Posts Tagged ‘unnecessary deaths’

Will Obamacare be a good thing for most people? Americans might take note of Britain’s National Health Service (NHS)

July 21, 2013

Will Obamacare be a good thing for most people? President Barack Obama should learn the lessons about governments controlling health care from the recent failures in the NHS

Obamacare had to square an impossible circle. In order to guarantee medical care for everyone in the country while avoiding universal government provision, the plan makes it a legal requirement for everyone to buy private health insurance.

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Obamacare had to square an impossible circle. In order to guarantee medical care for everyone in the country while avoiding universal government provision, the plan makes it a legal requirement for everyone to buy private health insurance.  Photo: Getty Images

After the sordid mud-wrestling session in the Commons last week (official title: statement on the Keogh report by the Health Secretary), could anyone still believe that politicians are the right people to be in charge of healthcare? As Jeremy Hunt and Andy Burnham traded accusations and self-serving denials of blame for the thousands of unnecessary (remember that word) deaths in 14 NHS hospitals, they almost clean forgot to offer expressions of remorse, regret or sympathy to the victims and their families.

For what it’s worth, Mr Burnham was rather worse than Mr Hunt, but that is by-the-by. This was about as low as party politics gets. Egged on by their screaming supporters behind them, the front bench spokesmen presented us with a very nearly perfect case for removing the care of the sick from government manipulation altogether.

An edited video of that squalid parliamentary occasion should be made available to every member of the Obama administration and every Democratic congressman who is desperate for the US federal government to take charge of healthcare. Lesson: this is what happens when political parties are directly responsible for the dispensation of medical treatment. If you have power over a system, then you are held responsible when it fails. If medical and administrative personnel know that they are accountable to government, they are liable to put the demands of politicians over the concerns of patients – even if they know those demands to be mistaken or absurd. Not that the White House plan (inevitably known – in spite of the President’s people insisting that it is the Affordable Care Act – as Obamacare) is as remotely monolithic as our own government-owned, government-run, government-funded system. That would be anathema to the political culture of the United States.

In fact, our two countries have precisely opposite phobias: in Britain, anything that is private (or worse, privatised) must be assumed to exist solely to produce Profit, which is axiomatically regarded as wicked. In the US, anything that is run by central government is seen as inherently threatening to personal liberty. So Obamacare had to square an impossible circle, and ended up with something like the worst of all worlds. In order to guarantee medical care for everyone in the country while avoiding universal government provision – which would be socialist in the true sense of the word – the plan makes it a legal requirement for everyone to buy private health insurance.

The original rule was that all companies with more than 50 employees would be required by law to provide them with health cover but that has gone out the window (sorry, been delayed) because the business community objected.

Unfortunately, the poor individual, not having quite the same clout in Washington as big companies, is still stuck. He will have to pay for a health insurance policy – whether he wants it, or thinks he needs it, or not – or be fined.

Now that would be a very strange sort of law in any free society, let alone one that is positively paranoid about personal liberty. Should a democratic government be able to make it legally necessary for you to buy a product you do not want to cover the cost of your potential needs? It is true that in most countries you are legally obliged to have certain kinds of third party cover – on car insurance, for example – but that is to provide for the protection of other members of society, not yourself. What the Obamacare law is designed to do is pull the young and fit compulsorily into the health insurance net so that, in actuarial terms, risks are spread more widely and the cost of premiums comes down. It is a matter of hot debate at the moment in Washington as to whether this will actually be the result. In the meantime, there is huge popular resistance to the compulsion involved and to the overweening political interference in what most Americans see as the highly personal relationship between doctor and patient.

But America’s stumbling healthcare programme is not alone in creating bizarre anomalies. The absolute terror in which politicians of all parties in Britain confront the impossible dilemma of funding the NHS has led us into a positive Wonderland of self-contradiction and absurdity. The Nuffield Trust estimates that there will be roughly a £50 billion deficit between funding and demand for healthcare by the end of the next parliament.

Every sane politician knows that the present arrangements are unsustainable: even if we managed to reform the standards of hospital care to prevent patients dying of starvation and thirst, there is no way that a fit-for-the-21st-century comprehensive medical system can be afforded solely out of taxation. But say this to a Tory minister (or one of his team) and he will start shrieking about electoral doom. As one very sensible Conservative said to me recently: “You can’t start charging for things that people now get for free. We’d lose the next election.”

Well no, that is not the way to introduce a mixed economy in healthcare: you don’t “start charging for things” willy-nilly. You just start allowing people to pay for things above and beyond their NHS care without penalising them. Which, of course, is what they do already every time they go to the chemist and buy aspirin for a headache – on which grounds nobody threatens to take away their right to NHS treatment for the headache.

But try that with a cancer drug that the NHS doesn’t believe is cost-effective and will not administer, and you will be accused of illicitly “topping up” your NHS care and possibly (as has actually happened) be denied further treatment for your illness. Our healthcare system is so monopolistic that it will not permit you to spend your own money (for fear of creating “two-tier” healthcare), while the proposed US system is determined to force you to spend your money on a product you don’t want. This is crazy.

