As if enough isn't going wrong for the Government. The NHS Watchdog report into the dreadful drop in standards at Stafford Hospital which it is alleged was caused by focusing too hard on targets and not on patient care, may be the thin end of the wedge when it comes to the NHS generally.
It has caused not only the Health Secretary, Alan Johnson, to publicly apologise to families affected but the Prime Minister too. Johnson, who many believed was on a fast-track to potential party leadership, has seen his credibility severely eroded over the affair but this has all the tell-tale signs of more 'laissez faire' Government so much at the heart of the New Labour Project.
Targets And Health
Targets have been a feature of this Government and it is always good to have accountability in any organisation, whether in the public or private sector. Value for money is also important to make sure money being spent is helping achieve something rather than being sent down a large drain. But when it comes to healthcare, the primary target has to be about the survival and treatment of patients and this is something that the Government and the NHS has lost sight of. The growth in instances of superbugs being contracted after treatment at hospitals is now getting alarming and only yesterday I took a relative to a hospital where food lay discarded on the floor and sinks were dirty yet signs proudly displayed that the hospital had met its targets on decreasing waiting times for outpatients. That claim seemed debatable as we sat there for over an hour past the appointment time only to be told that it was the time taken to register you at check in which needed to be below the hour.
The NHS Watchdog revealed that Stafford Hospital had over 400 excess deaths between 2005 and 2008. While it is impossible to work out what an excess death is all about other than by looking at countrywide averages which may be misleading as there may be more critically ill people looked after in Stafford, but what the report did focus on was that there were 'deficiencies' at almost every stage within the treatment process.
Despite all the rhetoric and promise of the Government about healthcare standards and money going into the NHS, it was found that low staffing levels, inadequate nursing, lack of equipment, lack of leadership, poor training, and ineffective systems blighted the fulfilment of healthcare with things getting so bad at the hospital that receptionists were drafted in to do initial assessments. There is little doubt that these factors played a major part in the excess death rate.
To add to the misery for the Government, a new agency takes over from the Healthcare Commission, the Care Quality Commission, and the new CEO, Cynthia Bower, was the Head of the Strategic Health Authority responsible for Stafford Hospital in 2006. So we can expect a general lowering of standards in the future, is the implication asserted by Opposition MPs.
The Wider Issues
I live in an area which has 3 major hospitals at St Albans, Watford and Hemel Hempstead. There was a time when each had Accident and Emergency Departments, this has been consolidated to just one, at Watford General. It has been revealed that both Hemel Hempstead and St Albans will be effectively closing down many of their services and they will all be transferred to Watford General which is having a new building to cope. For the population who find it difficult to get to hospitals when they are relatively close, this will be a major blow. Apart from the fact it costs a minimum of £3 to park and have a short appointment or visit someone which is just profiteering, the care of patients seems to be well down the pecking order when measured against the targets the health region needs to achieve, most notably to cut costs.
I am sure that a great deal of costs can be saved by doing this but judging by the full waiting room at St Albans yesterday, a lot of people are going to struggle to get good treatment, if any. I should explain that Watford General abuts Watford FC's ground on Vicarage Road just off the centre of Watford. To access it you from either Hemel Hempstead or St Albans you have to negotiate the busy ring road system and on match days (remembering these will be more frequent than usual as Watford ground share with Saracens Rugby Club) or busy shopping days, traffic can be gridlocked.
Anyone requiring critical emergency treatment may find it quicker to get to an undertakers.
That's not all. A very good friend of mine was a nurse and rose to become a senior administrator at a major hospital in West London. She told me the only way to hit targets and not to get penalised by funding withdrawal penalties was to reallocate senior surgeons and consultants away from life saving, expensive and lengthy operations and switch them to minor operations like in-growing toenails as more of these could be done in shorter times. It caused massive uproar and many skilled people being demeaned enough to join private practices and firms as well as waiting lists for life saving treatments getting extended.
The growth of the career administrator at healthcare authorities and hospitals has presided over the decline in standards as suddenly hospitals have been run as commercial bodies rather than centres for the treatment of patients. The salaries are fabulous and there is a massive opportunity for thinly skilled interims to make over £1,000 per day for short assignments - it's a feeding ground for accountants and cost cutting experts to make money.
The IT side is the other fiasco. Full to the brim of contractors, consultants and external advisers, healthcare has become one of the most lucrative areas for IT firms as the NHS and the authorities have no idea what they want and so IT companies charge whatever they like. The consolidated patient information system - a national database of medical records has been promised for years and has consumed billions while ambulance dispatch systems produced shambolic processes and caused more harm than good while costing a fortune. The accountability for misspent money is tiny yet the accountability for missing a simple target is huge.
Getting The Balance Right
On a recent trip to France, our companions informed us that France had more hospitals, doctors and nurses per head of population than Britain and the system was clean, efficient and modern - a far cry from the British set up. Our companion should know a thing or two about it as he is one of the world's leading authorities in the field of Pharmacology.
As with bank bail outs, there seems to be an obsession within this Government that 'big that is beautiful' which says more hospitals can be absorbed into less bigger ones and that masses of money can be spent therefore that must treat the problems. It seems that there is incompetence all round and that Stafford Hospital is the first to slip through the net of statistics and lies and let the truth be told. For patients, what has been observed at Stafford comes as no big surprise. Take away Government statistics, targets and made up figures and the reality is dreadful treatment, low staff standards, lack of adequate equipment, long queues and poor cleanliness while the NHS actually shrinks rather than expands to take care of an expanding and ageing population.
It seems that the balance is all wrong. The only real measurement of the NHS should be the health of its patients, and that is one statistic you will not see on the budget sheets.
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