Nhs

I knew that British doctors are well-paid but unti I saw, via Kevin Drum, this chart I had no idea they were so much better-paid than most of their peers in the western world.  This is culled from a 2004 OECD report (Pdf) and all figures are in PPP-adjusted dollars. Of course, doctors received significant pay increases during the Blair years. Specialists were not treated as kindly as (well-trained) GPs but even their wages increased by more than 30% in real terms. Which is fine. The constituency demanding pay cuts for doctors is very small. Nevertheless, these charts (which are not, I think, outdated in any significant sense) are worth

Health tourism is raised every now again by politicians, but never has it been raised so forcefully by such a senior doctor. In this week’s Spectator, Professor J.Meirion Thomas, a consultant surgeon with the NHS and one of Britain’s leading cancer experts, speaks out about health tourism. He writes: I am frustrated at seeing the NHS targeted by patients who are ineligible for free care, but who usually get through the net. Specialist units may be especially vulnerable. Reluctantly, I have decided to share my concerns. The final trigger to write this article was a potentially ineligible patient who accused me of unethical behaviour because I would not promote his

Can anyone think of a bigger scandal in any British public service than that revealed at Stafford Hospital? It is worse than Aberfan, or Bloody Sunday, or the King’s Cross fire, or Jimmy Savile, or even the abolition of grammar schools. Up to 1,200 people died unnecessarily, not because of one error, or a particular set of errors, but because of the way an entire hospital was run for several years. There is plenty of evidence now emerging that comparable disasters have taken place at other hospitals, for similar reasons. Yet I searched last Saturday’s Guardian in vain for a single mention. Politicians are desperately closing the subject down. They have persuaded

There’s normally no shortage of outrage in our politics. In Britain today, we specialise in working ourselves into a bate. This is what makes the lack of outrage at what happened at Mid Staffs all the more peculiar. If the government had received a report detailing such appalling behaviour in any institution other than an NHS hospital and responded so meekly, there would have been a series of angry front pages denouncing Whitehall complacency. The government is considering changing the law of the land because of what happened at the care home Winterbourne View, which was appalling but nowhere near as serious as what happened at Mid Staffs. But when

Is it time we faced up to the fact that the NHS itself is the reason for the continuous stream of scandals? It’s not just the Mid Staffs Foundation Trust, or the ‘Nicholson Challenge’ or ‘the reforms’, or ‘the culture’. The NHS suffers from systemic faults. Above all, the regular flow of defects and failures is what you would expect from a command-and-control regime that has a monopoly. It’s not as though making this claim is new. The last Labour Government recognized the structural flaws in the NHS nearly a decade ago. The NHS Improvement Plan of 2004 specifically denounced monopoly: There would be ‘contestability … so that patients and

Should heads roll over the Mid Staffordshire Hospitals Trust scandal? I ask only because as I listened to Mark Carney giving evidence to the Treasury Select Committee for several hours this morning, I found myself browsing through a number of articles on this site and others about the Libor scandal. Back in those heady days of George Osborne accusing Ed Balls of having questions to answer, and Bob Diamond resigning from Barclays ahead of his appearance before the same select committee, people were very keen for heads to roll, and not just those sitting on bankers’ necks. They were also keen that those who performed badly when questioned about their

Jeremy Hunt has announced new plans to shift the NHS into the twenty first century by removing all vestiges of paper by 2018. While computerising health records sounds mundane and complicated, the Health Secretary has done his best to make the plans appear logical and advantageous. In his announcement, Hunt says: ‘The NHS cannot be the last man standing as the rest of the economy embraces the technology revolution. It is crazy that ambulance drivers cannot access a full medical history of someone they are picking up in an emergency – and that GPs and hospitals still struggle to share digital records.’ The interim stages to Hunt’s ultimate goal sound realistic. Records held

While Ed Miliband wasn’t exactly Mr Pugnacious today at PMQs, one of his better blows was when he read out the promise in the Coalition Agreement to ‘stop the top-down reorganisations of the NHS’ and asked whether that would be on a list of broken promises in the audit of government achievements. Labour always sees the NHS as an easy way to score points now that the government’s hard-won credibility has been scuppered by the Health and Social Care Act, and naturally Miliband roused some cheers from his MPs. James argued back in December that it is now impossible to have a mature conversation about the NHS. Indeed, the Tories

Nigel Lawson described the NHS as the closest thing to a national religion that this country has. The NHS is certainly like a national religion to the extent that it is pretty much impossible to have a rational debate about it. There is often a choice posited between the NHS and no healthcare at all. One can see this mindset in today’s Guardian article on the news that the Thatcher government in 1982 held Cabinet discussions about fundamental rethinking the size and shape of the state. Here is the section on the health service: ‘But the earlier version’s most controversial privatisation proposal concerned the health service: “It is therefore worth

Tory MP and GP Phillip Lee made a striking call this morning for patients suffering from lifestyle-related diseases such as type 2 diabetes to pay for their prescriptions as part of a larger shake-up of the NHS. He was speaking as part of a series of presentations from members of the Free Enterprise Group ahead of next week’s Autumn Statement on their proposals for spending cuts which would allow George Osborne to meet his target of having debt as a proportion of GDP falling by 2015/16. Lee said that to ensure that people could continue to access care when they needed it, the NHS needed a fundamental reform. He told

Earlier this week my wife called to make a GP appointment for our daughter, who has been experiencing some worrying tummy pains.  Middle of next week she was told, earliest. ‘It’s a pity you didn’t call at 8 o’clock,’ the receptionist chided. ‘We had several slots then, but now they’ve all gone.’ Silly us for prioritising getting the children to school at that time of the morning. I expect that Jeremy Hunt would say that it is precisely this kind of thing – not a scandal, not a crisis, but just one of a million similar tiny rebuffs people experience at the hands of the NHS every week – that

Her Majesty’s Comptroller and Auditor General seems to have been nicking ideas from Private Eye. National Audit Office reports these days arrive with a frontispiece of ‘key facts’, reminiscent of the Eye’s ‘number crunching’ feature, plucking a handful of noteworthy numerals from the deluge of auditry that follows, and designed presumably to make the reader go ‘gosh’. In the NAO’s latest report, on the awarding two years ago of a franchise to run a hospital in Cambridgeshire, one ‘key fact’ leaps out. ‘£0’, it says, ‘is the amount Circle will earn over the ten-year life of the franchise, unless the Trust achieves a surplus under its management’. Yes, that’s right.

The recent media storm over the Liverpool Care Pathway has obscured the progress doctors and nurses have made over the past decades in the UK in improving care for patients who are near death. Since the LCP was developed, patients in busy hospitals and other institutions are  less likely to be left to die in pain and discomfort. The Pathway itself is simply a framework which reminds professionals to consider, and document, the process of care for people in the last days of life. Without it, some professionals may struggle to shift their focus to important aspects of care such as comfort measures, pain control, communicating with, and supporting, the