Tuesday, January 18, 2011

Parts of the NHS are second rate

It seems it was the American journalist Michael Kinsley who first observed that a gaffe takes place when a politician inadvertently tells the truth. There is no clearer illustration of this than David Cameron's interview for the Today programme yesterday in which he said or implied or was thought to have implied that parts of the NHS offer a second-rate service.

Of course parts of the NHS offer a second-rate service.

If you doubt this, have a look at the front page of yesterday's Leicester Mercury:
Two elderly women were let down by the NHS in the care they received up until their deaths.

Today, we reveal that staff are facing disciplinary action following the treatment of 72-year-old Sylvia Densham, who died of infected bed sores while waiting for a hip replacement operation.

Leicester City NHS Community Health Service has admitted failings.

In another case, the health ombudsman has found that 92-year-old Joan Adams, who died from internal bleeding four weeks after being admitted to hospital, suffered more discomfort and distress during the last weeks of her life than was necessary because of "service failure".

Following the inquest into Mrs Densham's death, Leicester coroner Catherine Mason wrote to the Community Health Service listing her concerns over the treatment she had received.
"Second-rate" appears something of a euphemism here.

What is also telling is Labour's reaction to Cameron's interview. John Healey, one of the more able figures in the shadow cabinet, is quoted by the Daily Telegraph, as calling the prime minister's remarks "an insult to millions of NHS staff".

This is a thoroughly modern reaction: what matters is not whether something is true but whether it might cause offence to someone.

More than that, Healey's implication that the only factor that determines the quality of care received is the efforts of staff is strange. A socialist, of all people, should understand that workers can be doing their best but be poorly managed or resourced.

Besides, amongst "millions of NHS staff" there are bound to be some who are not doing their best.

The government's NHS reforms look rushed to me. But the direction of travel - making NHS services more responsive to individual and local circumstances - is one that Liberals should support.


Moggy said...

I can only confirm this from useage of the service by self and family over last couple of years. Parts of the NHS are very good indeed, parts of it are shameful with slovenly staff with unhygienic habits. The mystery is not only how this occurs occurs within the same service, but also in different units in the same hospital.

Anonymous said...

Hear, hear!

Paul Leake said...

Why is it such a gaffe? Labour have previously acknowledged some parts of the NHS as second rate either locally or nationally but left fewer second rate services than when they came into office.

No system is perfect, and it is that sort of attitude that leads to the likes of the Mid Staffs scandals. I can't see how introducing price competition and more fragmentation into the NHS is particularly going to help tackle those services that are second-rate in quality.

beerdrinkingbookreader said...

I tend to agree with Paul.

As regards the proposed reforms, I don`t believe they will help, and I don`t trust the government`s intentions.

Having said that I have fairly recent experience of the NHS concerning the death of my father and the birth of my two children. I would say there are flaws that could be addressed, though any effective management should be able to do so. I`d say there is too much inter-disciplinary rivalry, and sometimes a degree of breathtaking insularity and arguably complacency.

Against that, the work makes unusual demands on people and I think different people find different ways of coping - not always the best ways.

It should be possible to come up with a viable set of reforms, but I`m not sure the current govt has done so or can be trusted to do so.

dreamingspire said...

After considerable experience with the NHS over the last few years, both personally and on behalf of an ancient relative, and also the experience of another relative who is long term disabled, it is obvious that the NHS works because the people in it make it work. It isn't and never can be fully top down managed, although sections, particularly the independent factory setups (private providers of, for example, surgical procedures - in my case in at 0915 after the first member of staff who I encountered displayed initiative to overcome an admin error, out at 1600, for something that in earlier years would have meant a week in hospital) do work to build a creative tension between top down and individual initiative. Within that, my experience is that pro-active persistence by patients and relatives works, but some cannot do that, and in some cases (e.g. dirty wards) you just cannot win. I welcome giving more responsibility to GP practices, particularly as more than once I have had to find out for myself when the local practice should have been able and empowered to work towards the required outcome.