NHS Prevents, Does Not Provide, Health Care

The only thing that shocks me about this is that everyone else is so shocked over the report:

The "shocking" state of affairs at Mid Staffordshire NHS Foundation Trust meant patients admitted as emergencies suffered due to serious lapses in care.

Between 400 and 1,200 more people died than would have been expected in a three-year period, the head of the investigation for the Healthcare Commission said.

Families have described "Third World" conditions at the trust, with some patients drinking water from vases because they were so thirsty and others screaming in pain.

The Commission launched an inquiry after concerns were raised about higher than normal death rates in emergency care, in particular at Stafford Hospital.

The trust argued the anomalies were due to "problems with its recording of data and not problems with the quality of care for patients", the report said.

Not satisfied with this reponse, the Commission launched a formal investigation last year, sifting through more than 1,000 documents and interviewing some 300 people.

It found deficiencies at "virtually every stage", including inadequately trained staff who were too few in number, junior doctors left alone in charge at night and dirty wards and bathrooms.

Some patients were left in pain or needing the toilet, sat in soiled bedding for several hours at a time and were not given their regular medication, the investigation found.

Receptionists with no medical training were also left to assess patients coming in to A&E.

The investigation found heart monitors were turned off on wards because nurses did not know how to use them and some patients were left dehydrated because nurses did not know how to work intravenous fluid systems properly.

The report also found that the Government's target for patients to be seen within four hours at A&E meant patients could be taken to "dumping grounds" to avoid breaching the target.

Some patients had their operations cancelled for up to four days running and were "nil by mouth" for most of those days, leaving them hungry and thirsty.

In one ward, 55% of patients were found to have pressure sores when only 10% had sores on arrival.

The trust was also found to be 120 nurses short in 2007/08, of which about 17 were needed in A&E, 30 in surgery and 77 on medical wards.

The Commission said the trust's board was more focused on finance, targets and achieving foundation trust status, as well as its desire to save £10 million.

Despite the fact concerns had been raised about the trust, it was awarded foundation trust status - designed to mark out outstanding hospitals - just weeks before the investigation was launched.

Earlier this month the trust's chief executive, Martin Yeates, stepped down and has now been formally suspended on full pay, while chairman, Toni Brisby, resigned.

Sir Bruce Keogh, medical director of the NHS, said today there had been a "gross and terrible breach of trust" of patients, adding the report showed there had been a "complete failure of leadership".

He added: "I'm proud of the NHS but actually I'm really saddened by this report."

Dr Heather Wood, who led the Commission's investigation, said the number of excess deaths between April 2005 and March 2008 was between 400 and 1,200, although it was expected the figure of 400 would be closer to the mark.

It is not clear how many of these deaths could have been avoided.

Chairman Sir Ian Kennedy said the report detailed "a shocking story".

"Our report tells a story of appalling standards of care and chaotic systems for looking after patients," he said.

"These are words I have not previously used in any report.

"There were inadequacies in almost every stage of caring for patients.

"There was no doubt that patients will have suffered and some of them will have died as a result."

Local MP, David Kidney, said: "The exhaustive Healthcare Commission report is both definitive and damning.

"In A&E, emergency admissions and medical wards 10, 11 and 12, care standards were unacceptable during the three-year period investigated.

"As a result, some patients experienced intolerable conditions and lessons were not learned by the hospital trust from those experiences.

"So more patients suffered.

"It is galling for patients and patients' relatives and carers that their complaints were not believed or were fobbed off with excuses and promises that the report shows were worthless."

Julie Bailey, 47, has spent 14 months campaigning for an inquiry into Stafford Hospital following the death of her mother in November 2007.

Ms Bailey, from Stafford, was so concerned about the care being given to her 86-year-old mother Bella that she and her relatives slept in a chair at her hospital bedside for eight weeks.

"What we saw in those eight weeks will haunt us for the rest of our lives," she said.

"We saw patients drinking out of flower vases they were so thirsty.

"There were patients wandering around the hospital and patients fighting. It was continuous through the night.

"Patients were screaming out in pain because you just could not get pain relief.

"Patients would fall out of bed and we would have to go hunting for staff. There was such a lack of staff.

"It was like a Third-World country hospital. It was an absolute disgrace."

Eric Morton, chief executive of the trust, apologised to patients but said "significant changes" had been made within a very short period of time, including new management, more staff and new systems in A&E.

