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DJP Update 3-7-2010 Critical evaluation of
British National Health Service by 3 organizations
(IHI, JCAHO Int. & Rand) invited by British Gov to
investigate; Lessons for U.S. Congress?
Below is tweet I sent out in early hours of this day
as soon as the article came out in London.
"..ugly truth National Health Service" #NHS -
Congress should read this article in #Times in UK
http://tinyurl.com/yhdjy4c
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Alternative link to National Health Service story in
the United Kingdom:
http://www.timesonline.co.uk/tol/news/uk/health/article7052606.ece
Here is headline and some excerpts from article by
Lois Rogers in Times of London. Read the entire
article.
Labour hid ugly truth about National Health Service
(NHS)
(DJP comment: This article is based on 3 reports
from different organizations evaluating the NHS. The
reports were obtained under a Freedom of Information
request. The organizations: IHI of Massachusetts, JCAHO
International, and the third report, by the US-based
Rand Corporation)
DAMNING reports on the state of the National Health
Service, suppressed by the government, reveal how
patients’ needs have been neglected.
They diagnose a blind pursuit of political and
managerial targets as the root cause of a string of
hospital scandals that have cost thousands of lives.
The harsh verdict on the state of the NHS, after a
spending splurge under Labour between 2000 and 2008,
raises worrying questions about the future quality of
the health service as budgets are squeezed.
One report, based on the advice of almost 200 top
managers and doctors, says hospitals ignored basic
hygiene to cram in patients to meet waiting-time
targets.
It says “several interviewees” cited the
Maidstone and Tunbridge Wells [NHS Trust in Kent where
269 deaths during 2005-6 were caused by infection with
Clostridium difficile bacteria].
“Managers crowded in patients in order to meet
waiting-time targets and, in the process, lost sight of
the fundamental hygiene requirements for infection
prevention,” the report stated.
There were subsequent failings at health trusts in
Basildon in Essex, and Mid Staffordshire. Filthy wards
and nurse shortages led to up to 1,200 deaths at
Stafford hospital.
Lord Darzi, the former health minister, commissioned
the three reports from international consultancies to
assess the progress of the NHS as it approached its
60th anniversary in 2008. They have come to light after
a freedom of information request.
The first report, by the Massachusetts-based
Institute for Healthcare Improvements (IHI), identified
the neglect of patients as a serious obstacle to
improving the NHS. “The lack of a prominent focus
on patients’ interests and needs ... represents a
significant barrier to shifting the trajectory of
quality improvement in the NHS.”
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Some subheadlines in the article:
A damaging rift between doctors and managers.
Pointless new structures.
A culture of fear and slavish compliance.
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Note that the reports by IHI of Massachusetts and
JCAHO International and Rand Corporation were done at
the request of the British Government.
The IHI report, whose interviewees included Lord
Crisp, chief executive of the NHS between 2000 and
2006, also described a system of self-assessment where
only 4% of trusts are externally inspected.
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A similar picture emerges in the second report, by
the US-based Joint Commission International. It says
the “quality and integrity of [NHS] performance
data is suspect”.
Dennis O’Leary, its lead author and an
international expert on patient safety and
improvement...
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A Department of Health spokesman maintained that the
three reports were never intended for “wider
circulation” ...
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DJP Comment: Lessons for U.S. Congress to learn?
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Stay well,
Donald
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Donald J. Palmisano, MD, JD
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