Our glorious NHSMarch 4, 2013 Tim WorstallHealth Care35 CommentsAs many as 1,165 people starved to death in NHS hospitals over the past four years previousThey really do want their ID cards, don\’t they?nextThe Murphmeister\’s latest paper 35 thoughts on “Our glorious NHS” Andy B. March 4, 2013 at 10:08 am It would be interesting to know which arm of the state is more prolific when it comes to killing people, the British Army or our Health Service. john b March 4, 2013 at 10:12 am Again, fairly irrelevant data unless we know the extent to which this happens in different systems. For what it’s worth, the multiple-funder multiple-provider system in operation in Victoria shows 48 in-hospital deaths a year from malnutrition, which would equate to about 500 a year if Victoria had the same population as England. If I were silly, I’d then try and use that point to say that the NHS model is twice as good as the Australian model (mixed state/private funding and mixed state/private provision). But I’m not. Serf March 4, 2013 at 10:28 am They are no doubt saboteurs starving themselves to undermine the envy of the world. As john b said other systems might be as bad or worse, but it still bears saying, that the NHS is starving people to death. Kevin Lohse March 4, 2013 at 10:38 am Dying of starvation takes about 3 weeks. Dying from dehydration takes about 3 days, thus freeing up beds that much more quickly and making targets more achievable. I wonder what we’re not being told? Peter Risdon March 4, 2013 at 10:45 am I thought you’d got over this behvaiour, John B. From your own link: “There is insufficient analysis of the reasons for the deaths, leading to a false perception that people are dying in hospital of starvation or lack of food, because of neglect,” she said. “There is no evidence for that. “The figures do seem very high. “However it is not unexpected in the sense that most people who are dying are not eating or drinking.” My father died of starvation and dehydration in a hospice in Tasmania, but not through neglect. He was dying, couldn’t feed, that was the pathg of least distress for him. The deaths in the NHS ARE NEGLECT! A bloke phoned the police from a fucking trolley in a corridor because he was dying of thirst, literally – he died of thirst in the end. bloke in spain March 4, 2013 at 10:49 am Can’t say I’m too happy with statistics that begin “up to”. One is part of the number series “up to”. But @ john b, bugger Victoria, one is 100% too many. Rob March 4, 2013 at 11:02 am Nurses are too busy? How many extra nurses does it take to move food 6 fucking inches closer to the patient? What sort of mindset thinks feeding patients is dumping food out of their reach? Rob March 4, 2013 at 11:07 am “Sir David, who has faced calls to quit since the Francis report revealed issues a Stafford Hospital, was instead given a vote of confidence.” We are all in the trough together. Jim March 4, 2013 at 11:08 am “What sort of mindset thinks feeding patients is dumping food out of their reach?” The sort of mindset that 60 years of socialism creates. Surreptitious Evil March 4, 2013 at 11:18 am I’d like to see a proper breakdown of stats: Died on LCP – full recorded agreement with patient and / or NoK. Died on LCP – “well, obviously we had full agreement but appear to have lost the records”. Died of malnourishment or dehydration, not recorded as being on the LCP. That way, we might have some idea what is actually going on. Edward. March 4, 2013 at 12:19 pm Hold up a minute, now modern medicine has come a long way an’ all and nurses all tooled up wiv degree quals – it’s simply super that Jacinta and Jessica are now fully qualified…… Though, I thought everybody knew – good food and proper care, in clean wards is more than half the battle – Florence knew that – in the Crimea. Rob March 4, 2013 at 12:25 pm Edward, we have moved on from that reactionary dogma. PaulB March 4, 2013 at 12:29 pm All this story tells us is that newspaper stories can’t be trusted, especially not if they’re in the Daily Mail, and we knew that already. The true figure for deaths from starvation reported by NHS hospitals in 2011 is 43 – it’s given in the sub-head. And the claim in the headline that the deaths are “because ‘nurses are too busy to feed patients” is not a quote from any cited source. And the scandalous case of Martin Ryan which it uses for illustration is from 2005. The statistics tell us nothing about how many patients die from or with severe malnutrition as a result of hospital neglect. It’s common for elderly, sick patients to be malnourished when they’re admitted. And some patients will refuse to eat, as is their right. On the other hand, my guess is that the true numbers for patients dying of or with severe malnutrition is much higher than these statistics say, because doctors may choose not to mention it on the death certificate – Ryan was recorded as having died from pneumonia. If we want to know the extent to which inadequate feeding in hospitals is a problem, counting death certificates is the wrong way to find out. We need proper nutrition in hospitals. And if we really care about nutrition in the elderly, we should fund the social services and care homes to stop old people becoming malnourished before they reach hospital. ken March 4, 2013 at 12:53 pm The problem with the NHS at the moment is that some idiot (previously it was Tony and Gordon, now it’s Dave) can say “we need hourly ward rounds” and make it happen. Through