Sunday, October 14, 2007

Porkies Mr Johnson?

The graph shows the number of reported deaths as a direct result of Clostridium difficile in recent years, hardly an encouraging trend; especially when one considers that there is evidence suggesting that some trusts have illegally ordered doctors to lie on death certificates, thus covering up the true extent of the problem. This would be embarrassing for any country, however this is happening in one of the wealthiest countries in the world.

Alan Johnson claims that:
"To suggest that in this particular incident, this reflects what's happening in the NHS across the country is absolutely wrong," he said. "There are nurses and clinicians across the country who have dealt with the targets... but kept the highest safety standards."

The Healthcare Commission's report rather contradicts Mr Johnson:
"The investigation into the outbreaks at Maidstone and Tunbridge Wells NHS Trust has thrown up a number of similarities with the findings of our previous investigation into outbreaks of C. difficile at Stoke Mandeville Hospital, part of Buckinghamshire Hospitals NHS Trust. Both trusts had undergone difficult mergers, were preoccupied with finances, and had a demanding agenda for reconfiguration and private finance initiative (PFI), all of which consumed much management time and effort. They also had poor environments, with many dormitory style wards and few single rooms which could be used for isolating patients with infections.

In both we observed unacceptable examples of contamination and unhygienic practice. Additionally, the impact of financial pressures was to reduce further already low numbers of nurses and to put a cap on the use of nurses from agencies and nursing banks. There was unrelenting pressure to reduce the number of beds.

Thus, both trusts had very high occupancy levels, could not manage with fewer beds, and so had to open 'escalation' beds, often at short notice and in unsuitable environments, without proper support services and equipment in place and, by definition, without permanent staff. The effect of all this was to compromise seriously the control of infection and the quality of clinical care. While it should be noted that improvements have subsequently been made at Stoke Mandeville, it seems unlikely that these similarities are coincidental. We are concerned that where trusts are struggling with a number of problems that consume senior managers' time, and are under severe pressure to meet targets relating to finance and access, concern for infection control may be undermined."

There are clearly major problems here that go right up the chain of command, all the way to central government. Undoubtedly the local management were grossly negligent and must be held accountable for their actions or lack of them, however to deny that the government's policies are also to blame for this systematic problem is nothing but dishonest denial.

As James Le Fanu puts it in today's Telegraph, the malignant over interference of successive governments has resulted in hospitals being run from Whitehall and not running themselves. Whether public or private, the fact that hospitals have no freedom whatsoever to run themselves is the real problem here:
"The Health Service does not need ever more new-fangled schemes of "provider competition" and "practice based commissioning". What it needs is to return to the system when hospitals ran themselves."


Anonymous said...

dk -> what do you make of this video:
Google video link

on the EU and "Common Purpose". deranged ramblings of a wild eyed conspiracy nut, or something more sinister?

Anonymous said...

'there is evidence suggesting that some trusts have illegally ordered doctors to lie on death certificates..'

link please DK

Mark Wadsworth said...

Easily fixed Dr D, just throw another £10 billion a year at the problem.

Anonymous said...

Throw £10 billion at it ?

Tut, tut, Mark - that type of expenditure might finally bring us into line with the French, Germans, Swiss and Americans, and that would never do would it ?

Henry North London 2.0 said...

No just employ the doctors that have left for Australia and the ones that have given up


Anonymous said...

if they werent spending so much on "Common Purpose" then they might actually be able to run a hospital.

if you want to know why Dawn Primarilo, Ruth Ketty and all the others all look like zombiefied cultists , there's your answer.

read more here

Dr De'Ath said...

throwing money at it won't help, when the money is consitently frittered away on gimmicky centralised initiatives; the point is that the NHS was much more efficient when hospitals had the power to make decisions as to how they were run, before Thatcher started buggering it all up with excessive interference and the internal market, local autonomy and bottom up management is much better than top down control freakery.

"Junior doctors were also allegedly ordered not to put clostridium difficile on death certificates."

trust me, this ain't a one off, and the statistics leave no doubt

that common purpose stuff is quite interesting...

Anonymous said...

here's Julia Middleton, founder of Common Purpose in a realplayer video

Note the mad , staring , psychotic EYES.
very very fucking wierd.

here's her book on amazon

and guess who fucking loves it - why none other than David "I love the terrorist Michael Collins" fucking Puttnam. Who is now head of UNICEF (!!!). I alway knew they were fucking evil....

"What you will learn from this book is worth more than money. Not only will you learn to lead beyond your authority, but also how to be a better leader within your authority too. If you were only to buy one book about leadership, then it should be this." - David Puttnam, President of UNICEF (UK), former filmmaker.

Anonymous said...

oops. links got fucked.

Middleton video

Amazon book

Anonymous said...

"lead beyond your authority" = lead when you have no mandate whatsoever to lead.

i.e. it's anti-democratic.

which is exactly what the EUSSR wants.

Anonymous said...

And why is the government throwing money at Common Purpose for a "Muslim Leadership
Development Project"?

Hansard question here

Anonymous said...

dr de'ath - throwing money at it won't help ?

Take a look at "Securing good care for older people"

Maybe if there were a few more side rooms and better nurse:patient ratios then the situation in Kent might have been contained sooner, and deaths could have been prevented ?

Obviously these measures are expensive and time consuming - I sometimes wonder if doctors fully appreciate just how long it actually takes to wash, mobilise, and feed a ward full of debilitated or demented patients, several of them suffering with incontinence ?

If I hear another platitude about how badly we treat our elders then I'm going to puke.
We've been saying EXACTLY THE SAME THING for yonks, yet all too frequently they are treated like second class citizens, you know it, and I know it.
Lets face it as a culture our complacency is breathtaking.

As one microbiologist commented on telly, if we were talking about 90 kids that had died from a HAI then there would have been anarchy [unless it was happening if Africa of course, in which case most of us would simply start channel surfing].

Johnson may be a vile cynical liar but is he really any worse than the families who dump elderly relatives in A&E at Xmas [with some vague and ill defined problem that suddenly needs to be sorted out] - because such things happen every year you know.

Anonymous said...

"than the families who dump elderly relatives in A&E at Xmas"

jesus wept.

is that really happening? i take from your nom de plume that you have first hand experience of this. if what you are saying is true, then that act is so bereft of any morals that it is utterly evil.

it makes you want to just give up and move to Japan (where respect for the elderly is a tad higher...)

Mark Wadsworth said...

A&E, Dr D, my remark about throwing another £10 bn at the problem was sarcastic.

A&E, I have no strong opinion on the total size of our health budget, what hacks me off is that a lot of it is not spent on health. It is spent on pen pushers, quangista and so on.

A&E if there were a few more side rooms and better nurse:patient ratios . That was the whole point of my posts on earlier thread. If hospitals got paid by results, there'd be less administrators and managers and more nurses, for any given budget.

AZ said...

I was told myself to lie on a death certificate after a patient died from an infected IV site. I refused and hung up the phone. Presumably they dreamt up a new certificate.

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