Well, no, not really

More than 6,000 people in Wales who would benefit from palliative care are not getting it, according to a report.

The study by the London School of Economics (LSE) said the UK’s care system for patients with terminal illnesses needed a major overhaul.

Err, NHS Wales is a different organisation than NHS England. Run much more by the government and with much less private contracting. A finding about NHS Wales does not extend to NHS England therefore.

22 thoughts on “Well, no, not really”

  1. bloke (not) in spain

    “UK’s care system for patients with terminal illnesses needed a major overhaul.”
    Having just watched it in actiion – yes.
    I’d suggest a bullet in the back of the neck for one in ten of the staff would be good start & might serve to concentrate minds.

  2. Envy of the World: a friend was phoned by an English hospital last Wednesday to be told that a relative had died, and had named him as next of kin. Would he please come in and collect the death certificate. He said he lived four hours away. They pressed him. So the next day he got on the train. On arriving at the hospital he was told (I paraphrase) “Tough luck, the death certificate office is closed in the afternoon.” And of course it would be closed on Friday, Saturday, Sunday, and Monday. So he got the train home again.

    Do these fuckers realise that they have become hated by many people?

  3. That review is dated July 2011
    Yes I know it is. The “More than 6000…” Tim W quotes is based on the following in the BBC Wales story:

    Based on calculations in the 2011 Palliative Care Funding Review, 6,200 people in Wales who would benefit from palliative care are not getting it

    you weren’t supposed to actually follow the link.
    That’s exactly wrong.

  4. @ PaulB
    The link is useful and interesting,
    But the BBC story is based on a LSE report that is based on the 2011 report which has a vast confidence interval for the number needing and not receiving palliative care, from zilch (because the number receiving palliative care exceeds those in the last year of their life needing palliative care)to more than 300,000. Extrapolating from that to a different country with a slightly different NHS and a different age-profile nearly four years later is a level of competent relevance that I should not tolerate in any report going out over my name. Maybe I am picky.

  5. bloke (not) in spain

    Dearieme’s anecdote about sums up the NHS. The person at the hospital’s function is to find someone to collect the death certificate. They found someone to collect the death certificate. Whether the death certificate was colectable was not part of their function & nothing to do with them. As lost_nurse would probably say “they were working to the best of their abilities, selflessly doing a valuable job under difficult circumstances” (No doubt with added Tory cuts & wholesale privitisation yadda yadda.)
    Truth of the matter; the difficult circumstances are mostly supplied wholesale by the people work in the NHS

  6. There is a new report, which seems to have come online today:

    …No such estimate of unmet palliative care need has been made for Wales, Scotland or Northern Ireland. However, extending the same assumptions and calculations made by Hughes-Hallett et al. to the other three countries and nations of the UK, gives estimates of around 6,200 people in Wales, 3,000 people in Northern Ireland and 10,800 people in Scotland who would benefit from, but do not receive, any palliative care services.

    [Hughes-Hallett et al. is the review I linked to earlier]

    What’s going on is that Marie Curie has changed direction somewhat from cancer care to palliative care generally, and has commissioned a report to emphasize the need for its services.

  7. “extending the same assumptions”

    Let’s stretch something which is probably quite stretched already.

  8. @ PaulB
    “What’s going on is that Marie Curie has changed direction somewhat from cancer care to palliative care generally, and has commissioned a report to emphasize the need for its services.”
    You’re right. Palliative care for cancer patients must have reached saturation level if cancer patients comprise 88% of those receiving palliative care but only 29% of deaths and if between 30% and 43% of all those dying receive palliative care. So if Marie Curie want to expand – which is a bad idea – they need a secondary purpose.
    It is a bad idea because they spend £43.7m to raise voluntary income of £91.1m (48%) which is incompetently inefficient – it looks even worse if you strip out the legacies which have tiny associated fund-raising costs (most come from sufferers or relatives/friends so the activities involved in generating legacies are classified under “charitable activities”) so £43.7m spent to raise £64.6m – more than two-thirds of this income is devourted by fund-raising costs. Appalling!

  9. re Dearieme’s story, I hate to be unsympathetic, but can anyone spot the missing element (which I have inserted into the following imagined conversation)?

    Hospital (to friend of Dearieme): ‘Your relative has died. Will you please come in and collect the death certificate?’

    FOD: ‘But I live four hours away.’

    H: ‘Can we press you?’

    FOD: ‘I SUPPOSE SO. WHAT TIME IS THE DEATH CERTIFICATE OFFICE OPEN AND WHEN DOES IT SHUT?’

    Next day gets on train having ascertained the above info.

    Given that this blog does talk a lot about self-reliance, I think it’s a stretch too far to place *all* of the blame for the above shambles on the NHS (for which I have little time).

  10. FOD: ‘I SUPPOSE SO. WHAT TIME IS THE DEATH CERTIFICATE OFFICE OPEN AND WHEN DOES IT SHUT?’

    Next day gets on train having ascertained the above info.

    Given that this blog does talk a lot about self-reliance, I think it’s a stretch too far to place *all* of the blame for the above shambles on the NHS (for which I have little time).

    I don’t think it’s too much of a stretch to assume that the death certificate office is open during normal office hours.

    Even if we are talking about the public sector.

  11. Next-of-kin will often be of the same generation as the dead person – i.e. usually old. They will quite often be reeling from the bad – sometimes unexpected – news. Is it too much to hope that the fucker at the hospital mention the opening hours to someone whom they have just pressed into a long trip? Would you be happy for your staff to be so unfeeling and stupid? Would you expect to make much of a living if your staff routinely treated customers in that sort of way?

  12. Indeed, one of the hallmarks of an organization that has fallen to producer capture is arbitrary opening times for certain services. Sections of oil companies work like this. Any organization or department at least pretending to give a fuck keeps normal office hours as a bare minimum.

  13. Just saying, it’s an obvious question. The person was reluctant to travel, I’d have thought they’d have asked.

    I don’t like the NHS and have personal family experience of how shit they are – just don’t think this is all that fair as an attack.

  14. J0hn, having been a charity fundraiser at several charities yes that is indeed a bad return. Particularly when legacies and high net individuals are included.

  15. @ Martin Davies
    i) Good for you (although while I was an active CAWeek collector I was asked to collect for another charity and found it confused some of my neighbours so decided it wasn’t worth it).
    ii) Christian Aid which collects literally tons of tuppences and pennies (each year I carried more than own weight in coppers to the *nearest* bank) used to have a cost/funds raised ratio of less than 10%.

  16. john77: thanks for those numbers. In so far as I can find comparable numbers for my local hospice, its fundraising costs are about 19% of funds raised excluding legacies.

    fwiw, Marie Curie justifies some part of its costs with the note “Costs of generating voluntary income increased by 17.0% as the charity further increased its investment in recruitment of committed givers to provide a source of regular income to support its activities. Income from committed giving increased by 23% as a result of this investment”.

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