Lessons: no country can afford modern health care without a mixed funding system of some kind. The more power politicians have over the running of that system, the more likely it is to get bogged down in partisan point-scoring. The more choice and responsibility reside with the patient and the clinician respectively (rather than with the bureaucrat and the government), the greater the chance that people will receive proper care. The more government tends to function as an exacting purchaser and regulator of services, rather than as a provider of them, the less likely it is to cover up or ignore the fact that thousands of people are dying unnecessarily on its watch.

Couldn’t we start treating voters like grown-ups, and talk sense about this?

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(Some leaders in Britain hope new immigrants will pay enough in taxes to reduce the cost of health care for everyone else)
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Many in Britain Now Say National Health Service Was a Mistake — “Runs Like an Old Soviet System”

June 22, 2013

In Britain First Mid Staffs and now the CQC scandal show the failings of a system built by Labour

The Telegraph

It all started with an SUI. As a result, issues arose with UHMB and with the SRA. The Complainant went to the CPHSO. At roughly the same time, the CQC got involved, sometimes employing its STEIS, and gave UHMB a clean bill of health to register under the HSCA. On Wednesday, we were told that “Mr B”, “Mr E”, and others had deleted a CQC internal report into what had gone wrong with this process, and that this “might well have constituted a deliberate cover-up”.

Such is life – and death – in the organisation which bears the better known initials, NHS.

I won’t translate all of the above, but it helps to know that an SUI, in the NHS, stands for a Serious Untoward Incident. In this case, it is what you and I would call a death – that of a newborn baby, Joshua Titcombe. He died because, in Furness General Hospital, he caught an infection from his mother, and, despite repeated pleas by his parents, no doctor attended him. The Complainant was Joshua’s father, James.

This weekend, the greatest controversy surrounds the fact that, for 24 hours, we were not allowed to know the real identities of Mr B and co. The Care Quality Commission (CQC), which had commissioned a report into its own failings under the previous management, did not dare to give them their real names when publishing the report. Lawyers had told them that to do so would breach the Data Protection Act. A day later, public outcry forced the CQC to back down. The gentlemen with letters instead of names suddenly all changed sex. “Mr B” turned out to be Dame Joan Williams, the former chairman. “Mr E” was Cynthia Bower, the former chief executive.

It was indeed foolish of the CQC to have hidden behind its lawyers: lawyers give advice. They do not make decisions; it is not (yet) illegal to ignore their advice. It looked as if the CQC had flinched. Having declared a cover-up, it then half-covered up the coverers-up.

But I cannot help thinking that our rage against the “anonymising” of the former officials is a form of displacement. It is simply the easiest thing to hold on to in a story where everything is so long-drawn-out, complicated and appalling that it is almost impossible to focus.

The CQC report this week is about (in part) the suppression of another CQC report which was itself looking at whether the CQC had done a proper inspection into a hospital trust before registering it. In the background is yet another report (about which the CQC was not, allegedly, informed) about what happened in Furness, where not only poor Joshua but several other babies and two mothers were also SUIs (ie dead).

Red Tape

Reading through the evidence, you keep coming across new mind-boggling facts. You learn that there were, at one time, three Joint Collaborative Reviews of similar things going on. You encounter jargon, such as this from the meeting notes of CQC’s Regional Director, which says “Bulleting to cascade lessons learnt shared across trust has been developed”. And sloppiness: an investigation manager decides not to pursue the story of Joshua Titcombe after he has given himself only an evening to study 13 documents and 95 pages of information. “I do not think the case meets are [sic] criteria for further investigation”, he emails yawningly when he wakes up the following morning.

You gradually understand that the system doesn’t and can’t work. Those employed inside it recognise this. If they are brave people, they complain, and this makes them unpopular. If they are average, not very brave people, they simply do their best to survive, pretending to hit the targets which are themselves pretences. If they are unpleasant people, they grab such power as the system affords – the power to appoint your cronies, secure large pensions, accumulate honours, invent new “training toolkits” for Equality and Diversity etc, and work out how to use their present job to get an even better-paid one.

“Wherever we find failure,” proclaimed the CQC annual report in 2010, the year when it gave the Furness hospital trust (UHMB) the unwarranted all-clear, “we do not hesitate to take appropriate and proportionate action.”

The resemblance to communist regimes boasting about their five-year plans as the harvest fails or steel production becomes unsellable is spooky. In the Sir David Nicholson/Cynthia Bower scheme of things, patients play the same role as workers in the old Soviet system – forever invoked, forever oppressed.

Like Politburo members doing well out of the Ukrainian famine, Sir David and Ms Bower rose to even greater power through their triumphs in Mid Staffs where (over a period which extended longer than their own particular terms of office) 1,200 patients died unnecessarily. After the Francis Report into the Mid Staffs scandal appeared, David Cameron made a critical error. Instead of showing Sir David the door, he praised his “grip and grasp” of the NHS. Sir David stayed. Now the great man has finally told us that he is leaving his job as Chief Executive next year, but he departs full of official honours, gripping and grasping a pension pot of £1.9 million.

