Wintery Knight

…integrating Christian faith and knowledge in the public square

White House review of VA finds “corrosive culture” to blame for poor patient care

The Wall Street Journal reports.

Excerpt:

A White House review of the VA health system points to a culture that has degraded the timely delivery of care and requires a restructuring to improve transparency and accountability.

Acting Secretary of Veterans Affairs Sloan Gibson and Rob Nabors, White House deputy chief of staff, told President Barack Obama on Friday that significant further action was needed to address systemic problems.

Six weeks after the president dispatched Mr. Nabors to assess problems within the VA, the president’s aide outlined a long list of issues affecting access to timely care at VA medical facilities.

Mr. Nabors’s work is the latest in a series of reviews and reports issued in the past two months, including those from the VA’s independent inspector general, the Office of the Special Counsel and the VA itself. The new report found what Mr. Nabors described as a “corrosive culture” that affects employee performance and patient care. He added that the Veterans Health Administration structure has “impeded appropriate management, supervision and oversight.”

The review also found that the VA’s goal for scheduling many medical appointments within 14 days is “arbitrary, ill-defined and misunderstood.” That goal had been set in 2011. The VA recently eliminated that 14-day target.

Mr. Gibson praised the report. “We know that unacceptable, systemic problems and cultural issues within our health system prevent veterans from receiving timely care,” he said in a statement.

The White House has scrambled to respond to evidence of widespread mismanagement within the VA and to fill a growing number of vacancies in top posts. An internal assessment also revealed improper appointment-scheduling procedures and efforts to hide long wait times across the VA health system.

Another interim report from the VA inspector general confirms that:

The VA’s independent inspector general office has said it would likely issue in August its full report on its sweeping review of the department. An interim report, issued just days before Mr. Shinseki’s resignation, showed problems throughout the VA. They included employees tinkering with official patient appointment wait times to make them seem much shorter than the actual times veterans were having to wait.

In case you were wondering why this is all happening in the VA health care system and not in the private health care system, it’s because the VA is 100% pure government-run health care, as health care expert Avik Roy explains in Forbes magazine. The VA is not scandal is not some sort of aberration from government-run health care. Long wait times and patient deaths are essential to government run health care, in practice.

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New study: NHS patients are 45 percent more likely to die than US health care patients

Wes sent me this article from the UK Telegraph.

Excerpt:

Patients are 45% more likely to die in NHS hospitals than in US ones, according to figures revealing how badly England’s health service compares with those of other countries.

Previously unpublished data collated by Professor Sir Brian Jarman over more than 10 years found NHS mortality rates were among the worst of those in seven developed countries.

A patient in England was five times as likely to die of pneumonia and twice as likely to die of septicaemia compared to similar patients in the US, the leading country in the study, the data suggested.

The elderly were found to be particularly at risk in English hospitals compared with those in the other countries.

The figures showed that the situation had improved since 2004, when the death rate in English hospitals was 58% higher than that in the best performing country.

But NHS institutions still lagged behind in the most recent data, from 2012, despite reforms of the health service and increased funding.

Of the other six countries studied, only the US was named because of the sensitivity of the data.

Prof Sir Brian, who adjusted the data to take account of differences in the countries’ health services, did not initially release his figures because he was so shocked by them he at first assumed there must be a flaw in his methodology.

There was, however, “no means of denying the results,” he said.

“I expected us to do well and was very surprised when we didn’t,” the Imperial College London medic told Channel 4 News.

“If you go to the States, doctors can talk about problems, nurses can raise problems and listen to patient complaints.

“We have a system whereby for written hospital complaints only one in 375 is actually formally investigated. That is absolutely appalling.”

Previously, I had posted a summary of a book by Scott Atlas, a medical doctor at the Hoover Institute at Stanford University. In that article, he laid out the reasons why the U.S. healthcare system was the best in the world.

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New report exposes NHS socialized medicine as an unmitigated disaster

The UK Telegraph reports on the sorry state of socialist Britain. (H/T Dina)

Excerpt:

Eleven NHS trusts were put into “special measures” after an investigation found thousands of patients died needlessly because of poor care.

The report blamed poor staffing levels and lack of oversight, and said that staff did not address the needs of patients. It concluded the hospitals investigated were “trapped in mediocrity”.

[...]The review, ordered by the Prime Minister, began in February following the public inquiry into the scandal at Mid Staffordshire Hospital Foundation Trust, where up to 1,200 people died amid “appalling” failings in care.

Inspectors visited 21 hospitals, run by 14 NHS trusts, which had the highest recent mortality rates in England. They found that some of the risks to patients were so severe that they were forced to step in immediately.

[...]At Buckinghamshire Healthcare NHS Trust, junior doctors described a “frightening” workload which left them responsible for up to 250 patients at weekends. Elderly patients were left on the lavatory with the door open, while others were left on trolleys for hours on end. At one of the trust’s community hospitals, nurses were forced to call 999 because there were not enough doctors.

At Blackpool Teaching Hospitals Foundation Trust, patients’ families had to feed other patients because nurses were busy while other vulnerable elderly people were left in soiled conditions. At Northern Lincolnshire and Goole NHS Foundation Trust, relatives said they were not only washing and dressing patients but turning them to prevent bed sores. Receptionists were left to take decisions about how quickly patients were seen in A&E, as happened in Mid Staffs.

