can do and instructed me to go to the toilet."
After making her way through a crowded emergency department waiting room, Ms Whiteside reached the women's public toilet. "It's a bit of a blur to me, all I know is I gave birth to the child, I had it in my hands, I was given no other option, I just didn't know what to do ... I put it in the toilet and I had what they call afterbirth everywhere and I was thinking what poor woman wants to come into the cubicle after me," she said. "I tried to tidy it up a bit because it was just a mess."
A short time later Ms Whiteside was found a bed, was given an ultrasound and saw a doctor. She was offered surgery or told she could go home, and was then told that thousands of women had gone through what she had just experienced. Ms Whiteside chose to go home and has since written letters of complaint to the hospital and NSW Health Minister.
Chief executive of the Hunter New England Area Health Service, Nigel Lyons publicly apologised to Ms Whiteside today. "Let me say I'm very distressed to hear about the circumstances of Jodie's care," he said on Fairfax Radio Network. "It's clear that the distress that was caused by Jodie's experience at the hospital is something that we deeply regret and apologise for. "We'll fully investigate this and find out what's occurred and why and what we can do better. But the aspects that come through to me is that it is about the care that we've provided in terms of sensitivity."
Her experience is similar to that of Jana Horska, who miscarried in a Sydney hospital toilet in September 2007 after waiting two hours in the emergency department.
Source
Friday, January 09, 2009
Australian mother dies because of closed government maternity services
Rural doctors have blamed the closure of country maternity wards for a mother's death. The Barooga mother of one, 38, died from heavy bleeding caused by an ectopic pregnancy after allegedly waiting more than two hours at Cobram District Hospital for an ambulance to take her to Shepparton's Goulburn Valley Hospital for emergency surgery. Deaths from ectopic pregnancies, where the fertilised egg grows outside the womb, are rare and the coroner has begun an investigation.
The Cobram hospital's obstetrics unit closed about six years ago and Rural Doctors Association Victoria president Dr Mike Moynihan said a lack of specialists may have cost the woman her life. "On the surface, it would have made a difference if there was a maternity ward if it was a straightforward ectopic," he said. ". . . There are going to be more of these incidents and we have pointed this out to the Government."
The Cobram and Shepparton hospitals declined to comment on the woman's death because of the coronial investigation. But Opposition health spokeswoman Helen Shardey said the Brumby Government had endangered lives by closing 20 country maternity wards, including Cobram's. "John Brumby has breached the trust of Victorian families by closing maternity wards and presiding over an underfunded health system which endangers the lives of Victorian women," Ms Shardey said. "Many country paramedics have told me response times are poor and plenty of rural doctors have warned the Brumby Government time and time again that the closure of maternity units could cost lives. "John Brumby and the Minister for Health will be held accountable for the closure of 20 maternity wards, particularly in light of their flippant claim that Labor has provided record funding for health."
Premier John Brumby said funding was not an issue as it had doubled in the past nine years. "In relation to any local services, whether they're maternity or any other specialist services, it's the local doctors and clinicians who make the decisions about whether those services are provided," he said. "I understand in the case of this hospital (it) took the decision that better services were available elsewhere."
Source
Australia: Five-year surgery wait for almost 400 Queenslanders
ALMOST 400 sick Queenslanders have been placed on surgery waiting lists for more than five years, figures released today have shown. Figures obtained by the State Opposition also show 264 people assessed as category two patients - needing surgery within 90 days - have been waiting up to two years for surgery. Opposition Health spokesman Mark McArdle said the government was failing some of the state's sickest people. "These are life threatening illnesses and this government has done nothing to save these people," he said. The figures also showed a blow out in waiting times for a hospital bed, which has grown from four hours and 48 minutes in 2004-05, to nearly six hours in 2007-08.
Australian Medical Association of Queensland (AMAQ) says the figures were unacceptable. AMAQ acting president Mason Stephenson said the figures were not new but once again highlighted a need for more beds. "Beds are on top of the list, then you need more medical man and woman power - more doctors and nurses - then you need the operating time," Mr Stephenson said. "If you look at the 400 waiting for more than five years, they are category three patients - often elderly patients needing prosthetic knees and hip replacements or orthopaedics ... they are suffering to a lesser extent but they are suffering none-the-less and this is unacceptable." He said in past 20 years there has been a reduction in public hospital capacities and now it was up to all governments to reverse this trend and cut waiting lists.