The Government has not emphasised that the currently disastrous shape of the NHS and its regulatory system is the creation of Labour. The Nicholsons and Bowers are figures of the Blair/Brown era. They are the breed of managerialists who have come up through directing social services, working for trade unions, running local councils, unsullied by any humane education, professional knowledge (hardly any of those who run health are doctors) or experience of business. They have titles and salaries which ape the private sector, but a mindset and a network which are the purest creations of pre-credit-crunch welfarism. Why hasn’t the Coalition, especially its dominant Tory partner, made hay with this?

Because it made a huge strategic error very early on. Mr Cameron became Tory leader largely because he rightly recognised that his party needed to commit itself to public services. How could a party govern unless it could be trusted with health or schools? But he wrongly decided that this meant endorsing existing forms. In his first party conference speech as leader, in 2006, he said: “Tony Blair once explained his priority in three words: education, education, education. I can do it in three letters: NHS.”

Instead of endorsing what mattered – health care for all – Mr Cameron endorsed our particular system delivering it. It is the worst in the Western world. It is organised from the centre and run by the producers and the trade unions. The one thing it cannot do is what we all most want – to look at the whole patient and meet his or her medical needs. Anyone on a waiting list (currently 24 weeks in our area for a rheumatology appointment) experiences this. So does anyone elderly, or with an elderly relation. So do the queues in A and E, the sick who cannot get a GP at weekends; so did the dead in Mid Staffs or Barrow-in-Furness.

Out of a sense of their own weakness, the Conservatives put themselves in hock to the sort of service that a man like David Nicholson delivers. It was out of a similar vulnerability – in Labour’s case, about how to deal with capitalists – that Gordon Brown abased himself in front of the bankers. It has all gone wrong. As the Health Secretary Jeremy Hunt rushes from studio to studio trying to get ahead of the story, you can tell by his hunted look that he sees this, too late.

Britain’s National Health Service (NHS): Eleven deaths from wrong medications last year, poor management and communications commonplace

April 27, 2013

In Britain  Eleven people died in the National Health Service (NHS) in England last year after being given the wrong medication, Health Secretary Jeremy Hunt said today.

Jeremy Hunt: I will not tolerate British patients being put at risk

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Mr Hunt said that gaps in information put patients at risk; Hopes to attain a health service “more ambitious and enlightened”  Photo: Leomn Neal/AFP

By Laura Donnelly and agencies

Speaking at a conference in London, Mr Hunt said that patients are too often put at risk because information is not properly passed around the healthcare system.

He said that most NHS users would be “astonished” that their information does not regularly pass between GPs and hospitals and that patient safety could not be improved unless this situation changed.

Mr Hunt said that none of the big challenges facing the NHS can be resolved unless the health service becomes “more ambitious and enlightened” about sharing information.

As well as not being seen by a doctor, registrars were not told of Mr Coles' move and his medication chart went missing (stock photo)

Speaking at the Delivering a Paperless NHS conference in London, Mr Hunt said: “Most NHS users would be astonished that information doesn’t flow around the system. In many hospitals the IT systems aren’t even linked within a hospital, let alone between hospitals and other parts of the health economy. That’s I’m afraid a fairly normal situation across the country. Eleven people died last year in the NHS from being given the wrong medication.”

Mr Hunt said that gaps in information put patients at risk. Improving them was “a really important part of the compassionate care agenda, the safety agenda, the integration agenda,” he said.

In the speech, he said: “A few weeks ago I was in the A&E department at Watford and they admitted a lady there with late-stage dementia from a care home. I was completely shocked to see that they knew absolutely nothing about her. She was wasn’t able to speak and she had bruises all over her face but they didn’t know for example whether that was her normal state not to be able to speak or whether that was a result of her fall , they didn’t have her medication, medical history, anything like that.

Mr Hunt also announced that the Government has agreed that patients should be allowed to opt out of a national data base holding their information.

He told the conference that there must be “proper” safeguards in place to protect patients’ personal information.

Mr Hunt said: “That’s why I have agreed that GPs will not share information about what’s on people’s GP records with the Health and Social Care Information Centre if people object. There will be some overrides but only in situations like a public health emergency or in life or death situations or child abuse.

“Essentially, people will have a veto on that information being shared in the wider system.”

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The lack of communication across the NHS is “completely shocking”, the Health Secretary said yesterday as he disclosed that 11 people died last year after being given the wrong medication.
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The Culture Secretary, Jeremy Hunt, is facing criticism over his role in the BSkyB bid -

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Mr Hunt wants to make the NHS “paperless” within the next five years Photo: REUTERS

Highlighting the benefits of sharing data across the health service, Jeremy Hunt said that most NHS users would be ”astonished” that their information does not regularly pass between GPs and hospitals.

Mr Hunt said that none of the big challenges facing the NHS can be resolved unless the health service becomes ”more ambitious and enlightened” about sharing information.