Health Secretary Alan Johnson also apologised to families and patients, and announced a review of current A&E services at the hospital as well as one to establish how long problems had been going on for.

He said: "There was a complete failure of management to address serious problems and monitor performance.

"This led to a totally unacceptable failure to treat emergency patients safely and with dignity."

Shadow health secretary, Andrew Lansley, said: "The public will be rightly shocked by the poor standards of care exposed at this hospital.

"It is unacceptable that the pursuit of targets - not the safety of patients - was repeatedly prioritised, alongside endless managerial change and a 'closed' culture, which failed to admit and deal with things going wrong."

Thank Democracy for Kim Jong Il

Democracy triumphs again! Kim Jong Il has been re-elected as leader of North Korea with an overwhelming 100% of the vote. This is a giant win for Kim, and a giant win for democracy. Hooray!

Admittedly, Kim was the only one on the ballot. But those who voted for him had the option of leaving their ballots blank, which they did not. No, they happily punched the "Kim Jong Il" option with visions of Juche circling their heads.

Other great leaders who were elected democratically:

Adolf Hitler
Joseph Stalin
Pol Pot
Fidel Castro
Hugo Chavez
George W. Bush

Protecting Us From 15 Year Old Girls

A juvenile criminal mastermind disrespected the police officer and indeed the people of the Glorious State of Washington. She received the swift application of moral justice in the form of a knuckle sandwich to her 15 year old face. Hoo-rah!

The officer deserves a shiny gold medal. Unfortunately, this brave guardian of the public interest is being investigated for improper behavior. Oh, the injustice!

Mish: With All Due Respect, Mr. Slavemaster

In my opinion, this letter is far too respectful. Nonetheless, it is a good read:

Dear Mr. President, I read your New Era $3.6 Trillion Budget Proposal. I also listened to your speech Tuesday night. You made a great campaign speech. However, the campaign is over. You won. And the reason you won is you offered hope as well as a promise of change.

With all due respect Mr. President, Tim Geithner and Ben Bernanke are offering the same policies as President Bush and Secretary Paulson. Those policies are to bail out banks regardless of cost to taxpayers. Mr. President, it's hard enough to overlook Geithner's tax indiscretions. Mr. President, it is harder still. if not impossible, to ignore the fact that neither Geithner nor Bernanke saw this coming. Yet amazingly they are both cock sure of the solution. Even more amazing is the fact that solution changes every day.

With all due respect Mr. President, Geithner and Bernanke are a huge part of the problem, and no part of the solution and the sooner you realize that the better off this nation will be.

With all due respect Mr. President, your budget proposal is the same big government spending as we saw under President Bush. The only difference is you promised more spending and bigger government, while President Bush promised less government and less spending and failed to deliver on either count.

With all due respect Mr. President, it is impossible to spend one's way out of a problem, when the problem is reckless spending.

With all due respect Mr. President, you and Congress want to force banks to lend when banks (by not lending) are acting responsibly for the first time in a decade. Mr, President can you please tell us who banks are supposed to lend to? Do we need any more Home Depots? Pizza Huts? Strip malls? Nail salons? Auto dealerships? What Mr. President? What? And why should banks be lending when unemployment is rising and lending risks right along with it?

With all due respect Mr. President, we were hoping your administration would not carry on the war mongering policies of your predecessor. Instead we see amazingly that you Seek $75.5 Billion More for Wars in 2009. Mr. President, do we really need another $75 billion for wars? Was there nothing in the military budget that could be cut?

With all due respect Mr. President, The United States spends more on its military budget than the next 45 highest spending countries in the world combined; The United States accounts for 48 percent of the world's total military spending; The United States spends on its military 5.8 times more than China, 10.2 times more than Russia, and 98.6 times more than Iran. Isn't that enough Mr. President?

With all due respect Mr. President, the downfall of every great nation in history has been unsustainable military expansion. Mr. President, the US can no longer afford to be the world's policeman. You act as if we can. Mr. President, can you please tell us how we can afford this spending?

With all due respect Mr. President, Fannie Mae Reported A Fourth Quarter Loss Of $25.2 Billion. Can you please tell us where you draw the line on taxpayer bailouts of Fannie Mae? Freddie Mac? AIG? Mr. President is there a line anywhere, on anything? If there is, we would appreciate knowing where it is.

With all due respect Mr. President, how can you talk about reducing the budget deficit while proposing the biggest budget in history?