Mr McArdle said the figures were proof the government had mismanaged the health budget throughout the state's most prosperous period. "In the best economic times this state has seen for many years, this government has blown the health budget and has not provided adequate care for Queenslanders," he said. The Liberal National Party would improve the health system by "streamlining" funds to the frontline, but that didn't mean sacking bureaucrats, Mr McArdle said. "We'll move to ensure these (waiting) lists are reduced dramatically and provide an efficient Queensland health system," he said.
"We know that the efficiencies in the Queensland Health department are there to be utilised, we know that there are millions of dollars misspent in Queensland Health that can be redirected to the bottom line - to the doctors to the nurses, allied health professionals." Mr McArdle said the opposition would release its health policy "in near future".
Source
Rural doctors have blamed the closure of country maternity wards for a mother's death. The Barooga mother of one, 38, died from heavy bleeding caused by an ectopic pregnancy after allegedly waiting more than two hours at Cobram District Hospital for an ambulance to take her to Shepparton's Goulburn Valley Hospital for emergency surgery. Deaths from ectopic pregnancies, where the fertilised egg grows outside the womb, are rare and the coroner has begun an investigation.
The Cobram hospital's obstetrics unit closed about six years ago and Rural Doctors Association Victoria president Dr Mike Moynihan said a lack of specialists may have cost the woman her life. "On the surface, it would have made a difference if there was a maternity ward if it was a straightforward ectopic," he said. ". . . There are going to be more of these incidents and we have pointed this out to the Government."
The Cobram and Shepparton hospitals declined to comment on the woman's death because of the coronial investigation. But Opposition health spokeswoman Helen Shardey said the Brumby Government had endangered lives by closing 20 country maternity wards, including Cobram's. "John Brumby has breached the trust of Victorian families by closing maternity wards and presiding over an underfunded health system which endangers the lives of Victorian women," Ms Shardey said. "Many country paramedics have told me response times are poor and plenty of rural doctors have warned the Brumby Government time and time again that the closure of maternity units could cost lives. "John Brumby and the Minister for Health will be held accountable for the closure of 20 maternity wards, particularly in light of their flippant claim that Labor has provided record funding for health."
Premier John Brumby said funding was not an issue as it had doubled in the past nine years. "In relation to any local services, whether they're maternity or any other specialist services, it's the local doctors and clinicians who make the decisions about whether those services are provided," he said. "I understand in the case of this hospital (it) took the decision that better services were available elsewhere."
Source
Australia: Five-year surgery wait for almost 400 Queenslanders
ALMOST 400 sick Queenslanders have been placed on surgery waiting lists for more than five years, figures released today have shown. Figures obtained by the State Opposition also show 264 people assessed as category two patients - needing surgery within 90 days - have been waiting up to two years for surgery. Opposition Health spokesman Mark McArdle said the government was failing some of the state's sickest people. "These are life threatening illnesses and this government has done nothing to save these people," he said. The figures also showed a blow out in waiting times for a hospital bed, which has grown from four hours and 48 minutes in 2004-05, to nearly six hours in 2007-08.
Australian Medical Association of Queensland (AMAQ) says the figures were unacceptable. AMAQ acting president Mason Stephenson said the figures were not new but once again highlighted a need for more beds. "Beds are on top of the list, then you need more medical man and woman power - more doctors and nurses - then you need the operating time," Mr Stephenson said. "If you look at the 400 waiting for more than five years, they are category three patients - often elderly patients needing prosthetic knees and hip replacements or orthopaedics ... they are suffering to a lesser extent but they are suffering none-the-less and this is unacceptable." He said in past 20 years there has been a reduction in public hospital capacities and now it was up to all governments to reverse this trend and cut waiting lists.
Mr McArdle said the figures were proof the government had mismanaged the health budget throughout the state's most prosperous period. "In the best economic times this state has seen for many years, this government has blown the health budget and has not provided adequate care for Queenslanders," he said. The Liberal National Party would improve the health system by "streamlining" funds to the frontline, but that didn't mean sacking bureaucrats, Mr McArdle said. "We'll move to ensure these (waiting) lists are reduced dramatically and provide an efficient Queensland health system," he said.
"We know that the efficiencies in the Queensland Health department are there to be utilised, we know that there are millions of dollars misspent in Queensland Health that can be redirected to the bottom line - to the doctors to the nurses, allied health professionals." Mr McArdle said the opposition would release its health policy "in near future".