Speaking at the Delivering a Paperless NHS conference in London, Mr Hunt said: ”If you look at the big challenges facing the health service with an ageing society – things like the A&E departments that I spoke of yesterday, the problem with joined up services, the issues of patient safety and compassionate care that came into the Francis review – none of those issues are going to be resolved unless we take a much more ambitious and enlightened view as to the power of information.

”Most NHS users would be astonished that information doesn’t flow around the system.

”In many hospitals the IT systems aren’t even linked within a hospital, let alone between hospitals and other parts of the health economy. That’s I’m afraid a fairly normal situation across the country.

”Eleven people died last year in the NHS from being given the wrong medication.

”This is a really important part of the compassionate care agenda, the safety agenda, the integration agenda.”

He added: ”A few weeks ago I was in the A&E department at Watford and they admitted a lady there with late-stage dementia from a care home. I was completely shocked to see that they knew absolutely nothing about her. She was wasn’t able to speak and she had bruises all over her face but they didn’t know for example whether that was her normal state not to be able to speak or whether that was a result of her fall , they didn’t have her medication, medical history, anything like that.

”That simply cannot be in people’s interest to have those gaps in information.”

He added that there must be ”proper” safeguards in place to protect patients’ personal information, adding: ”That’s why I have agreed that GPs will not share information about what’s on people’s GP records with the Health and Social Care Information Centre if people object. There will be some overrides but only in situations like a public health emergency or in life or death situations or child abuse.

”Essentially, people will have a veto on that information being shared in the wider system.”

Mr Hunt’s comments followed the publication of Dame Fiona Caldicott’s review into how NHS data is handled.

Dame Fiona highlighted a number of problems about the way information is handled within the health and social care system in England.

Her report says that people’s lack of access to their own records causes “great frustration”.

She recommended that all letters, emails, and other communications that health and social care teams make regarding a patient’s care should be replicated for the patient.

The report also says that some NHS managers are “unduly restrictive” with information for fear that their organisation will be fined for breaching data protection laws.

Mr Hunt has previously set out ambitions to make the NHS “paperless” within the next five years.

He also said that GPs should make patient records available online by 2015.

In Britain: Trying To Blame Nurses For Unnecessary Suffering and Deaths In Government Health System Won’t Work

April 24, 2013

The British Healthcare Scandal:  It was senior nursing staff and bureaucrats who were cruel and callous in the Mid Staffordshire hospital scandal

Wrong medicine: Health Secretary Jeremy Hunt's back-to-basics approach to nursing and health-care misses the target

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Wrong medicine: Health Secretary Jeremy Hunt’s back-to-basics approach to nursing and health-care misses the target Photo: HEATHCLIFF O’MALLEY FOR THE TELEGRAPH

The Telegraph

Like a lot of people at our stage of life, my friend Claire is negotiating care for her elderly father. She is caught between the Scylla of a norovirus-infected ward and the Charybdis of a residential home where a room with no view starts at £650 a week.

Visiting her dad in hospital the other day, Claire was hailed by a young guy in the next bed. He told Claire that her father had not eaten for two days, but that he had given him water. Meals were brought to the 92-year-old’s table, but they were left out of reach. No attempt was made to coax the patient to eat. Nor was any comment passed on the untouched plate when it was taken away. “What kind of person doesn’t even ask an old chap why he hasn’t tried his lunch?” asks my tearful, fearful friend.

The shocking thing is such stories don’t shock us any more. They’re not even unusual. When my mother woke up after her heart bypass last year, the first thing she murmured groggily was: “That poor lady opposite hasn’t eaten anything.” If a heavily drugged elderly woman can see that another patient isn’t thriving, why the hell can’t a nurse? Why does a sick young man have to crawl out of his bed in one of the country’s better teaching hospitals to put a glass of water to Claire’s father’s lips? Surely that’s the nurses’ job.

Such dismaying neglect has inspired the Government’s plan to make student nurses spend a year as health-care assistants to improve compassion in the NHS and avoid scandals such as the 1,200 unnecessary deaths at Stafford Hospital. You could practically hear the lips smacking with satisfaction in the Commons as Health Secretary Jeremy Hunt outlined his back-to-basics approach. Get those uppity nurses wiping bums and we’ll soon have everything just as Matron ordered! If nurses are “too posh to wash”, we’ll weed them out, and tender care will be restored to our hospitals once more.

Only it won’t. The Royal College of Nursing says the scheme is “stupid” and “unworkable”. I agree. And why are nurses being made to carry the can – or the bedpan – for the Mid Staffordshire scandal? It wasn’t student nurses who were cruel and callous in that hospital; it was senior nurses and bureaucrats. One idealistic junior nurse, who complained repeatedly that standards were dreadful, was threatened and silenced. Robert Francis’s report is quite clear that the human catastrophe of Stafford arose from a target-driven culture and a lack of clinical staff, particularly nurses, following the management board’s decision to cut costs.

