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Dont Panic, Dont Panic !!!!!!!!!!!

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anneasquith | 13:07 Tue 16th Jul 2013 | News
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don't panic, via bbc news the 14 hospitals which have been investigated for poor quality services ( including high death rates ) are to have managers put in place to manage and oversee the managers. problem solved, .......ed sorry about the capitals but im so angry, :(
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I don't seriously believe that the Conservatives plan to kill the NHS - not because they agree with it, but because to do so would be political suicide.

No, the problem is with politicians who mix with businessmen and number crunchers who believe that any institiution can be run on a 'for profit' model, with bonuses as incentives.

As anyone working for an organisation that works to this ethis - and I do - knows, this means that management minds are focused fairly and squarely on saving money as a priority, because that is what funds and increases their bonuses.

The fact that some organisations, and the NHS and utilities, as well as schools and universities stand as prime examples, are patently unsuited to this business model is a simple fact that politicans have a vested interest in failing to grasp.

For that reason, they continue to use this failed and failing mechanism, constantly hammering square pegs into round holes, with the fallout being uneducated citizens who are dying needlessly.

Until a government will accept that this method of running these institutions is utterly futile, and returns to the notion that health and education do not, and should not run like banks or manufacturing industries, or supermarket chains, the problems will continue to increase.

The first party leader who puts consumers - i.e. patients, and children, ahead of managers in terms of ethos and motivation, will receive my vote in the time it takes to write a cross on a ballot paper.

I am not optimistic, because too many business gurus are too hand-in-glove with too many politicians for the notion of doing right by the people of the country to have any meaningful incentive.

The motivation needs to be for moral good, and comfort, happiness and security for all - and where is the political or financial gain in that? There is none, so we carry on as we are.

Shame on all of them.
Jake-the-Peg

You once on a thread told me that I didn't like state medicine and i didn't answer.......NO, I don't like state medicine.

You oft quoted how much the NHS cost per patient as compared to other countries including the US of A.....but in that statistic there was never any mention of quality if care.

This is not a recent outrage of NHS "standards" as it has been going on for decades under both Political persuasions.

Previous Governments have realised that the NHS is hemorrhaging tax payers money but can do little to change the system as it would be political suicide. The electorate are also to blame as the majority have only known a free NHS and any complaints about it from any source has been labelled as "NHS bashing" and kicked into the long grass.

The doctors and GP's have held Governments to ransom over pay negotiations and this is not sustainable for much longer. The NHS will be bankrupt in a decade if something isn't done.

The arrogance of previous Governments and the attitude of the British people concerning the quality of care in the NHS is breathtaking.

The cry of the Labour Party "the NHS the envy of the World" is another example of the arrogance shown when discounting other methods of healthcare in other countries.

This is a financial barnacle on the hull of the UK.


Whilst working at a large NHS hospital in the early 1980s, in a senior teaching position, there appeared, unbidden, a swathe of hitherto unknown managers. Their first act was to take over the whole frontage of the hospital and provide themselves with spacious offices, with slightly smaller offices for their numerous clerks, typists and assorted underlings. Medical and nursing staff were displaced. Two large car-parks at the hospital entrance were earmarked specifically for 'management'. Suddenly, every grade of professional worker was demoted as a heavy new tier of bosses appeared out of the blue.
A new language appeared, with Aims, Objectives and Targets being the key words. The hospital began to function for the benefit of 'Management',at an expense which made medical and nursing stall the 'poor relations'.
By governmental decree we were thrown to the wolves. And so it continue to this day. Woe betide the patients; they found themselves at the bottom of the hierarchy. Management rules, OK?
Sqad - as the NHS spends less per capita on health than many other developed countries, it should continue to be able to afford it if they can.
http://www.commonwealthfund.org/News/News-Releases/2010/Jun/~/media/Images/Publications/Fund%20Report/2010/jun/MM2010l.gif
I put this up (for the third time)from the New York based Commonwealth Fund, as you can see quality of care is included, and the NHS does not do badly. Would you like to comment?

Well from a lot of experience of the NHS over the last few months I can say, it has been wonderful. I have had nothing but excellent care from both our medical practice, our regional hospital and other services.

But I do think their are too many chiefs and not enough Indians. And I totally agree with Andy's postings.
No Jake - 50% are not below average
and I have said this before - to you perhaps

The value that has 50% above and below is... the median.

Really you should know that

I thought the same - 50% are are above average and so presumably they are resurrecting some of their patients......

IF you have a data set, { 1,2,3,4, 1000) the average is around 200
and ooopth ! four values are below average and one value is above.......
slaney.........yes i would like to comment.
It is statistics versus anecdotal evidence again.

I look at that normogram, if that is what it is and i have no idea what it means.
I don't know what the numbers mean, I don't know how the compilation is made and i have no idea what it is trying to tell me.

You and Lazygun are academics and to you it is meaningful....to me it means nothing.

Anecdotally i have seen gross spending, poor quality of care in the NHS and recently, we have seen what must be considered to be "scandals" starting of course with Mid Staffordshire and others will undoubtedly follow.

The NHS, British Public, Politicans and particularly do not take kindly to "criticism" of the NHS.