Source
Thursday, January 08, 2009
Surgeons who leave operating equipment inside patients cost NHS 9m pounds
Patients who leave operating theatres with surgical equipment accidentally left inside them are being awarded millions of pounds in compensation. About two people a week find surgeons have left behind foreign objects such as surgical swabs, clips and screws, according to Government figures released after a Freedom of Information request. And with the average victim pocketing 17,900 pounds, the mistakes have cost the NHS a total of o9million over the past five years, with payouts made to more than 550 patients.
In the past year, the highest payouts were 115,000 to a person who had the tip of a needle left inside them, 75,000 to a patient who later found a surgical clip and 60,000 to someone who still had `packaging material' inside them after an operation. The total compensation bill during 2007-2008 for such incidents was 2.2million, considerably more than the 1.4million awarded in 2003-2004, even though the number of incidents has not increased. The average payment has also risen from 15,000 just under two years ago. In 2006-2007, the damages reached a record level of 2.6million paid to 149 patients, including 119,000 to one patient found to have had a swab left behind and 100,000 to another who had a clip left inside them.
One victim was grandmother Gladys Condlyffe, 71, from Porthill, Staffordshire, who died in 2005 after surgeons accidentally left a plastic stent - a small pipe - inside her for seven years after a routine gall bladder operation. She died 12 hours after an operation to have it removed at the University Hospital of North Staffordshire. In 2007, two new mothers were sent home from Birmingham's City Hospital with surgical swabs inside them after bungled emergency caesareans.
Experts suggest the level of claims is just the tip of the iceberg, as many people do not discover a mistake unless it causes a problem, often years later. The incidents generally happen as a result of oversights by doctors under pressure in `stressful situations', such as emergency operations. Overweight patients are also more likely to be affected because their extra body mass can make it more difficult to spot tools that have been left behind.
Peter Walsh, chief executive of the patients' charity Action Against Medical Accidents, said the figures were scandalous and disappointing. He added: `These incidents are all easily avoidable. They are only the cases where compensation has been paid. You can safely assume there are many more out there where people have not brought cases for compensation.' And Susie Squire, campaign manager at the TaxPayers' Alliance, said: `All available funds should be put into improving frontline health services, not spent on paying out for costly and easily avoidable cock-ups.'
A list of `never events' - those which are serious and largely preventable - drawn up by the National Patient Safety Agency after Lord Darzi's review of the NHS, is currently out for consultation. It includes objects being left in the body after an operation. Kevin Cleary, the NPSA's medical director, said: `The World Health Organisation has started a Safer Surgery Saves Lives campaign that includes a checklist for surgical teams to help avoid such blunders.'
Source
Australia: Three deaths blamed on public hospital overcrowding
QUEENSLAND Health has linked three deaths of mental patients in the past two months to overcrowding at the crisis-ridden Logan Hospital . "Capacity management" issues have been blamed for the fatalities involving the hospital's mental health unit since late October. A leaked internal report prepared for Queensland Health hierarchy shows that the deaths were "potentially related" to overcrowding, with 16 patients waiting for a bed on December 4. "The number of presentations is consistently higher than the number of discharges," the report said.
The revelations come after a top Logan Hospital doctor enlisted by Premier Anna Bligh to advise her about health issues quit three months ago because the hospital was "too dangerous and dysfunctional".
Health Minister Stephen Robertson ordered independent coroner's and internal investigations into all three deaths. "I always feel very sad when I receive reports of mental health patients who, for one reason or another, treatment doesn't help," Mr Robertson said. "That's why I am keen to have these cases investigated."
The first patient absconded from the busy inpatient unit on October 28 and was later found dead at Brisbane's Fairfield Railway Station. Another patient escaped from the emergency department on November 11 during an assessment and was later found dead. The third on November 25 occurred shortly after a patient was sent to a motel due to "accommodation issues". The patient's family has lodged a complaint but Mr Robertson said his department went beyond what was required as the patient was homeless.
Opposition health spokesman Mark McArdle has questioned why the minister had not been transparent and told the public about the cases, given he had known about them for weeks. "These are people dying and it is this minister's and this Government's inability to plan and resource our public hospitals properly," Mr McArdle said.