Yet, apart from a new criminal offence to prevent the fiddling of waiting times and death rates, NHS managers seem to have ’scaped whipping for that entire tragedy. Not to mention He Who Cannot Be Sacked, NHS chief executive Sir David Nicholson. So who was responsible for a tick-box culture that ranked the completion of “tasks” above spending time with a person in pain? Who decided that tasks that needed doing on a ward should be split into “essential and non-essential” and “medical or non-medical”? Who cut staffing to dangerous levels? Who was it that spent millions of pounds of public money silencing whistleblowers who were only trying to protect the public? It wasn’t nurses, that’s for sure.

As the Telegraph revealed on Monday, more than 8,000 NHS managers are being paid stonking six-figure salaries. This pampered breed skulk in their offices with luxuriant pot plants while nurses are dispensing complex medication, answering phone calls from vexed relatives, bleeping doctors who are too busy to reply, and trying to prevent a confused patient climbing out of bed – all of which means they can’t answer the call bell rung by another patient who needs a bedpan. Oh, and then there’s filling in the paperwork to prove that they have, in fact, done all of the above. And people wonder why compassion is in short supply.

As well as not being seen by a doctor, registrars were not told of Mr Coles' move and his medication chart went missing (stock photo)

I’d like to see an NHS manager try to tend to a 22-bed ward (three bays of six patients, four isolation rooms) staffed by two very tired nurses and one care assistant with uncertain English.

According to a poll this week, two in three nurses think patients in their own hospitals are at risk of neglect. The vast majority believes that managers put financial targets ahead of patient care. Jeremy Hunt says he is keen for NHS whistleblowers to be treated fairly – but, in the same breath, rubbishes RCN claims that staff shortages are jeopardising patients. Perhaps the nurses are blowing the wrong kind of whistle.

This is not to say that the RCN doesn’t need to be honest about the failings of some of its own members. Making nursing a degree-entry profession was a disaster. It was like decreeing that motherhood should be for graduates only. You automatically excluded many of the best and gentlest candidates. If degrees gave nurses more status, they also, quite understandably, made them less inclined to carry out “non-medical” tasks. It was about timesheets, not clean sheets. Too often, basic care became something you studied in training and didn’t do once you were qualified. That explains why a 92-year-old gentleman has no one coaxing him to eat.

Forcing student nurses to do a year as healthcare assistants isn’t going to help Claire’s father. Not if staffing levels remain the same. Changing a target culture that rates simple kindness and feeding an old person as “non-essential” might be a good start. So would sacking some of the massed battalions of NHS managers and using their large salaries to employ more nurses on the frontline. A good heart is essential for a compassionate NHS. So are many hands.

Britain’s National Health Service (NHS) Has 8,000 Hospital Managers and Consultants Paid Six-figure Salaries While Nurses Struggle

April 22, 2013

Britain:   Almost 8,000 NHS hospital managers and consultants were paid six-figure salaries last year while nurses were “run ragged” because of dangerously low staffing levels.

The 8,000 NHS staff on six figure salaries

The number of NHS staff paid more than £100,000 has increased in the past year at almost half of the 75 trusts surveyed. Photo: ALAMY

The Daily Telegraph

A survey by The Daily Telegraph has found that more than 7,800 NHS staff were paid over £100,000 last year, with a third of them earning more than David Cameron’s £142,500 salary.

The figures indicate that NHS managers and consultants have been protected from the Government’s £20 billion cost-cutting programme, with the number earning six-figure salaries increasing slightly in the past three years. Their total pay also rose over the same period, amounting to almost £1  billion last year.

Many of the highest paid individuals were based at hospitals which have been at the centre of patient care scandals or are in serious financial difficulties.

The trust with the highest number on six figures – Southampton, with 384 – was deemed by the Care Quality Commission last year to be “placing patients at risk”, so poor were its staffing levels.

Photo: Getty Images

Dr Peter Carter, chief executive of the Royal College of Nursing, said the six-figure salaries sent the “wrong message” as front-line staff struggled to cope with “deep cuts” and pay freezes.

The highest-paid executive earned £340,000 — almost 16 times more than ward nurses, who earn as little as £21,388-a-year. Eleven high earners have been paid more than £250,000 each. The true figures are likely to be far higher as dozens of hospital trusts failed to respond.

Dr Carter said hard-pressed nursing staff “often feel undervalued, especially if senior NHS staff are not experiencing the same pay restraints”.

The number of NHS staff paid more than £100,000 has increased in the past year at almost half of the 75 trusts surveyed. In some parts of England, the number of high-earners has risen by more than 50 per cent.

Last year 17 NHS hospitals were censured for dangerously low staffing levels amid growing concern about the safety and dignity of patients.

At Mid Staffordshire NHS Foundation Trust, which was condemned for its “appalling” lack of care after one of the worst health scandals in living memory, a total of 85 staff are paid more than £100,000, up from 79 the year before.

Darren Cattell, the trust’s interim finance director, was paid £340,000 last year — almost £1,475-a-day — as the trust headed towards financial meltdown.

He left in May, four months before a team of consultants were sent in to investigate the trust’s £20 million deficit. Last week the trust went into administration and on Monday it will begin the bidding process for services to be taken over by other NHS trusts or the private sector.