targets. And there are a multitude of other idiots lower down in the NHS hierarchy who are busy setting other equally stupid targets. http://www.dailymail.co.uk/news/article-2285658/Labour-accused-suppressing-reports-NHS-culture-fear-saved-lives.html?ito=feeds-newsxml “One involving interviews with dozens of individuals across the Health Service, by the US-based Institute for Healthcare Improvement (IHI), described in raw terms how Richard March 4, 2013 at 1:00 pm “A bloke phoned the police from a fucking trolley in a corridor because he was dying of thirst” Poor bugger should have phoned Tesco; they’d have delivered some water. john b March 4, 2013 at 1:11 pm Peter: the Victorian stats are compiled on *exactly the same basis* as the NHS stats. Both include people who can’t eat, and people who aren’t fed. The Daily Mail has chosen to illustrate the NHS stats with a few rare cases of the latter, despite the fact that – as in Victoria – the vast majority are actually the former. john b March 4, 2013 at 1:12 pm (the fact that the ABC reports the stats honestly, including the disclaimer that they largely aren’t to do with neglect, whilst the Mail fails to do this, says nothing about the two healthcare systems, but a great deal about the probity of the two news organisations) Dave March 4, 2013 at 1:23 pm Would it spoil the game to point out that the NHS definition of malnutrition (rightly) includes overnutrition – that is, obesity – although is only rarely given as a cause of death in such cases? As PaulB says, counting death certs is the wrong way to measure. The simply way to find out the truth would of course be to do a simple experiment. Cook some snacks and take them round to your local hospital, then offer them round a ward filled with the kinds of patients we’re talking about. Control group could be an office, perhaps. If the levels of take-up differ significantly, we would then have some evidence to work with. Dizzy Ringo March 4, 2013 at 3:08 pm I had a mother with dementia. If my granny sitter and I hadn’t gone in at meal times to hospital, she would have starved to death. I was able to bring it to the attention of the authorities because I’m an awkward so and so – I suppose people need to remember that they pay for the NHS and if things are not right they should shout and scream, call for the consultant and generally make a fuss. Don’t take no for an answer. john77 March 4, 2013 at 3:27 pm Gordon Brown decided to increase (doctors’) and nurses’ pay without changing the NHS budget so NHS cut the number of nurses. When the EU demanded we cut junior doctors’ hours, he talked to the BMA and increased the number of consultants rather than the number of junior hospital doctors (it should have been obvious to a blind man that the solution was to increase from three years to four the number of years that junior doctors had to work in a hospital after qualification). Now someone claims that we have patients starving to death because nurses are “too busy to feed them” Ian Reid March 4, 2013 at 5:22 pm [email protected] and [email protected] And besides anyone who has been educated this century knows it was Mary Seacole who did the nursing, it was only a racist conspiracy which ensured Florence Nightingale got the credit. Monty March 4, 2013 at 5:49 pm In the past few years, the golden oldies in my family have passed away, mostly well into their eighties, and mostly in hospital. In each case, I made a point of being with them every day for their main meal, to make sure they were able to eat it, spoon feeding where necessary. And every day, there was at least one other patient in the 6-bed bay who also needed help with feeding- so I got on with it. (Scrub your hands first, put the antiseptic gel on your hands, then put on a disposable plastic pinny- you’re all set…). On entering the ward, I would observe the small ante-room which was the nurses common room. Maybe five of them in there, none on the ward. Maybe we should have fewer nurses, and more auxiliaries. Dave March 4, 2013 at 6:20 pm Monty> Re the nurses in the common room, I’ve noticed the same thing in some hospitals, and the opposite in others – nurses rushed off their feet for their entire shift, and still not getting everything done. I’ve worked in places where the workload was so ridiculously overwhelming that eventually everyone have up on trying to do more than the bare minimum – although I’m not a nurse – and I suspect the same was happening with the nurses. If you have five people and ask them to do six people’s work, they generally pitch in and do an extra 20%. When those five people are asked to do fifteen people’s work, though, they say sod it and go back to just doing their own. Ian B March 4, 2013 at 6:44 pm I don’t know if this is relevant, but in my anecdotal experience (and from chats with norses) terminal cancer patients just stop eating. Even if you’re there with a bowl and a spoon and so on. It’s not a death wish. They just have no appatite. So I don’t know how many cancer patients die of malnutrition as such. May or may not be relevant. IANAD and all that. john malpas March 4, 2013 at 9:45 pm If you want barbaric indifference to pain and suffering you should really try some hospitals in Australia. There is even a new gimmick on dehydration. Tell the customer they have to be fasting for a procedure. Then postpone it repeatedly. Without time to drink. Works quite well;. lost_nurse March 4, 2013 at 10:32 pm Regardless