This is not a critical evaluation of your graph, but as I explained, it is meaningless to me.
Bring back the ward matrons ,how are we pay them simple get rid of all managers and none medical staff .You would not ask the opinion of a painter in a garage would .Oh and one more thing the sick mp is only allowed to get treated on the national health and the money we save would pay the afore mentioned matron also
There's some doubt about the 13,000 avoidable deaths. It doesn't come from any official source or report. Looks as though someone has taken one small number for one place and multiplied up.So that's all right then! Look,minister,something is wrong. Two in one place would be two too many. It looks as though there is systemic failure.
Fred......State medicine is "ripe" for statistics, as they pundits have carte blanche to put whatever spin thye want on whatever set of figures..........and they do.

How accurate is the input, what accurate reports are shredded....who knows.

I prefer to go on anecdotal evidence and all the dangers that it may incur.
Sqad - it's just a ranking for the various parameters on the left, for example the NHS ranks 2 out of the 7 countries for safe care etc.
As a retired NHS consultant, I'm flattered to be thought of as an academic.

Have to go out now but have been reading this which explains the "average problem" as regards excess deaths.
http://skwalker1964.wordpress.com/2013/07/14/why-13000-needless-nhs-deaths-is-more-nonsense-propaganda/
slaney....ye i know that you are a retired NHS Consultant........but that doesn't exclude you from being an "academic"..............many of my mates are academic but many i would describe as "clinical".

Yes I know that you had a clinical role..................
slaney......have just "read it"............so who does one believe?
Slaney and Sqad, I love it. It's as though I said to Barmaid "What do you know?You've never seen a jury! Yours is all academic stuff, trusts and things!" But lawyers are lawyers, and have a general grasp of what goes on and it's far better than a layman's.

What's your overall impression? This layman thinks that the problem is exaggerated but it is still there and there are a number of avoidable deaths, notwithstanding the argument in slaney's link.
Fred

\\\What's your overall impression? This layman thinks that the problem is exaggerated but it is still there and there are a number of avoidable deaths, notwithstanding the argument in slaney's link.\\\

I don't know the truth....honestly.

Yes slaney has produced that link which is the correct procedure.

I do not know whether to believe the comments. The NHS is HUGE, anything can and does happen.It is almost treason critisise it and that, in my opinion how it gets away with some of the scandals.

Of course there are problems Fred, of course it provides a service, acceptable, but it hates criticism and that is it's biggest fault.
They are good Consultants, average Consultants and poor Consultants, providing good, average and poor quality care.
Depends where you are and what your particular medical problem is, as to the quality of care.
It is not "treason" to criticize the NHS for petes sake. It makes use of public moey, and the public are entitled to reassurance that masses of money is being spent correctly.

That requires best practice, through evidence based research.

The NHS has long been a political football, suffering more re-organisations in the last few decades than any comparable private concern - and costing billions of pounds in the process.

But- the same thing applies when reading reports about the benefits or the shortcomings of the service, and this is a case in point. The media trumpet huge numbers of "excess deaths" - but misunderstand the complexity and the meaning of the figures they are extrapolating such figures from.

Bruce Keogh himself, the author of the report,has cautioned people on how they make use and interpret these figures. The link that Slaney provides should be required reading before anyone comments on "excess deaths".

There are definitely lessons to be learned from the report - inadequate or incompetent management, fragmented and poor value outsourced ancillary services, poor financial controls, funds spent in the wrong places, the legacy of the whole PFI debacle, all of which has distracted clinical and nursing staff from providing the best quality of patient care. Those lessons do not require yet another NHS re-organisation however.
Who to believe Sqad? The author of the report perhaps..
Keogh's report will say: "However tempting it may be, it is clinically meaningless and academically reckless to use such statistical measures to quantify actual numbers of avoidable deaths"

http://www.guardian.co.uk/society/2013/jul/16/report-nhs-hospitals-claims-care
I'm not denying there are huge problems in the NHS - just glad that I don't have to put up with the criticism on a daily basis.
LazyGUn

\\\\It is not "treason" to criticize the NHS for petes sake.\\\

It was a joke...tongue in cheek....turn of phrase........for Pete's sake....;-)

\\\That requires best practice, through evidence based research.\\\

That is one of the problems..."evidence based research" is tending now to be a cliche.......how accurate is "evidence based research?".......Research that hasn't been shredded

\\\\There are definitely lessons to be learned from the report \\\

Agreed.....but how many times have we heard that phrase "lessons to be learnt?"

\\\Those lessons do not require yet another NHS re-organisation however.\\\

Well I disagree, it needs one, but will get the wrong one due to NHS being a Political animal.........i.e any changes will be politically motivated and almost certainly the wrong changes.
The wrong changes in your opinion, Sqad :)

If you can point me to any - any- surgical procedure or medical intervention where the systemic evidence was shown to be wrong, and anecdotal evidence proven to show better outcomes, I would be very grateful.....

And I know you do not like the reference, but sometimes facts need to be re-iterated. Pound for Pound, the NHS achieves broadly the same performance of health outcomes, as measured by the standard indicators, for around half the price.
LazuyGun...yes...yes....I almost forgot the "indicators".......;-)

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