The trust’s medical director was paid between £225,000 and £230,000. A spokesman said the trust had been forced to employ expensive interim directors to help turn the scandal-hit hospital around.

Julie Bailey, whose mother died in Stafford hospital and who later formed the Cure the NHS campaign group, said: “We have lost sight of what’s important, people are being rewarded for failure.”

At Morecambe Bay NHS Foundation Trust, which is being investigated by police after the deaths of a number of babies, 121 staff are paid more than £100,000.

The highest paid individual was a consultant who earned £280,000, while Tony Halsall, the trust’s former chief executive who resigned in February last year, was given a £225,000 pay-off. A spokesman said that pay was “in line” with other NHS trusts throughout the country.

Many of the high earners are at trusts which are currently being investigated for having high mortality rates. These include Basildon and Thurrock, Buckinghamshire Healthcare, Burton Hospitals, Colchester Hospital, East Lancashire Hospitals and North Cumbria, which have 274 staff on six-figure salaries between them.

At University Hospital Southampton NHS Trust, 384 staff were paid six-figure salaries last year, almost half of whom earned more than the Prime Minister.

But last October the Care Quality Commission warned that a shortage of nurses at Southampton General Hospital was “placing people at risk”. Inspectors heard staff were “run ragged” with some patients waiting hours for their meals

A spokesman for the trust said levels of pay reflected the “high number of senior and experienced clinical staff”.

Trusts said that the majority of high earners were senior clinical staff. The average consultant is paid £84,000, but can receive an additional £76,000 a year in “clinical excellence awards”, which critics claim are given as a matter of course.

At many trusts the number of staff on six-figures rose significantly. The number at Cumbria Partnership NHS Foundation Trust increased from 20 to 31 in the past year, while at City Hospital Foundation Trust in Sunderland, 165 staff earned more than £100,000 — a rise of 10 per cent.

A Department of Health spokesman said: “Many of these staff are senior consultants and their pay reflects responsibilities and clinical skills. However, pay restraint is essential right across the public sector, and the NHS cannot be exempt from that. We have cut spending on managers and back office administration costs, and the number of admin staff has fallen by over 18,000.”

In Britain: Government Goes After Chatty Nurses

April 1, 2013

Nurses in the accident and emergency dept of Selly Oak Hospital work during a busy shift on March 16, 2010 in Birmingham, England

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Nurses have been criticised for not spending enough time on wards Photo: Getty Images
Nurses spend too much time “constantly chatting” in their office space and should be brought back on to hospital wards, the Government’s new patient adviser has warned.
Rowena Mason

By , Political Correspondent

The Telegraph

Ann Clwyd, a Labour MP advising the Coalition, has received thousands of letter from people worried about the poor care of their relatives in NHS hospitals.

In an interview with the Independent, Mrs Clwyd said she had been told of nurses who ignored a relative because they were waiting for the end of an eBay auction.

She said the Government should consier scrapping “nursing stations” and bringing staff desks into the middle of wards.

The MP was brought in to advise the Government after she gave an emotional speech in parliament about the poor care received by her husband in an NHS hospital.

“A big thing that patients that have contacted me talk about is getting rid of nursing stations,” Ms Clwyd said.

“People are incensed by nurses’ stations. They say they just gather and chat constantly. They are suggesting bringing back the desk on the ward – not off the ward.”

One person wrote to her of their “horror as elderly and infirm patients went hungry and thirsty”.

“They were left for long periods in soiled bedding and clothing,” the letter said. “Wards were dirty. We turned up at visiting time and saw uneaten meals still left on patient tables. The nurses weren’t busy – they preferred to gather round the nursing station and discuss their social lives.”

Mrs Clwyd said the same problem had come up “over and over again”.

However, she said complaints were not getting through to hospital managers.

Mrs Clywd’s review of patient complaints comes after the Francis Inquiry into the Mid Staffordshire NHS scandal where up to 1,200 patients died unnecessarily under poor standards of care.

The Government last week promised to overhaul the system by improving training standards and putting care back at the heart of the health service.

Britain: Healthcare chief executive allegedly ‘gagged’ at taxpayers’ expense

March 27, 2013

Healthcare in Britain:  The former chief executive of the scandal-hit Mid Staffordshire NHS trust was allegedly gagged at taxpayers’ expense, ministers finally indicated on Tuesday.

Martin Yeates

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Mr Yeates is believed to have walked away a huge pay-off when he resigned following a series of disclosures about failings at hospitals under his control Photo: EXPRESSANDSTAR.COM

By , Political Correspondent

The Telegraph

Ministers have admitted to Parliament that a “compromise agreement” had been agreed with Martin Yeates, who led Mid Staffordshire Hospital Foundation trust for four years until his resignation in 2009.

Jeremy Hunt, the Health Secretary, on Tuesday appeared to blame Mr Yeates for the scandal at Mid Staffs, where up to 1,200 patients died needlessly.

Mr Yeates is believed to have walked away a huge pay-off when he resigned following a series of disclosures about failings at hospitals under his control.

