The ongoing NHS scandal

michael m

We have had hospital scandal after scandal, our cancer recovery rates are one of the worst in Europe, money spent on the NHS has doubled in ten years, not matched by service improvements. All in Labour years

Can someone please explain to me then why a sizeable majority still trust the Labour Party to run the NHS?

Holdsworth

There is a lot of truth in what you write, especially with respect to dementia care. But the article lacks any information on the performance of alternative systems. Take the US: there are hardly any doctors specialising in the care of older people. I'd like to see direct comparisons - do you have these?

r Whitehand

this and many other reports over the years plus almost everyone's experience have shown that the NHS is failing badly in many key areas, yet the left (Labour, Lib Dems et al) are dead set against reform and change. i really do not understand why this is as it must impact their viters and them personally. Can anyone explain ?

Sir Trev Skint MP

It's a pity that no msm or broadcaster like the BBC and Sky will ever allow a sensible debate on these issues without bussing in loads of lefty useful idiots.

They are not bothered about the quality of the care, just the size of the unionoised labour force and gold plated pensions.

It's the socialists that are killing patients at the end of the day.

BTW, I see Burnham is back in the job, he signed of the Staffordshire hospital, so that makes 3.

Haldane

Spot on! I was nodding to your every word up to the moment when you talked of the whole edifice crashing down. It will never happen. Our spineless leaders will just pour more and more money into it, because the ill-informed public of this great nation of ours will never know the true situation.You can't blame them. After all,throughout their lives, most people will never have a point of comparison with any other healthcare provider.And if all the vested interests have their way, they never will.

LedZep

Well said! Sadly any criticism of the NHS, direct or implied, is treated by the Left as akin to racism and the perpetrators of such criticisms are invariably denounced as evil. The Left will also point to surveys supporting the contention that the public are 'satisfied' with the NHS. I believe the public are happy with a nebulous concept of the NHS as opposed to its operational practice.This concept holds that: "you are all treated equally and nobody has to pay". Honest people realise that this is not the operational reality and that staff are preoccupied with their own comfort and job preservation. Until we are allowed to have an honest debate about the NHS without the Left shouting everybody down we cannot introduce the measures, driven by genuine competition, which will put patients ahead of the producers. This would take real poilitical courage so don't hold your breath.

In2minds

"the public remains in thrall to the myth of the NHS"

I'd not be too confident about that, I detect a shift of opinion. A lot of people have their own horror story of dealing with the NHS to tell and they are angry. They can also see the waste, that annoys them too.

Dimoto

Instead of rushing through some half-baked "reforms", the Conservatives should have embarked on an in-depth, careful study of the options and alternative models (similar to the education studies).

Real reform of the health system will require a second-term majority, careful preparation, and probably, some carefully applied investment. None of these are presently available.

The present LibDem-mauled quick fix, will probably make a long-term solution much harder to achieve.

And if Labour return to power next time, the NHS will become terminal.

Magnolia

Quote "First break the stranglehold of consultants who restrict the number of entrants to their hallowed and well-paid circle, thereby producing bottlenecks in hospitals."

Firstly, Consultants set and control the quality of professional exams in order that useless doctors are not passed as 'fit' to be consultants.
This ensures professional standards and competence.
Would you like these tests to be dumbed down?
Secondly, the number of places in medicine at our universities has increased markedly since I trained in the eighties, with whole new medical schools opening up. It should be easier to qualify in medicine than ever before but do our bright young graduates stay and work in this country?
Thirdly, postgraduate professional training is now shortened with the move to five year run-through training brought in under Labour.
This has lowered standards considerably but the intention was to increase the number of 'consultants' .
My own DGH now has about ten consultants paediatricians instead of the original two who used to do a one in two on call rota to cover special care.
This article reads like an ignorant rant by a frustrated parent of a disabled child without any knowledge of how medical careers have been changed and messed about by politicians.
My own spouse's NHS workload has increased relentlessly as cases have become more complicated due to medical advances.
Their job is to diagnose cancer. They could easily have made more money with their ability if they had chosen another career in life.
What clever young person is going to pay £9000 plus maintenance expenses to study medicine for five years only to end up working in the c**p NHS?

Woody

I was complaining about the lack of care for elderly patients 10 years ago. My mother who was suffering was cancer would have literally starved had I not gone in and fed her and tended to her other needs, all this whilst trying to hold down a full-time job.