With all due respect Mr. President, how is it possible to talk about reducing health care costs while proposing to increase the health care budget?

With all due respect Mr. President, you have talked about "hard choices". Can you please tell us what hard choices you have made other than to throw money at every problem? Sure a few programs have changed but Bush orchestrated the biggest Medicaid/Medicare package in history and you upped it. You upped military spending. You criticized McCain for cutting programs that amount to peanuts, and all you can find to cut out of the budget is peanuts.

With all due respect Mr. President, your "Era of New Responsibility" is nothing more than a continuation of the Bush administration Era of Irresponsibility. Mr. President, we hoped for more and deserved more. Yet, behind the charade of campaign messages of hope and change, we essentially see the same fiscal irresponsibility and misguided policies as before. Oh sure Mr. President, your budget priorities have shifted a bit, sadly the irresponsible spending did not.

Mike "Mish" Shedlock
http://globaleconomicanalysis.blogspot.com

A Million A Day

365.25 days in a year
x 2009 AD
x $1,000,000
-----------------------
$733,787,250,000

If you spent $1,000,000 every day since the birth of Jesus, you still wouldn't have spent as much money as the proposed economic stimulus. This is the worst misallocation of money in the history of mankind by a very far margin.

United Kingdom: Prison Nation

I have an internets tubes friend who lives in the UK. Recently he made a forum post where he complained about the UK's nanny state and prison state antics. I'm going to quote his post here. Read what he says, then re-read it, and let it sink in.

The UK is becoming a police state where everyone will be under surveilance, everyone's DNA will be stored, everyone's actions will be tracked (phone, email, travelling) and the police will have immunity to guard the public interest in any way they deem fit. "Public interest" means "government interest" because of course, a strong government is in the public interest.

You should hear the adverts here, they are blatantly offensive. Here's some examples.

"Be sure to notify the DVLA if your car is sold or is off the road, because doing so will help you avoid penalties if you forget."

"The DVLA are reasonable people, they just want to help you pay your car tax. And they have the power to clamp, tow and crush your car."

"But officer, I only had 2 pints, doesn't matter, you're over the limit!
I'm sorry, I'm going to have to let you go.
No license, no job, now what?
---
Don't drink and drive!"

The public announcements openly threaten even people who have done nothing wrong. There's absolutely no leeway for forgetting, etc. If you don't do exactly what you're told, you'll get a fine.

For instance, if you get a speeding ticket, you normally have to pay a £60 fine, but if you go to court to query the ticket and fail, you'll automatically pay £1000. The penalties are set up so that no one will challenge them.

Then, you can only buy a new tax disc for the car in the last month of the old disc, from the 5th day of that month, and you have to buy it in person. Then when you have the new disc, you may only replace the old disc on your car when it expires at the end of the month, you may not put the new one in sooner. If you forget to change the disc, even if you have bought a new disc, you will still be fined the same as if you hadn't bought one. They set up roadblocks early in the new month to catch you. If you happen to be away in that month, there are more hurdles to jump through, you need to designate someone to buy the disc for you, etc.

There is no hint at being on your side in any of it, you are the enemy, and there is no hint that the law is well-intentioned, there is just "the law!". So it doesn't surprise me to hear now that they are setting up a goon squad to persecute people they don't like in the name of public interest. I guess threatening is not enough for them anymore.

-----------------
In fact, having written this post, I think it's time I thought about leaving the UK, I see what it is becoming. It won't be long before troublesome people are sent to a Siberian equivalent.

Why Does the USA Want Universal Healthcare?

Seriously, why does the USA want universal healthcare?

Why does Tom Daschle write a book appealing for a European-style healthcare system? Why does Michale Moore make a movie begging for a Canadian/European hybrid healthcare system?

You see, I work in the health insurance industry, and I see the problems with healthcare from the inside. I also know what statistics to look at that average Joes, politicians, and even doctors don't know about.

Granted, the US healthcare industry is far from "free market," but it is still not nearly as nationalized as the European and Canadian systems are. What do you say that I take you, dear reader, through the wonderful land of facts, and compare the Canadian and European systems to the current American system?

In Canada, the healthcare is so fantastic that MPs fly to California to get treated! What does it say about Canada's healthcare system when a Canadian politician, not just a commoner, pays twice for healthcare: once through Canadian taxes, and a second time out of pocket for the actual treatment in a California hospital? This was no sprained ankle that the MP had treated. No, it was breast cancer! Most Canadians of course don't have the luxury to fly to the US and pay out of pocket for cancer treatment.

