Friday, February 8, 2013

When a 'treasure' is also a shame

I was in Vietnam during the London Olympics and missed much of the opening ceremony, including the, subsequently much talked about, praise-piece for the NHS.  I haven't missed, over the years the ill-informed and ignorant spew of comments from people who all stand-up and say what a wonderful service is the NHS!

Where were these people earlier this week?  Where were the unions - the Royal College of Nursing (RCN) and the British Medical Association (BMA)?  Why weren't these organizations out there, demanding the names of their members that had so patently and regularly failed in their basic duties - not just as so-called health professionals but as human beings?

Where too were the police?  They can find the time to undertake a never-ending investigation of hacking.  They can release all sorts of allegations about Jimmy Saville and presume guilt.  They can conspire in the unseating of a senior government member.  However, investigate abuse after abuse?  Make arrests?  Leak names of the 'guilty'.  No, they can't be bothered to investigate their 'colleagues' in the emergency services.

I am, of course, referring to the scandal at Mid Staffordshire Foundation Trust.

I took the opportunity to print-out the Executive Summary (kudos to HMSO on their commitment to transparency!).  This document is 125 pages long and page after page one finds a litany of facts that shame the UK.

One of the first reactions of the political parties was to close ranks and focus on 'the way forward' and emote by expressing  wordy sympathy for the families of the victims.

While I am sure that the Conservatives would not want to stir the pot too much in case any early skeletons come tumbling out of its historical closets, I have no such inhibitions.

The bulk of these abuses happened while Labour was in power.  They happened while Labour was shoveling obscene amounts of taxpayer money into the NHS.  They happened while those 'healthcare professionals' regularly received real-term increases in incomes and membership.

Did these same professionals have their noses so far into the trough that they couldn't see what was happening?  I don't think so.  I think they just didn't care.

I have written here many times before, that in my view and based on experience around the world, the NHS is by no means a 'treasure'.  It is a shaming institution for the UK.  Over paid, over funded and over politicised.  Like an old relative with a drink problem, everyone knows he/she needs to be spoken to but rather than doing the right thing, we keep on slipping the old reprobate extra grog! 

The first inquiry, which reported in February 2010 reported.
  • Patients were left in excrement in soiled bed clothes for lengthy periods;
  • Assistance was not provided with feeding for patients who could not eat without help;
  • Water was left out of reach;
  • In spite of persistent requests for help, patients were not assisted in their toileting;
  • Wards and toilet facilities were left in a filthy condition;
  • Privacy and dignity, even in death, were denied;
  • Triage in A&E was undertaken by untrained staff;
  • Staff treated patients and those close to them with what appeared to be callous indifference.

The first inquiry report was published on 24 February 2010. It contained damning criticism
of the care provided by the Trust, drawing out a number of conclusions, including:
  • There was a lack of basic care across a number of wards and departments at the Trust;
  • the culture at the Trust was not conducive to providing good care for patients or providing a supportive working environment for staff; there was an atmosphere of fear of adverse repercussions; a high priority was placed on the achievement of targets; 
  • the consultant body largely dissociated itself from management; 
  • there was low morale amongst staff;
  • there was a lack of openness and an acceptance of poor standards;
  • Management thinking during the period under review was dominated by financial pressures and achieving FT status, to the detriment of quality of care;
  • There was a management failure to remedy the deficiencies in staff and governance that had existed for a long time, including an absence of effective clinical governance;
  • There was a lack of urgency in the Board’s approach to some problems, such as those in governance;
  • Statistics and reports were preferred to patient experience data, with a focus on systems, not outcomes;
  • There was a lack of internal and external transparency regarding the problems that existed
    at the Trust.
So what must be done?

Well, criminal charges for one and sackings for the second thing.  The Police must review the evidence that has been so painstakingly gathered (why they have not already done so, is maybe not a mystery!) and they must make arrests.  Dawn raids, arresting people in their jobs, anything that shows these people to the world for the shameless and self-serving animals that they are.  Harsh words?  Think about it for a moment - people were entrusted to their care and then they didn't just die, they suffered and then died.  The 'caring' service.  Do you think?

Nurses, Doctors, 'managers' and executives need to face criminal charges for dereliction of duty and failure to provide care.  These people need to be named and shamed and put in the dock.

Medical folks and social workers talk about people needing 'closure' - that was the term used by Andy Burnham when talking about the Hillsborough disaster - the families of Liverpool fans needing closure.  So now, how about some closure for the Mid Staffs victims?  How about senior heads rolling?  Maybe start with Andy Burnham, who was the Health Minister in charge of the NHS, during part of the period?.

Those members of the various Health Authorities must all lose their positions.  If they are still employed by the government, in any form, they must be fired.  Simple.  Their current employers needn't worry about employment tribunals.  Having these heartless people, named and shamed, will be worthwhile.

They MUST lose the honours that were bestowed!  If Fred Goodwin can lose his knighthood, why not people like Sir David Nicholson - now head of the NHS, and, in 2005/6 ultimate head of Stafford Hospital.  Hundreds of people died and suffered on his watch.  That he has no sense of decency is apparent but that shouldn't stop the Honours Forfeiture Committee being called into action!

Also, take the maximum possible action on their pensions - whatever it is, don't be nice, be mean, don't err on the generous side, punish them.

Then of course, there are all of those Labour politicians.  Those sanctimonious fools who believe that money is the solution to all problems, so long as it is other people's money.  Those same people who oppose any reform that looks to improve and only allows surface level reform that entrenches vested union/provider interests at the expense of consumers/patients and taxpayers.

Let's have a debate on this but turn this into a debate on the future of the NHS.  Cameron should set the attack dogs free so that they can tear into the hypocrites that still sit on Labour's front bench.  Those that still say the NHS is safe in their hands - in a way they are right, the organization is safe in their hands but the patients and their families that use it, aren't!

The real answer is to move away from the outdated model and adopt something similar to that which operates in other countries - a mix of public and private - but who will have the courage to do this?  This report should be the most potent weapon in the NHS reform arsenal but instead it will be buried and the culprits will go free and enjoy their knighthoods and gold-plated pensions, while vulnerable people continue to suffer and die while receiving treatment that is 'the envy of the world'.

On reflection, I am glad I missed that Olympics opening!

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