Even then you could see that nurses were lacking in basic caring skills and I lost count of the number of times I complained. It seems nothing has changed for all the money thrown at the NHS, which just proves it is not about money.

Stewie

I run a large PFI hospital, we take pride in maintain the highest standards in everything we do.
Funny thing about the Westminster protests, you know the one with the NHS staff wearing their uniforms. I didn't see any banners complaining about poor care for patients under a broken NHS system desperately in need of reform.

Louise Norman

Very well said. I continue to be amazed by reports that the public hold the NHS in high regard, and in particular place great trust in their GPs. My GP is just an ordinary person, OK but nothing special, and he views it more important that he makes time for his daily run than provide an evening surgery I could get to. Yet he is an unimpeachable gatekeeper to just about all medical services I might want to use. The medical profession in the UK needs a culture transplant, it also needs to improve its skills. We should not be surprised that the NHS accepts doctors and nurses trained in 3rd world countries to practice here; they fit right in. There are some exceptions, but our indigenous medical and nursing professionals don't seem to have noticed how far behind the rest of the western world their standards have fallen, and the UK tax payer continues to be fed propaganda that the UK has world class doctors and nurses. Sadly we don't.

toco

Too many staff in the NHS regard themselves as above what they believe are menial tasks such as providing water,communicating with patients and attending to personal cleanliness of patients.In addition training and the requirement to converse in adequate English has slipped dramatically during the last decade as political correctness and positive discrimination towards overseas employees has driven down standards.The NHS does indeed require a complete overhaul in order that future generations enjoy a decent level of care.

Louise Norman

reesponse to Magnolia: "what clever your person is going to pay £9k..." Answer: an awful lot of the currently unemployed new grads (and they haven't all done hopeless courses at sink universities) would give their right arm to have a safe job, gold plated pension, prestige and inflated social standing that the UK medical profession has. Get real and look around you.

Wily Trout

The public is not in thrall to the myth of the NHS. The NHS is in thrall to the Labour Party and the Trades Unions, and a huge portion of the public is employed by the NHS.

Pettros

Remember that labour had to spend a huge amount of money just to repair a horribley neglected health service. From experience I have seen big improvements. Obviously many others have not.
However I do agree that reform is needed (including competition). This will never happen under the coalition. Cons need a majority.

strapworld

Pettros. I think you need to see a doctor, quickly. You appears to be talking from your backside. Total and utter crap!

Another useless bunker boy or girl with no knowledge whatsoever of the health service. Patients die, are killed and ignored. Patients are treated with total and absolute disregard and we still call this a national treasure?

It is a damned disgrace and it is about time people got sacked. Chief Executives, Medical Directors, Nurses you name them they should all be sacked without compensation or pension. Time to get real.

2trueblue

The elderly are looked on as a drain and are continually discussed as same, and in an offhand manner, and this is reflected in how we are treated by the health service. This is despite the fact that we have already paid.
We are looked on as 'bed blockers', spending our kids inheritance, the list is endless. You can not refer to people in this way and it not to permeate into how we are viewed and treated. This is a shameful country to grow old in.

Magnolia

@Louise
I have a degree in medicine as well as my spouse.
Mine was paid for by the state, completely free because my family was so poor.
I would not do it again if it meant taking on all those debts without parents paying for some of it.
Clever school leavers won't pay for the extra two years of uni when three years of costs would get them on in biomedical sciences with all the potential for research based goodies and rewards from industry and business in future.
New Labour grossly overpaid doctors and GPs now earn as much as hospital consultants when they used to earn about half as much. They 'bribed' them to keep the show on the road.
That's why the pay and pension now looks so enviable.
It will not be possible to keep this up as the country pays for the debt crisis well into the future. It's only the private sector which will grow now or we're all doomed.
Medicine is a horrible job and one in which the employee is stuck in a state monopoly as well. You end up just going through the motions because there's no scope for any individual being able to change anything in the centrally controlled system. Much of it is boring, tedious and repetitive as well as downright unpleasant. Just ask yourself if you'd like to examine obese patients who don't wash too well in private areas?
It's not always about money.
We always told our kids, any degree except medicine.
It's status is very over rated.

Fish

Shush all of you. Dianne Abbott said that the NHS is the third rail of British politics and no one must touch it.

So there you have it. Put up with it. Change will not be tollerated.