He subsequently said he was too ill to be cross-examined during the public inquiry into Mid Staffs.

However, it is now emerged that Mr Yeates was given a controversial compromise agreement by NHS chiefs.

In the three years up to 2011, a total of £14.7million of taxpayers’ money was spent on almost 600 compromise agreements, most of which included gagging clauses to silence whistleblowers.

The disclosure came as the Government published its response into the Francis Inquiry into poor care at the Mid Staffordshire NHS Foundation Trust.

Ministers announced plans to blacklist failing NHS managers and said that pay will in future be linked to performance rather than length of service.

The Government will also introduce a statutory duty of candour, meaning hospitals and GP surgeries that conceal mistakes will be punished.

The Health Secretary on Tuesday appeared to lay the blame for the Mid Staffs scandal on Mr Yeates.

However, he once again defended Sir David Nicholson, the current chief executive of the NHS.

Asked whether Mr Yeates is the type of manager that he would blacklist under the new plans, the Health Secretary said: “It’s a bit difficult to answer speculatively about an individual…but if you’re asking me, should someone who is responsible for the appalling things at Mid Staffs be prevented from ever running a hospital again – yes.”

In an answer to a Parliamentary question from Steve Barclay, Conservative MP for North East Cambridgeshire, ministers conceded that Mr Yeates was given a compromise agreement when he resigned.

Dr Dan Poulter, a health minister, wrote: “We understand from Monitor [the foundation trust regulator] that this payment was made in the context of a compromise agreement between the trust and Mr Yeates, the terms of which are confidential between the parties, and therefore are not known to the Department.”

Mr Barclay said it gives the “clear impression that Mr Yeates was subject to a gagging clause”.

Andrew Hodge, Mr Yeates’ lawyer, on Tuesday said “it would have been standard practice for a compromise agreement to contain a confidentiality clause”.

Britain’s National Health Service Scandal Isn’t Old News Yet: Now Managers Involved Face Blacklisting After “Found Guilty by the Hostility of Their Peers”

March 26, 2013

Britain’s National Health Service Scandal isn’t old news yet. Now, managers “found guilty by the hostility of their peers” are blacklisted….

Failing NHS managers could be blacklisted and barred from ever working in the UK healthcare system again, Jeremy Hunt has said.

Safety concern over breast cancer services at Mid-Staffs: report

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Mid Staffordshire hospital  Photo: ALAMY

By , Political Correspondent

Responding to the Francis Inquiry into poor care at the Mid Staffordshire NHS Foundation Trust, the Health Secretary said the Government wants to introduce a barring system to ensure that “there is a mechanism in place which prevents unsuitable board level executives and non-executives from moving to new senior positions elsewhere in the system”.

However he again defended Sir David Nicholson, the current chief executive of the NHS, despite conceding that his failings as a manager contributed to the Mid Staffs scandal, where up to 1,200 patients died needlessly.

Ministers are considering whether the barring scheme could eventually be extended to NHS managers below board level.

Calling the events at Stafford Hospital a “betrayal of the worst kind”, Mr Hunt also set out plans to ensure that NHS providers will have a new “statutory duty of candour”.

However, he has not said whether or not ministers will in future introduce a legal duty of candour for doctors and nurses.

A key recommendation of the Francis report was a legal obligation to blow the whistle on substandard care, but Mr Hunt said he was concerned about creating a “culture of fear” within the NHS.

Mr Hunt said that the Government is looking to take legal sanctions at a corporate level for NHS organisations which withhold information about concerns.

He said that a new Chief Inspector of Hospitals would be able to name and shame poorly performing trusts.

The Health Secretary warned that if trusts do not deliver adequate care to patients they could be put into a “failure regime” and may ultimately be put into administration.

He also confirmed that hospitals would be subject to Ofsted-style ratings – where hospitals will be rated as “outstanding”, “good”, “requiring improvement” or “poor”.

Mr Hunt also outlined plans to link NHS pay progression to performance in delivering high-quality care.

Robert Francis QC, chair of the public inquiry into the “disaster” at Stafford Hospital, made 290 sweeping recommendations for healthcare regulators, providers and the Government.

Andy Burnham, the Shadow Health Secretary, said the Government’s response “falls short” of the recommendations in the Francis report.

Mr Burnham said Labour would broadly accept the Government response but also questioned why there were not detailed responses to all 290 recommendations.

Julie Bailey, from the Cure the NHS campaign, said the Government’s announcements do not go far enough.

She told ITV News: “We know there are failings in the NHS now and there’s nothing being done about it. We need to ensure the culture changes, and the behaviour of the people in the NHS, and that starts at the top.

“These were systemic failings from the ward right to the top of Whitehall. I don’t seem to see anything in the recommendations to ensure that Whitehall has learnt.”

New Archbishop of Canterbury’s Gushing Praise of Britain’s Troubled National Health Service “Raises an Eyebrow or Two”

March 22, 2013

By Religion Last updated:

March 21st, 2013

The Telegraph

From Archbishop Justin Welby’s sermon: “Slaves were freed, factory acts passed and the NHS and social care established through Christ-liberated courage.”

