Category Archives: Uncategorized

NI chief asks for an “society-wide conversation on budgetary priorities”, which means rationing..

Marie-Louise Conolly in N Ireland BBC reports 9th October 2019: NI health chief Richard Pengelly warns ‘something has to give’

He will be aware of the denial and the lack of the honest debate asked for by the chief of NHS England (Mr Stevens) in 2014.  The NI chief is asking for an “society-wide conversation on budgetary priorities”, which means rationing..

In the Belfast Telegraph October 17th he warns: Health service faces difficult decisions on budget 

The man in charge of Northern Ireland’s health service has said he cannot afford to pay for lifesaving treatments and pay rises for staff while also tackling hospital waiting lists.

Richard Pengelly, the Department of Health’s Permanent Secretary, said the health service in Northern Ireland is facing a £20m black hole in its budget.

As a result, he said he is unable to adequately fund a range of crucial NHS services.

Speaking at a Chartered Institute of Public Finance and Accountancy conference in Belfast, Mr Pengelly said: “I have stated that my department does not have the money to do everything we are being asked to do.

“It’s now in the public domain that our health and social care trusts are facing a projected £20m deficit this financial year.”

He restated the need for a debate to establish the public’s spending priorities in the face of budgetary pressures.

“While intensive work will continue to ensure their books are balanced, the reality is that the projected deficit represents only a small part of the escalating pressures and demands we are facing in the months and years ahead,” he said.

“Currently these are presented to me with frustration – the argument being that because I don’t do something, it means I don’t want to do it. That is certainly not the case.”

Mr Pengelly said that he had been left with difficult decisions to make and could not please everyone.

“Why wouldn’t I want to reduce waiting lists, increase pay for hard pressed staff and reduce the pressure on those staff by recruiting and training more colleagues?  Why wouldn’t I want to improve mental health provision and focus on suicide prevention, commission new drugs for patients with cancer and other serious conditions?,” he said.

“The truth is I simply can’t afford to do all these things – in fact, I can’t afford to do all the things we currently do.

“And with a fixed budget, I can only do more in some areas by doing less in others. And that is the key challenge.

“It is why we need a society-wide conversation on budgetary priorities and how best to use the limited resources we have.  In the next year alone, the competing demands and pressures could between them add hundreds of millions to an already very stretched health budget.”

Belfast Telegraph Digital

Denial for 5 years. On 4th June 2014 Mr Stevens asked for an honest debate…

Image result for denial cartoon

More deaths in Wales. More attempts at unreal solutions… Across the nation standards are falling…

No amount of cultural change can occur without changing the ground on which the health services are built. Any moreover, to attempt to do this internally, and without outsider help the attempt, like most previous reorganisations, is doomed.

Leah Powell in the South Wales Argus reports: Relative of Nye Bevan – founder of the NHS – died after “life-threatening” mistakes from two trusts.

Mark Smith on 26th June in the same paper June 26th reports that “Huge numbers of patients are dying due to mistakes made by the Welsh NHS” and that Thausands of others may have suffered harm.

Whether as a result, or not, on 21st June the Health Service Journal reported: The Welsh NHS has embarked on a fundamental change of culture and services. Nesta Lloyd-Jones tows the line…

Lizzie Parry –  Sebbastian Hibbard’s death is reported in the Sun: NHS 111 handlers “missed numerous opportunities” to save boy aged 6 with blocked bowel says coroner.

Laura Donelly in the Telegraph  17th June reports on “Eight NHS Hospitals hit by Listeria deaths”. Hancock plans to restore catering services “in house”.

Hundreds of villages lose their GP services across the country… The Telegraph

 

 

 

 

 

 

 

From 40 hospitals to six: how the Tories’ NHS numbers don’t add up

The Liberal Party missed a great opportunity to use basic liberal principles to reconfigure the 4 UK health services in their recent conference. Once Brexit is over they have no differentiating or sustainable policy on health.

Conservatives:

In the Guardian today Sarah Boseley reports: From 40 hospitals to six: how the tories ‘ NHS numbers don’t add up. Experts say it is hard to know how much new money Boris Johnson’s government intends to put into the NHS

Labour: In the Guardian again reports: Labour’s NHS policies risk replacing one dogma with another

 

 

As seen from USA Nationalisation of Health gives worse outcomes…… than the G7 excluding USA!