Of course, the MP insists that it didn't have anything to do with speed of service or confidence in Canada's healthcare system. The MP did admit, however, that it was done for personal reasons as well as privacy concerns, which implies that one would lose privacy rights under a nationalized healthcare industry.

Speaking of cancer in Canada, their universal healthcare system isn't as universally effective at treating cancer as the US system is. Compare these numbers:

* For women, the average survival rate for all cancers is 61 percent in the United States, compared to 58 percent in Canada.
* For men, the average survival rate for all cancers is 57 percent in the United States, compared to 53 percent in Canada.

Part of America's superior cancer survival rates is due to the earlier detection that American's get for their cancer:

Early Diagnosis. It is often claimed that people have better access to preventive screenings in universal health care systems. But despite the large number of uninsured, cancer patients in the United States are most likely to be screened regularly, and once diagnosed, have the fastest access to treatment. For example, a Commonwealth Fund report showed that women in the United States were more likely to get a PAP test for cervical cancer every two years than women in Australia, Canada, New Zealand and Great Britain, where health insurance is guaranteed by the government.

Healthcare in Western Europe, and especially the UK, is often cited as a model that the USA should copy. Well sure it is, at least if you want to stop giving the world's rich and powerful people a reason to come to the US for their treatment! Western Europe, like Canada, has lower rates for cancer survival than the US:

Europe’s survival rates are lower than in the US, where 66.3 per cent of men and 62.9 per cent of women survive for five years, compared with 47.3 per cent of European men and 55.8 per cent of women. These figures may represent earlier diagnosis.

Another misconception that people often have is that a national healthcare system will guarantee that you will be cared for. Sadly, this is not the case. NHS, the UK's monopoly healthcare organization, routinely denies care for treatments that even the most stingy American insurance companies pay for. But unlike in the US, if you have a nationalized healthcare system, and you are denied care, you have no alternative - no other service provider that you can turn to (unless you are rich enough to pay out of pocket for healthcare in the US). That is why they refer to the NHS' denial of care decisions as "death sentences."

And finally, government is generally known to always perform more slowly, and at higher cost, than it promises to the citizens. The latest example is the UK's NHS medical database, which will cost at least 12.7 billion pounds (not dollars), and is already four years behind schedule. With that kind of abysmal performance, couldn't the UK hire a different service provider? No, because the NHS has a monopoly! The UK is stuck with it. In other words, the quality (or lack thereof) of the NHS services have no consequence for its revenues. No matter how badly the NHS performs, it will always have it's loyal, paying customers (even the rich people who pay out of pocket for care in the US still have to pay for the NHS system no matter what).

So why in the name of the Flying Spaghetti Monster does the USA want universal healthcare?

Professor: Ecstasy as Safe as Riding a Horse

Who would have thought that the chairman of the Advisory Council on the Misuse of Drugs in the UK would spit out the truth, that most illegal drugs are not that dangerous? In this case, the good chairman compares the dangers of MDMA, or ecstasy, to the dangers of riding a horse:

Taking the drug ecstasy is no more dangerous than riding a horse, a senior adviser has suggested.

Professor David Nutt, chairman of the Advisory Council on the Misuse of Drugs (ACMD), outlined his view in the Journal of Psychopharmacology.

The council, which advises the government, is expected next week to recommend that ecstasy is downgraded from a class A drug to a class B one.

Ministers have outlined their opposition to any such move.

Professor Nutt wrote: "Drug harm can be equal to harms in other parts of life. There is not much difference between horse-riding and ecstasy."

The professor said horse-riding accounted for more than 100 deaths a year, and went on: "This attitude raises the critical question of why society tolerates - indeed encourages - certain forms of potentially harmful behaviour but not others such as drug use."

Ecstasy use is linked to around 30 deaths a year, up from 10 a year in the early 1990s. Fatalities are caused by massive organ failure from overheating or the effects of drinking too much water.

The ACMD last night distanced itself from Prof Nutt's comments.

A spokesman for the body said: "The recent article by Professor David Nutt published in the Journal of Psychopharmacology was done in respect of his academic work and not as chair of the ACMD.

"Professor Nutt's academic work does not prejudice that which he conducts as chair of the ACMD."