of how we organise UK hospital care, the biggest single improvement would be to increase the nurse:patient ratio on general wards (say, to about 1:4). Even if you fired all the nurses who are guilty of neglect, it still doesn’t solve the larger problem – there simply ain’t enough of us, especially in areas like elderly care. Where I work (emergency surgical admissions) , we are lucky to have slightly increased staffing levels (1 RN + 1 Care assistant per every 6 patients), which gives us a slightly better chance of doing our jobs properly. By comparison, general wards are usually staffed with a ratio of about 1 RN + 1 Care Assistant per 8-12 patients (although short-staffing may mean they have to “manage” on less). To put it bluntly, these aren’t adequate numbers for the proper care of elderly & frail patients, many of whom will have very complex needs (nor is it a new problem – google Graham Pink). I no longer give a feck how much Daily Mailograph bile gets spouted about us being too posh to wash or the endless tea breaks we are apparently taking – the headline writers never grip the key issue: some things go wrong because slackers don’t do their job properly… but far more goes wrong because there simply ain’t enough boots on the gound. Our team manage, but the pressure is unremitting. We take all A+E/GP surgical emergencies – many of whom will be very sick (bowel obstructions, severe pancreatitis, aortic aneurysms etc etc, plus a fair amount of trauma). We don’t stop – and we are better staffed than many other areas. I won’t offer a blind defence of the NHS – it has immense problems. My chief worry is that we are about to screw things up in a major way – & in the way that increases, not reduces, the likelihood of more Mid.Staffs meltdowns. I don’t think Tim really grasps what is happening down here on the ground (any more than I would claim to know about the procurement of exotic metals), and I don’t much care for the manner inwhich he belittles the concerns of frontline workers – indeed, he regards such concerns as a most excellent sign that the reforms are heading in the right direction (anybody whistleblowing about skeleton staffing on Serco’s out-of-hours cover shoud just quit whining, right?). Grimly amusing, because (beyond the usual & vague platitudes about competition) I doubt he is able to explain exactly how the ConDem policies will improve matters. Indeed, I expect ever more pressure to placed upon acute care – as services become increasingly fragmented & existing working relationships (not least between hospitals) are weakened. In the meatime, far from moving us towards the Franco/German models, the yardsale will simply roll on, in classic British privatisation fashion – with various healthcare corps looking to skim easy profits, whilst the NHS shoulders the risk (Circle are a prime example of this, whatever their press releases may claim). And I’m willing to bet on Old Flo’s bonnet that the McKinsey-infested tendering process now being forced upon the new commissioning groups will actually increase bureaucracy. Oh, the irony. So Much for Subtlety March 4, 2013 at 11:36 pm john b – The NHS model is twice as good because it is starving people at twice the rate? Silly is not the word I would use to describe that. John B March 5, 2013 at 2:19 am Erm, *half* the rate. Jim March 5, 2013 at 11:51 am @lost_nurse: can you explain why the NHS was consuming Jim March 5, 2013 at 11:52 am FFS! When is someone going to sort out the comments on this site? Its totally f*cked. Thornavis March 5, 2013 at 10:32 pm lost nurse may be over stating things a bit as does everyone on the sharp end of some politician’s wizard wheeze but I know from the experiences of my sisters, both of whom are nurses, though not on general wards, that she/he is basically correct. Which is why the NHS ‘reforms’ are probably at the top of the list of the many things that will sink the coalition. Which is tragic as the NHS needs some serious attention which it certainly won’t get from Labour who will ignore it, pretend that everything is now wonderful and get away with it thanks to their mates in the media. So Much for Subtlety March 6, 2013 at 1:09 am John B – “Erm, *half* the rate.” According to you, adjusting the figures for population, Victoria is starving 500 or so people to death every year. The NHS is starving just over a thousand. 1000 seems to be twice 500 to me. So why might you claim the NHS is twice as good? PaulB March 6, 2013 at 1:37 pm SMFS: go back and read the OP again. So Much for Subtlety March 7, 2013 at 12:05 am Sure, Paul, why not? “As many as 1,165 people starved to death in NHS hospitals over the past four years” john b – “the multiple-funder multiple-provider system in operation in Victoria shows 48 in-hospital deaths a year from malnutrition, which would equate to about 500 a year if Victoria had the same population as England.” So according to the crude figures, as adjusted for Victoria’s smaller population, it looks to me like the Australians are starving half as many people to death as we are. I just do not get how this can translate into the NHS being twice as good. Now perhaps you are right and they are being dishonest with how they define starving to death, but for all we know that might apply to the Australians too. PaulB March 7, 2013 at 1:14 am over the past four years Leave a Reply Cancel replyYour email address will not be published. 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