Sorry if this is out of place, Your Grace, but I can’t help asking: it is now against the law to hold any grand public occasion in Britain without venerating the NHS?

It’s a system of delivering healthcare. There are many worse and, increasingly, many better around the world. Its foundation was a huge achievement, but it is currently so badly administered and employs so many dodgy staff that many people do not feel safe in its hands.

I wondered if the new Archbishop would be able to resist dragging it into his sermon. Obviously not.

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Damian Thompson is Editor of Telegraph Blogs and a columnist for the Daily Telegraph. He was once described by The Church Times as a “blood-crazed ferret”. He is on Twitter as HolySmoke. His book The Fix: How addiction is taking over your world has just been published in paperback.

Head of Britain’s National Health Service (NHS) lied to lawmakers who now are expected to call for his resignation

March 19, 2013

Head of Britain’s Health service lied to lawmakers.

Calls for the resignation of Sir David Nicholson, the chief executive of the NHS, were growing tonight after it emerged he misled MPs over how he dealt with a ‘whistleblower’.

Sir David Nicholson has been forced to correct himslf over evidence he gave to MPs about the 'whistleblower' Gary Walker.

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Sir David Nicholson has been forced to correct himslf over evidence he gave to MPs about the ‘whistleblower’ Gary Walker. Photo: PA
 

By Stephen Adams and Peter Dominiczak
The Telegraph

Sir David was forced to issue a correction over evidence he gave to the Public Accounts Committee (PAC) on Monday, after part of it was revealed to be untrue.

He had claimed that Gary Walker, former head of United Lincolnshire NHS Trust, had not identified himself as a whistleblower in a July 2009 letter to him. Sir David also told MPs that Mr Walker had not raised concerns about patient safety in the letter.

On Tuesday, Mr Walker produced the letter in his own evidence to the Health Select Committee, which flatly contradicted Sir David’s account.

He told the MPs that he had “asked for protection as a whistleblower” in the letter, which also warned that patient safety could be compromised because he was “being forced to comply with targets”.

Mr Walker said: “At the Public Account Committee, David Nicholson denied all of that.”

The letter, seen by the Telegraph, concludes: “I assume the Department of Health has a policy on whistle-blowing and would therefore like this letter to be considered in that context and not freely copied to the SHA [strategic health authority] or the local PCT [primary care trust].”

Mr Walker was sacked from his post in February 2010, for allegedly swearing in meetings.

He has always maintained the real reason was his refusal to bend to pressure from East Midlands Strategic Health Authority (SHA) to prioritise hitting waiting list targets. Mr Walker argued this would have endangered the safety of emergency patients.

He eventually received a £325,000 pay-off from the trust, on the condition he never talked about the dispute. Last month he broke the terms of that ‘gagging order’, resulting in him being invited to the Health Select Committee.

In the letter to Sir David, Mr Walker also claimed that he and David Bowles, the former chairman of the trust, had been the subject of “bullying and harassment” by the SHA.

Referring to the scandal at Mid Staffordshire NHS Foundation Trust, which at the time was just unfolding, he added: “This is the behaviour that gave this country a mid-Staffordshire.”

Sir David wrote on Tuesday afternoon to Margaret Hodge MP, chairman of the PAC, to “correct one specific point of detail”.

He wrote: “In response to a question from Stephen Barclay MP about Gary Walker, I said that when he initially wrote to me, I thought that he did not identify himself as a whistleblower.

“I have now had the opportunity to review the correspondence and would like to confirm that when Gary Walker wrote to me in July 2009 he did indeed ask to be considered as a whistleblower.”

The matter is important because Sir David is fighting to maintain his reputation in the fallout of the Stafford hospital scandal, in which up to 1,200 people died due to appalling care.

A culture of bullying, not admitting mistakes and slavish adherence to targets is now widely accepted to have led to the tragedy.

Mr Walker argues he was trying to bring to Sir David’s attention similar problems at United Lincolnshire and East Midlands Strategic Health Authority ( SHA), which oversaw it. At the time the SHA was run by Dame Barbara Hakin, who Sir David has just appointed as his deputy.

Mr Barclay, a Conservative MP, said the embattled chief executive was “compounding one mistake on top of the other”.

He said: “It is now clear he has made statements to a parliamentary committee which were completely untrue.

“Either he arrived at a parliamentary select committee woefully unprepared or he simply did not expect there to be any written evidence in the form of a letter sent to him in 2009 which contradicted what he said.”

He said the matter “raises further questions about his judgement and the power he wields”.

Charlotte Leslie, another Tory, who has led calls for Sir David to resign, said it was “absolutely inconceivable” that Sir David would not have known the Gary Walker case “inside-out”.

If he did not know Mr Walker had flagged himself up as a whistleblower to him “he is so incompetent, it is simply staggering”, she claimed.

A spokesman for the SHA said its evidence to the health committee “makes it clear” that it, and not Mr Walker, was the party concerned about patient safety at the trust.

 

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