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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