Queensland Health has allocated an extra $6.6 million annually since 2007 to fund an extra 53 mental health staff across the southside of Brisbane. A 16-bed community care unit is also being planned.
Source
Patients who leave operating theatres with surgical equipment accidentally left inside them are being awarded millions of pounds in compensation. About two people a week find surgeons have left behind foreign objects such as surgical swabs, clips and screws, according to Government figures released after a Freedom of Information request. And with the average victim pocketing 17,900 pounds, the mistakes have cost the NHS a total of o9million over the past five years, with payouts made to more than 550 patients.
In the past year, the highest payouts were 115,000 to a person who had the tip of a needle left inside them, 75,000 to a patient who later found a surgical clip and 60,000 to someone who still had `packaging material' inside them after an operation. The total compensation bill during 2007-2008 for such incidents was 2.2million, considerably more than the 1.4million awarded in 2003-2004, even though the number of incidents has not increased. The average payment has also risen from 15,000 just under two years ago. In 2006-2007, the damages reached a record level of 2.6million paid to 149 patients, including 119,000 to one patient found to have had a swab left behind and 100,000 to another who had a clip left inside them.
One victim was grandmother Gladys Condlyffe, 71, from Porthill, Staffordshire, who died in 2005 after surgeons accidentally left a plastic stent - a small pipe - inside her for seven years after a routine gall bladder operation. She died 12 hours after an operation to have it removed at the University Hospital of North Staffordshire. In 2007, two new mothers were sent home from Birmingham's City Hospital with surgical swabs inside them after bungled emergency caesareans.
Experts suggest the level of claims is just the tip of the iceberg, as many people do not discover a mistake unless it causes a problem, often years later. The incidents generally happen as a result of oversights by doctors under pressure in `stressful situations', such as emergency operations. Overweight patients are also more likely to be affected because their extra body mass can make it more difficult to spot tools that have been left behind.
Peter Walsh, chief executive of the patients' charity Action Against Medical Accidents, said the figures were scandalous and disappointing. He added: `These incidents are all easily avoidable. They are only the cases where compensation has been paid. You can safely assume there are many more out there where people have not brought cases for compensation.' And Susie Squire, campaign manager at the TaxPayers' Alliance, said: `All available funds should be put into improving frontline health services, not spent on paying out for costly and easily avoidable cock-ups.'
A list of `never events' - those which are serious and largely preventable - drawn up by the National Patient Safety Agency after Lord Darzi's review of the NHS, is currently out for consultation. It includes objects being left in the body after an operation. Kevin Cleary, the NPSA's medical director, said: `The World Health Organisation has started a Safer Surgery Saves Lives campaign that includes a checklist for surgical teams to help avoid such blunders.'
Source
Australia: Three deaths blamed on public hospital overcrowding
QUEENSLAND Health has linked three deaths of mental patients in the past two months to overcrowding at the crisis-ridden Logan Hospital . "Capacity management" issues have been blamed for the fatalities involving the hospital's mental health unit since late October. A leaked internal report prepared for Queensland Health hierarchy shows that the deaths were "potentially related" to overcrowding, with 16 patients waiting for a bed on December 4. "The number of presentations is consistently higher than the number of discharges," the report said.
The revelations come after a top Logan Hospital doctor enlisted by Premier Anna Bligh to advise her about health issues quit three months ago because the hospital was "too dangerous and dysfunctional".
Health Minister Stephen Robertson ordered independent coroner's and internal investigations into all three deaths. "I always feel very sad when I receive reports of mental health patients who, for one reason or another, treatment doesn't help," Mr Robertson said. "That's why I am keen to have these cases investigated."
The first patient absconded from the busy inpatient unit on October 28 and was later found dead at Brisbane's Fairfield Railway Station. Another patient escaped from the emergency department on November 11 during an assessment and was later found dead. The third on November 25 occurred shortly after a patient was sent to a motel due to "accommodation issues". The patient's family has lodged a complaint but Mr Robertson said his department went beyond what was required as the patient was homeless.
Opposition health spokesman Mark McArdle has questioned why the minister had not been transparent and told the public about the cases, given he had known about them for weeks. "These are people dying and it is this minister's and this Government's inability to plan and resource our public hospitals properly," Mr McArdle said.
Queensland Health has allocated an extra $6.6 million annually since 2007 to fund an extra 53 mental health staff across the southside of Brisbane. A 16-bed community care unit is also being planned.
Source
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