The idea that nationalised health care is worse than no health care, which applies to 40% of working American citizens is laughable. Yes, for those with cover the US system is better, especially for the elderly on retirement incomes, but it excludes so many. But against Australia, Canada, Denmark, Ireland, New Zealand, and Norway, the UK has worse outcomes. A pity the whole of the US population was not included in the study.

The UK system is failing, badly, and needs to change its rules. No other country tries to emulate any of the 4 UK health systems. But we don’t need to emulate the USA.

Sally Pipes (President of the Pacific Research Institute ) for Forbes 30th September 2019 reports : Across The Atlantic, Nationalized Health Care Is Failing Cancer Patients

The United Kingdom’s National Health Service is failing cancer patients. That’s the grim conclusion of a new study published in the Lancet, a medical journal.

Researchers examined five-year survival rates for seven types of cancer in seven “high income” countries. The United Kingdom came in dead last in five of the categories—and near last in the other two.

These dismal results have a simple explanation. The National Health Service is woefully short on doctors, nurses, and other healthcare personnel. Long waits and poor care are the result.

These are the stark realities of any government-run healthcare system. If the United States implements Medicare for All, British-style rationing is sure to follow.

There are few places in the developed world worse for those with cancer than the United Kingdom, per the Lancet study. From 2010 to 2014, just 16% of patients diagnosed with cancer of the esophagus survived five years. Less than 8% of those with pancreatic cancer and 15% of those with lung cancer lived that long.

Those results can partly be attributed to the country’s shortage of cancer care providers. About one in ten diagnostic posts is vacant, according to 2018 data from Cancer Research UK, a research and awareness charity. By 2027, the government must add 1,700 radiologists to its workforce to accommodate demand. It must also hire over 1,800 oncologists and 2,000 therapeutic radiographers—professionals who administer radiotherapy to patients with cancer.

“We don’t have nearly enough radiologists in the UK right now,” noted Gils Maskell, Cancer Research UK’s radiology expert. “And far too many patients are waiting too long for scans and results.”

In some cases, hospitals are so strapped for resources that they’re getting rid of crucial cancer services. Last year, for example, a London hospital announced that it would nix chemotherapy because it had too few qualified nurses to continue providing it. One health official called it a “serious blow to patient care.”

As a result, patients experience dangerous treatment delays. Data from the NHS revealed that nearly 58,000 patients didn’t see a cancer specialist within two weeks of getting an “urgent” referral from their doctor between April and June 2019. More than 18,000 didn’t see a specialist within three weeks.

These delays often mean missing tumors at earlier stages, when patients have a better chance of survival. In 2017 alone, 115,000 cancer patients in England didn’t get a diagnosis until the cancer had already reached stage 3 or 4, according to a recent Cancer Research UK report.

The results are often tragic. For example, while more than 90% of patients with bowel cancer survive for at least five years if it’s detected at its earliest stage, only 10% do so if it’s not discovered until the latest stage.

The statistics are similar among women with breast cancer. Eighty percent of lung cancer patients will live five years if the disease is diagnosed early, compared to only 15% if it is discovered in its most advanced stage.

And then there’s the outright rationing. The NHS simply denies patients treatments if it decides that they’re not worth their price. In 2017, for example, the NHS’s “rationing bodies” decided to reject a drug that could have extended the lives of hundreds of women with breast cancer.

Cancer patients fare far better in the United States than in the United Kingdom, according to 2005-2009 data from the Centers for Disease Control and Prevention. Here, 89% of female patients diagnosed with breast cancer survived for at least five years. In the United Kingdom, only 81% did so. Among patients with colon cancer, 65% of Americans survived five years, compared to only 54% of Britons. And U.S. lung cancer patients were about twice as likely to survive five years as those in the United Kingdom.

These stark differences show that the last thing the United States should do is import government-run health care—if we care about saving the lives of cancer patients.

