After latest damning report, when will Britain admit the NHS has failed?
British self-delusion about the NHS seems eternal, but at some point the country must come to its senses and seek a new model for health care
The Royal College of Physicians (RCP) is not usually associated with radical right-wing opposition to the National Health Service (NHS), nor should it be. In normal circumstances the question of how a country structures its health care provision would transcend ideology and dogma and focus instead on the purely pragmatic issues of whether the current system is fit for purpose or whether we should consider an alternative.
But this is Britain and the NHS is revered in religious terms.
Be that is it may, the great national delusion that the NHS is “the envy of the world“ keeps on running head on into reports from respected institutions packed with horror stories about its failings.
The RCP has now released just such a report, tellingly entitled: “Hospitals on the edge? The Time for Action“.
The report speaks of patients, especially elderly ones, being trundled around from ward to ward not uncommonly "four or five times during a hospital stay, often with incomplete notes and no formal handover". It states that patients are 10 percent more likely to die at weekends when too few senior staff are on duty.
In places, care on Saturday and Sunday is so bad that the report felt compelled to quote one hospital doctor as saying, "I am relieved on Monday that nothing catastrophic has happened over the weekend".
Some of the horror stories are almost too much to bear. Try this for example:
“An elderly, confused patient in her pyjamas was wheeled by a porter from her treatment to the entrance door, and left there. She was waiting for transport but obviously in dire need of care. She wore an incontinence pad that was saturated and the chair was also saturated with urine. She would get up and walk for a bit and then go back to the chair. No one spoke to her or tried to help her. She was just ignored. Was no one responsible for her care?“
In the report's concluding "10 Priority areas for action" it is surely telling that the first item on the agenda is the following:
"We must make sure patients are at the heart of service design and clinical practice. Hospitals must be a safe place in which all patients are treated with dignity and respect, including those with dementia. All health professionals have a duty to ensure patient needs are met, working together as a team to deliver the best possible care."
For a health system in one of the richest countries in the world, should this really need stating?
Sadly, this is where we are and most Britons don't know the half of it, especially as the country compares with European counterparts that do have universal health care but place far greater emphasis on partnership with the private sector.
We have noted before that when the former communist countries of central and eastern Europe embarked upon their reform process in the early 1990s not a single one of them chose the NHS as their model. Much as they liked and respected Britain, they were never going to do anything so daft as to adopt a system which is far inferior to available alternatives.
Take five year cancer survival rates. Numerous studies have shown Britain falling well below the European average, with Britain starting to be overtaken or rivalled by countries such as Slovenia and even Poland. As an editorial in the Lancet Oncology said in September 2007:
"Overall survival for all cancers combined in the UK as a whole is not only below the European average, it is also noticeably similar to some Eastern European Countries that spend less than one third of the UK’s per capita healthcare budget.
"The reports show survival for gastric, colorectal, lung, breast, ovarian and prostate cancer in England is lower than the European average, and in some cases among the lowest in Europe".
There have been desperate attempts by pro-NHS activists to suggest that the figures are somehow distorted. But the differences are too large to be explained away, which, to repeat, is why nobody in their right minds would emulate the NHS as their national health system of choice.
But away from such tiresome matters as data and evidence, and back in Britain, the NHS remains a subject beyond serious discussion as the ludicrous spectacle of Danny Boyle's celebration of it at the opening ceremony of the London Olympics testifies.
It's never a good sign when a nation is proud of the very things that cause it to fail. It's a tragedy when it gets to the point that it's harmful to that nation's health.
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