Chris

Well, if medicine's such a horrible job, Magnolia, go and do something else - perhaps for even more money than you get at the moment. And by the way, that you refer to your spouse as 'they' tells me all I need to know about the political axe you're grinding.

Holdsworth

I want to put forward a different perspective to that expressed by Magnolia.

I am a hospital consultant and academic. I feel extremely privileged to be in a job which is challenging intellectually and emotionally as well as highly rewarding.

I work 60+ hours per week. I consider myself well paid at £100K/year. Some docs don’t think this is enough because (in London at least) they can’t afford what they consider to be a good house and also private schools on this, but I think their expectations are wrong. I have a normal house and my kids to go state schools. I was state-school educated, then went at university for 6 years, and also have a doctorate. I’d say that I have worked more over the years than most of my schoolmates, but of course peers in other professional fields often do similar or more hours than me.

I agree that a career in medicine can be quite tough. It is not for everyone, and some, perhaps Magnolia, may have made the wrong choice. I would recommend it to those who are interested in working with people and who have an urge to care, but who also are interested in biology, psychology, etc. There’s a lot to it!

Personally I feel I did make the right choice. I’d much rather do what I’m doing than many other jobs. The primary reward isn’t the salary – comfortable though it certainly is. It is the enjoyment and fulfilment of the job itself. It has the advantage of being largely morally unambiguous (unlike a lot of other jobs). I do enjoy a lot of autonomy, and through the research side of my job I get to do work which has the potentially to be internationally influential.

Holdsworth

Regarding the state of the NHS, I absolutely agree that there is a long way to go before we reach adequate standards, especially for older people. I think inspections + tranparency + rewards/penalties is the way forward. Hospitals can compete to be the best. The profit motive could work for certain services, eg. labs or cleaning, but not for the core care. Anyone with even a passing knowledge of the US system knows this to be obvious.

Finally, I reiterate that though the report publicised in the article above clearly shows that a lot needs to be done, it does not say anything about the performance of alternative systems. I’d like to see a similar level of scrutiny of other healthcare systems. In my experience the issues of feeding, drinking and giving attention to older people in hospitals are problematic in any system. Consider the arithmetic: 4-5 nurses per 20 patients; maybe half of the patients requiring assistance with feeding and toiletting – so, say 2 hours per patient per day just for these tasks, not to mention drug administration, preparation of discharge medication and transport, speaking to relatives, reacting to emergencies, going on ward rounds, etc. It’s actually really hard to make all of it happen. Sometimes it is about attitude – that’s the case in every job – but more often I’d say it’s about sheer workload. I simply don’t see anyone not pushed hard every day in the modern NHS.

David L

In2minds and others are right. There's growing mistrust of the NHS, borne of people's own experiences. Trouble is, I haven't met anyone outside the front line of politics who thinks the current reform proposals will make matters anything but worse.

Magnolia

Chris, my spouse is 'they' because I prefer not to spell out my sex on a blog comment.

Baron

Whatever we do with the NHS, the old people’s homes will not change the plight of the majority of those inside unless we abandon the Left designed paradigm of care – that those suffering from serious illnesses, old age are better cared for in units stuffed with highly trained personnel - what’s been missing in such units, what these units, big or small, can never offer is what the long term ill, the old need most – the love, the compassion, the touch of someone who cares, trust Baron on this, he knows, he’s seen a lot of it. Even in the best run hospitals with caring, truly caring staff, many of the patients, in particular the older ones, long for the same they needed, longed for when they were children, don’t get it, cannot get it.

Mr L

I don't find this talk of 'the NHS' makes much sense. My GP practice is fine; my local hospital is not.

Those who pushed through the notion that all nurses should be graduates have a lot to answer for.

I S

Magnolia - Try something else you smug,ungrateful, overpaid bint. Medics are vastly overpaid, hugely arrogant sods who have a ghastly track record of killing their patients.
BTW, can anyone enlighten me why most nurses nowadays are morbidly obese?

anne allan

Magnolia - few males would choose such a pseudonym; unless they were fans of bland wall covering, that is.

