Yet again we have more terrible news of the failings in our much vaunted National Health Service. The Care Quality Commission today reports on its findings into inspections at 100 acute NHS hospitals inEnglandand announces that fully 20% were not delivering care that met the standards the law says people should expect in terms of dignity and nutrition. One in five hospitals failing to meet legal requirements in these basic areas despite the additional billions pumped into them over the last decade or so. How can we spend so much and get so little in return? Why does such a large section of the caring profession get it so wrong?
As I’ve blogged before (‘No way to run a health service’ June 2011) I’ve had both first hand experience of our NHS, been married to a health professional and seen some of the failings at first hand. Now don’t get me wrong if you think that I’m someone who doesn’t believe in our health service; it has saved my life on two occasions. But that doesn’t mean that it is without blemish. Just consider, it employs c.1.5m people and, sure, not all of these are going to be up to scratch in the care stakes. But 20% of hospital failing to meet legal requirements? A sad but true story first.
A few years back my late mother was admitted into one of the major London teaching hospitals as she had suffered a fall. I travelled the long journey down to visit as soon as I got the news and what I found shocked me to the core. Mum was groaning in apparent and considerable agony some 20 feet only and in full sight of the nurses’ station where 7 or 8 nurses and doctors were doing various things (including sharing jokes). It transpired that mum had received no assistance to relieve herself since being admitted earlier the day before and clearly had been ignored. Any ‘profession’ that can permit this level of indignity to be visited on another human being has serious failings.
The National Audit Office in a separate report today finds that 80% of hospitals were in some financial difficulties and two thirds had weak leadership and management delivered poor quality care to patients. According to The Kings Fund, of the funds invested in the NHS under Labour somewhere over a third went on increased salaries “and the returns, in terms of better care, higher productivity are somewhat elusive so far”. So, despite an increase from £52.9bn in 1998 to £118.3bn in 2010, nothing much to show in efficiency gains. Now, if as a chief executive of a public or private company I had gone to shareholders and asked for this sort of percentage increase and then said I had nothing very much to show for it, what do you think my survival chances would be? Especially if I had incurred a far vaster liability in terms of ‘off balance sheet’ (in the form of PFI) commitments for years to come
Now to be fair, the Government had to pay for the effects of the EU working time directive for junior doctors and for sharply increased costs of criminal negligence claims. But who agreed to the former and who created the environment for the latter? Sure, the cost of drugs rises inexorably but the waste in the system is incredible. There is almost no other subject that gets politicians and the public rushing to their respective corners as the NHS. It’s curious but mention profit in connection with healthcare and it’s battle stations at once. The fact that a private company might be efficient enough to make a profit is anathema to the likes of the Guardian readers. But mention that an equal or far greater amount is being simply wasted and you get a shrug or, at best, hands wrung, eyes averted.
The adverse effects of shifting demographics have been known to governments for over 25 years and caring for our elderly is going to take more than a few platitudes. Democracy has failed us because, frankly, the political elite haven’t had the guts to tackle the issue of funding healthcare in a sustainable manner. Does it matter if the care my mother (or yours) receives or the dignity she is afforded came from a profit making organisation that didn’t waste the funds we invest from our taxes? The health professionals may be capable of delivering care but don’t kill them with targets. And just because we are talking of professions don’t fall into the trap of assuming they know how to lead a multifunctional team and manage vast budgets.
The NHS was, in fact, an all party wartime coalition effort (despite the fact it was a labour government that was in power to introduce it in 1948). We are now in the midst of a crisis in healthcare that has been decades in the making and it will take a great deal of time to come up with a sustainable solution. We need, somehow, to take control of the means of a solution out of the party political system.
Don’t we owe it to our elders to spend their final years with dignity? They brought us into this world; shouldn’t we try to make their passing as comfortable as we can?