What’s in a health system?

Another day, another view on the failings of an NHS system in the UK is presented through the newspapers. The interesting part is not that we read it or that we know about it, for the most it seems to be about a level of blind acceptance that the NHS system might soon be no more. We see more discussions (at http://www.theguardian.com/society/2014/jun/28/cameron-warned-nhs-in-danger-of-collapse). One quote is “the NHS needed an extra £15bn from the Treasury over the next five years ‘if you don’t want the system to collapse during the course of the next parliament’“. Now, that comes down to an additional 220 pounds for every person in the UK. The additional quote “The grim analysis is backed by some of the country’s top health experts“, Really? Is that the actual solution? Perhaps the UK has the ‘wrong’ experts in the field. First we see a 10 billion pound IT system that never works, then we get another failed infusion of 3 billion pounds. Could the issue perhaps be that throwing money at it is no longer a solution? In addition, in a greying economy, healthcare will be the most important thing over the next 10-15 years, so perhaps sitting down and designing a completely new NHS, then seeing how the old system could be migrated might be a much better idea (especially as the other ideas are not working).

The quality of patient care will be compromised by not having enough doctors and nurses on the wards and in surgeries and clinics. The well-publicised failures of care at Mid Staffordshire NHS Foundation were caused by precisely this kind of cost cutting, with tragic consequences for the families concerned.” Is a quote that is in the article and I have a few issues with it. First of all, let’s take a look at the issue (at http://www.theguardian.com/society/2014/apr/28/mid-staffordshire-nhs-trust-fined-gillian-astbury), it is without any doubt a terrible event for the family. The quote “Mistakes were made as her ward underwent as many as eight shift changes and 11 drugs rounds per day. The system for handovers, when nurses arriving for the next shift should be informed of the needs of the patients, was ’inconsistent and sometimes non-existent’, the trust admitted.” So we can agree that there was a shortage, the point is, was it avoidable? This is where the issue starts. Throwing more money at it is NOT a solution, having 1 nurse per 5 patients is also a non-workable solution. The more people go into all this, the more time we see spend on handovers, with two sets of nurses getting/giving updates, not to mention the absolute fortune this setup will cost. I found the following (at http://straightstatistics.org/article/alcohol-related-hospital-admissions-set-tumble), it is about ‘Alcohol-related hospital admissions‘, the quote “If we limit the numbers to admissions wholly attributable to alcohol, the numbers have risen from 45,000 to 68,500, an increase of 52.2 per cent“. Really? Is that what doctors and nurses spend their time on? How about we change the approach to alcohol (and drugs for that matter) and take a page from the quotes of Ebenezer Scrooge “‘If they would rather die,’ said Scrooge, ‘they had better do it, and decrease the surplus population.’

It seems harsh doesn’t it? Does it? Now consider the possibility that Gillian Astbury aged 66, might be alive if something is actually dome about the alcohol cases. We see a little more clarity (at http://www.staffordshire.gov.uk/Resources/Documents/s/ss/SSPCTAlcoholneedsassessmentforStaffscountyJan08.pdf), where we find the quote “Trend data published by the West Midlands Public Health Observatory for selected alcohol admissions show that between 1999/00 and 2004/05 there was an increase in hospital admission rates by 40% for men and 30% for women across Staffordshire County“.

 

How about actually change people? So let’s do the following, a drunk in need is no longer given medical aid. If some youngling wants to be heroic and binge drink himself into a coma, then let his body fight it off in some cage (of course if they have money for private care, then that will be OK). If the body is unsuccessful, it will die. Plain and simple! We will call their mother telling them they should have raised them better and the case is closed. Consider the benefit of lower costs to the NHS, unemployment numbers will go down and we might even see an increase in rental options.

I know this is not a pretty picture, but these so called health experts need to see that the current course is no longer an option. We could do the same for the drug addicted population and get an even healthier commonwealth. The issue is not just the approach of certain people; it is the entire look that non-action gives all. Consider the PDF I added the linked to, in Table 9 (on page 26), we see a changed trend of 272%. So, almost three times as many go for the bottle in a group? The fact that this is not dealt with is a plain joke, especially as the NHS gets to clean up that mess in addition to dealing with the ‘actual‘ sick. There are alternatives! One is that all alcoholic beverages are raised by 23% taxation, which all goes to the NHS, which seems unfair to the population that can actually temper their alcohol use. The UK could instigate a Swedish approach to alcohol (also expensive), but you can only get hard liquor on an identity card, which gets registered and you cannot buy more than 2 bottles a month. Or we let the alcohol abusers die. You see, we can go in all directions, but most people, weak as they are, are unable to make the hard decisions and will force a situation where more money is given. This is fair enough, but then we add taxation, including to the lowest income bracket, to get more money for the NHS. Now, these same experts will tell you that this is not a solution either.

There is no choice; hard options will have to be selected in one way or another. It seems that steering clear of some zero tolerance options have been ignored for too long and those who are actually trying to get healthy so that they can contribute to family and society are dying, like Gillian Astbury. This part is however not shown to such a degree by the journalists at large. There is one more table to consider in that PDF. In table 19 we see that the total of the alcohol misusers cause a massive £1,701,900,000 to the UK health economy. So if we need cut backs, then here is one point seven billion in savings. Mr Prime minister! (I think I just earned my knighthood and a small cottage in saffron Walden) I think that the total savings in damages that these drinkers are causing is considerable larger than just to the health economy.

I am all for a better NHS, I am all for giving doctors and nurses a better tomorrow and if just throwing money at it would make that difference, then I would be all in favour of it, but there is almost 10 years of data disproving that, we see an NHS system that is rattled by big business (pharmacy and IT for example) and politicians and the approach as it is at present can no longer be maintained. Perhaps we need to make additional changes to the patients as well. The healthcare is all about keeping track of data and details, what if the patient becomes the data carrier? What if the nurse has a tablet with details and patient numbers, which is transferred to the new nurse and as they go over it, they can verify with the patient chip? When I go into ANY hospital, I see a multitude of papers, folders and more papers and people entering reports in computers and then printing it all. What if we take the next generation in solutions and take away 30% of that workload?

When people ask which company will do this, the answer should be ‘None!’. The UK is filled with universities, some of them regarded as the most prestigious and brightest on the planet. Consider that most IT people, might claim experience, yet their drama skills are the only ones that improved for the most, is it not up to the Universities, those who are introduced to the newest ideas, design a solution that would make the work of the doctors and nurses at the NHS better, slightly more efficient and a truckload of less hassle! Is that such a tall order?

We will get to the solutions if we are willing to navigate other options. We have seen that the current path is not a success; new methods might not be a failure. It is a road that politicians should be willing to go, if only to make sure that a possible solution was not overlooked.

 

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One response to “What’s in a health system?

  1. Pingback: Healthy or Smart? | Lawrence van Rijn - Law Lord to be

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