Yosemite Sam

I had 10 years as a non exec director of a NHS Trust. During my time (over ten years ago), we had problems with the care of the elderly, usually down to poor ward management and uncaring nurses. Even then I suggested that the Trust, the sisters, and the nurses were putting themselves at risk of criminal action - for not exercising their duty of care, dereliction of duty, negligence and cruelty. At the same time the Trust was putting itself at risk of civil damages for not exercising its corporate duties in respect of the patients under its care. I was pooh-poohed. However, I think I am right and I draw the analogy with the food industry. If the degree of disregard of duty, leading to illness or even death, that has been shown in some hospitals was shown in any branch of the food industry then the Environmental Health people would prosecute - no doubt about it. A few prosecutions of hospitals or their staff would soon put a stop to this neglect.

pharbitis

Magnolia - quite right.
My child chose 'anything but medicine' at university after seeing both parents work their butts off: nights and weekends on call, days which went into evenings with little 'family-time'. Medicine in my day became a daily grind of dealing with unreal and unaffordable expectations promoted by self-serving politicos, trivial complaints (thanks, V. Bottomley) with generally second-rate paper-chasing Health Authority staff for half the financial rewards of today's £120+K GPs. That was then.
Today my erstwhile GP colleagues work 9-5 weekdays only, seem to compete in lavish holidays, performance cars in the staff car-parks and time away on 'study-leave' in exotic locations. Their practice nurses do a lot of the clinical chores the GPs are paid to get done and patients can't get early appointments. Value for money?

Holdsworth: graduate nurses are not required to feed and toilet helpless patients. Kind sensible assistants can do that but it needs caring sensible nurses to set the ward culture of care and too many modern nurses - graduates who aim to be managers - expect patients to 'self-care', self-apply', self-feed' -anything but expect to be nursed because they are ill.
And too many consultants are remote, part-time and counting down to their well-superannuated retirements.

Yes, the NHS has changed; so have doctors and nurses and patients. Some of them almost deserve each other. But others don't.

Martin

How about stopping all payments of taxpayers' money to the NHS and the state education system, and with the money saved giving the British people big tax cuts?

Education and health care in Britain could then be funded by payment of fees (thus causing education and health care to benefit from market forces), and by charitable donations.

The NHS is funded by taxation and comes under no market forces whatsoever. So there is no limit to how bad it may become in the future. So far, the NHS has given us Harold Shipman and the Mid-Staffordshire Hospital. If it continues in its present form, I wonder what the NHS will bring us next.

Magnolia

@Anne Allen
Look up Sanderson's wallpaper 'Sweet Bay' in the Parchment Flowers collection and tell me if I've got good taste.
It was the first thing I saw when I tried to think of a nom de plume.
It's as good as any.

richardj

The State has no expertise in running anything - why are people suprised when the evidence has been there for decades.

The only business of the state is security and law enforcement - the rest is for other parties to carry out with the required regulation.

It is time for all political parties to recognise this and get on with representing the people who vote and the taxpayer who pays and organise an orderly and well thought out revolution in the provision of health, education and anything else the state is incapable of running.

alexsandr

Well done CQC for finding what has been endemic and known about for many years. How is it that thay have taken so long to find this out? Perhaps they should got off their fat arses and actually do their jobs more. Or be abolished as yet another useless regulator, like offsted, offwat, offf*ck et al.

Stewie

A lot of interesting comments, particularly the Consultant. My own view, as a PFI hospital manager, is that only the NHS can provide an integrated Clinical/Healthcare system. We do provide some clinical services and it's quite obviously a mistake, even though we do it to a high standard. It moves our focus.
But the NHS should be cut free to provide only those services.
All of the FM, from buildings to equipment to security to cleaning and hygiene should be Contracted out. Put us under demanding SLA's with REGULATED profit margins and competent Contract managers. Also regulate the salaries of the employees and Directors of the Contracting companies if you will, it's simple to achieve within a Contract.
It's a system that works very very well. It costs around 20% more than the current NHS, who do it rather badly, and I think that's a fair price to pay. It would help to hypothecate NI payments directly into the NHS so that everyone knows exactly how much and for what they are paying.

David Bouvier

But Stewie - the NHS does NOT provide an integrated healthcare service.

Heaven help you if you are taken ill in one region and need to arrange a transfer to another. Heaven help you if you need to access unique specicialist expertise in one hospital while making frequent visits to a local one. Heaven help you if your hospital consultant knows you need an urgent but not immediate operation but doesn't keep you filling up a hospital bed for a fortnight - because once you are out of the hospital you won't get back in it or months however urgent he thought it was.

It is a fragmented system that treats people when it has to.