As a GP, I know there is a huge void for patients where the NHS used to be

Zara needs to realise that all health systems ration care and services. Because we cannot get our politicians to admit this, we ration covertly and by post code, easy targets, and without reference to severity of symptoms or means, or cost and volume. The result is an unofficial two tier system whereby the richest pay for those rationed services, and the poor do without. Zara also needs to recognise that there are 4 UK health services, and no NHS.

In The Guardian Zara Aziz reports 1st October 2019: As a GP, I know there is a huge void for patients where the NHS used to be

Rationing means that hernia repair, hip or knee replacements and removing tonsils or a gallbladder are no longer routinely funded

….Did you know that hernia repair; hip or knee replacements; removal of cataracts, tonsils, haemorrhoids or a gallbladder; injections for back pain; and referral to specialised pain clinics are among the growing list of treatments that are no longer routinely funded by the NHS?

lost notes and illegible records

As a member of the Pembrokeshire LHG, now Hywel Dda Board I proposed that we introduced a GP medical records system into A&E. If this had been accepted the quality of records, their utility, especially regarding messages, phone conversations and e-mails could all be more accurate and complete. The demand for GP notes would have spread like cancer through the hospital. At a recent admission I had my history taken 10 times (at least) by different persons from different departments. Not one referred to the history taken previously, or to my thick paper medical record. On several occasions my records were not available. If they had been would they have been legible? 23 years after my proposition our local DGH is not computerised. … 

George Greenwood reports 2nd October 2019 in the Times: Lost notes and illegible records ‘risking lives of NHS patients’

Coroners have warned the NHS on dozens of occasions that its record-keeping is so poor that patients’ lives are at risk, an investigation by The Times has found.

At inquests into patients’ deaths across England and Wales they identified cases where records were illegible, had been sent to the wrong GP or lost.

Coroners have issued 62 warnings since 2013 in which they identified failings in record-keeping that could lead to the deaths of other patients.

In one case, an anorexic teenager who killed herself in 2017 after doctors had not properly documented her mental state was “failed by everyone”, her mother, Nicki Long, told The Times.

“It is clear staff were just not talking to each other. They just didn’t have a true picture of how unwell Ellie really was, and missed that she was self-harming,” Ms Long, 48, said.

The coroner, Jacqueline Lake, found that Norfolk and Suffolk NHS Foundation Trust staff had failed to upload important handwritten records about Ellie’s state of mind to her electronic file.

“I know the NHS is understaffed but using that as an excuse to a mother who has just lost a child is not good enough,” Ms Long said. Knowing that opportunities to look after her daughter better had been missed made losing her even harder, she added.

Staff at Stockport NHS Foundation Trust failed to carry out a blood calcium test on Gary Bradshaw, who died of a heart attack in 2012, because a laboratory staff member mistook a handwritten note requesting the test as reading “cancer” rather than calcium and disregarded it. Another inquest involving the trust had to be adjourned because medical staff were unable to read a patient’s records.

The coroner was surprised that the trust had failed to spot that the records for Geoffrey Ellis, 88, a retired Baptist minister, were illegible during his care or when preparing for the inquest.

After the deaths, the trust noted in a board report last year that NHS Improvement had raised new concerns about the quality of its record-keeping.

The coroner, Jacqueline Lake, found that Norfolk and Suffolk NHS Foundation Trust staff had failed to upload important handwritten records about Ellie’s state of mind to her electronic file.

“I know the NHS is understaffed but using that as an excuse to a mother who has just lost a child is not good enough,” Ms Long said. Knowing that opportunities to look after her daughter better had been missed made losing her even harder, she added.

Staff at Stockport NHS Foundation Trust failed to carry out a blood calcium test on Gary Bradshaw, who died of a heart attack in 2012, because a laboratory staff member mistook a handwritten note requesting the test as reading “cancer” rather than calcium and disregarded it. Another inquest involving the trust had to be adjourned because medical staff were unable to read a patient’s records.

The coroner was surprised that the trust had failed to spot that the records for Geoffrey Ellis, 88, a retired Baptist minister, were illegible during his care or when preparing for the inquest.

After the deaths, the trust noted in a board report last year that NHS Improvement had raised new concerns about the quality of its record-keeping.

However: There’s no way your information will be kept safely safely…

An NHS led by laggards