Over the last few years there have been a few problems with Stafford Hospital which then lead on to the Francis report a couple of weeks ago which lead to more media interest.
Politicians, activists and journalists have been quick to draw their own conclusions and focus on particular aspects of the story but the one thread I find weaved through almost all the coverage or discussion was the idea that the Mid Staffordshire NHS Foundation Trust was in some way some form of isolated incident showing a frightening situation which fortunately could not be emulated anywhere else.
I disagree with this. I firmly believe as a health professional that many other trusts will have a similar story to tell but with Mid-Staffs it was there, laid bare for the journos and it was easier, and still is easier, to focus on one place than look at the wider situation. The focus on NHS Trusts at board level to meet targets in order to become Foundation trusts has been evident from the inside for years. This pressure has been made significantly greater since the ConDem Government has insisted that all NHS Trusts become Foundation Trusts by 2014. If we put aside the rights and (mainly) wrongs of Foundation Trusts the significant truth is that the vast majority of the targets set to attain Foundation Trusts focus on finance and efficiency not quality of care. And poor quality of care is what can result in unexpectedly high levels of patient deaths and unnecessary discomfort and pain for others.
When the NHS is run like a business I am personally not surprised when we get stories like this:
Seventeen NHS hospitals are among 26 healthcare providers in England failing to operate with safe staffing levels, the Care Quality Commission has said.
Almost half of the acute hospital trusts in the East have been offered incentives by the government to put dying patients on a programme that allows doctors to withdraw treatment.
The question I think we should be asking is if free healthcare for all is so important (and I believe it is) why are we as a nation so reluctant to pay for it properly.
As a percentage of GDP the NHS is very cheap compared to the US healthcare system (which is a disaster for most of its citizens) and comparable to European nations. And this is after the last (Labour) Government spent thirteen years more than doubling spending on healthcare. Before this we managed to limp along spending less than nearly all the western nations.
And yet the current Government gets it's mandate from policies based on cutting taxes and therefore expenditure. The resulting increasing focus on meeting targets for efficiency and savings mean that, as in most situations where cash becomes king, human need and suffering becomes a lower priority than it should be.
The issues the Francis report outline go through the entire NHS and effect the entire organisation and have a direct effect on people, causing discomfort suffering and perhaps death..... It might feel like some comfort to blame am individual Trust and its managers and Board but I think in the coming months more and more Trusts will emerge to be failing, not financially as the Government is quite happy to publicise to further the cause of privatisation, but failing to provide adequate care.
When we remember what the NHS is for and abandon business models and efficiency measures - and the massive beauracratic load this involves - we will see more capacity for care and compassion, if we seek to blame individual truss, or indeed individual staff members in all but the most extreme cases, for the short falls in care we will fail to improve things and generate a culture which will further reduce morale and therefore carer's ability to be compassionate