Sir Bruce said: “For me this is in many ways a difficult day for the NHS — because we are laying bare some truths. On the other hand, the transparency with which this review has been conducted, I hope will be a turning point for the NHS.”

Dirt and dust was found to be “ingrained” on the wards at North Cumbria University Hospitals NHS Trust and two operating theatres were shut immediately due to poor hygiene.

Figures showed up to 13,000 excess deaths since 2005 at the 14 trusts investigated, advisers to the review said.

“No statistics are perfect but mortality rates suggest that since 2005 thousands more people may have died that would normally be expected at the 14 trusts reviewed,” Mr Hunt told the Commons.

At Basildon and Thurrock University Hospitals NHS Foundation Trust, up to 1,600 people more than expected may have died during the period. Inspectors found patients stayed up to two weeks in temporary areas without shower facilities. Others were left in ambulances “stacked” outside A&E departments, or waiting hours on trolleys.

At East Lancashire Hospitals NHS Trust, high numbers of stillbirths at the maternity unit — eight in March — were never investigated, nor reported to the trust’s board. An elderly woman was discharged at 3am and told she had “no choice”, inspectors found.

Patients at George Eliot Hospital waited up to 10 days to see a senior doctor. Nurses were not trained to treat bedsores, leaving patients in crippling pain. At Sherwood Forest Hospital NHS Foundation Trust, inspectors found significant backlogs of scans and X-rays which had never been examined, and complaints which dated back three years.

At Tameside Hospital NHS Foundation Trust, whose chief executive and medical director resigned this month, wards had no doctors in charge at nights, while patients were shifted from ward to ward.

At United Lincolnshire Hospitals NHS Trust there were 12 “never events” — incidents so serious, such as operations on the wrong part of the body, or surgical instruments left inside a patient, that they should never occur — in three years. Patients felt too frightened to complain in case it led to worse care, the report found.

What happened? How is it that UK citizens and businesses pay over half their incomes to the government, and yet the government cannot even provide basic health care for customers?

The missing factor

Let Dr. Walter Williams, professor of economics at George Mason University, explain why the NHS has failed to please their customers:

The NHS is what happens when people repeatedly elect governments that are ignorant of basic economics.

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How privatization turned the worst-performing NHS hospital around

From the American Spectator.

Excerpt:

[T]he most successful of the “drastic” experiments put in place is that much-hated bête noire of progressives and Obamacare supporters everywhere: privatization. The Mail Onlinereports that Hinchingbrooke Hospital, “The first NHS trust to be operated entirely by a private company has recorded one of the highest levels of patient satisfaction in the country.”

In other words, the Brits were so desperate to fix their crumbling health care system, they experimented with the private market and it is outperforming government-run health care without breaking a sweat. Hinchingbrooke was, like so many hospitals in the UK, about to go under when a private company called Circle Holdings was awarded a 10-year contract to run it. This is the first time such a company has been given control of an NHS hospital and the results will not come as a surprise to anyone who understands free enterprise.

As the Mail Online goes on to report, “The company running the trust has slashed losses at the hospital by 60 per cent and will soon begin to pay… debts built up over years of mismanagement.” Though will be no surprise to free market advocates, it has been a real eye-opener to the NHS. Privatization isn’t the dirty word it once was in the much-maligned health system: “The takeover deal … is seen as a blueprint for the future of many NHS trusts. The George Eliot Hospital in Warwickshire is already considering adopting the model.”

It will also come as no surprise to those who believe the market provides the most efficient health care delivery model that, in addition to dramatically improving the financial prospects, privatization has improved patient satisfaction. Before Hinchingbrooke was taken over by Circle Holdings, patients had a very low opinion of the hospital and the care it provided. Now, this perception is dramatically improved: “Patient satisfaction has risen to 85 per cent, placing Hinchingbrooke in the top six of the East of England’s 46 hospitals.”

I took a look at the UK Daily Mail article and found an interesting section:

Patient satisfaction has risen to 85 per cent, placing Hinchingbrooke in the top six of the East of England’s 46 hospitals. The feedback is calculated by asking families and patients whether they would recommend the hospital, then weighting the answers compared to local peers.

Previously the trust was among the lowest ranking for satisfaction.

Figures also show that Hinchingbrooke has risen from being one of the worst performing trusts to one of the best under the private firm’s management.When Circle took over, the hospital was consistently near the bottom of the 46 trusts, with many patients waiting more than four hours in A&E.

It now tops the list for short waiting times, seeing 98.2 per cent of patients within the required window.
The hospital also ranks fifth for the proportion of patients with suspected cancer having tests within a fortnight.

Before the takeover it had missed targets every month since June 2010.

It now treats 89 per cent of cancer patients within 62 days, beating the 85 per cent target.

Circle saved millions of pounds a year by cutting out arduous paperwork and middle management.

Under the former ownership, a lengthy form had to be filled out every time a lightbulb needed changing, in a process that often took more than a week.

The group, which runs independent hospitals in Reading and Bath, inherited debts of £39million with the project.

The hospital had been expected to lose £10million last year, but this has been whittled down to  £3.7million by the Circle group.

It made up the deficit from its own coffers, rather than taxpayer funds, and is expected to break even in the current year.

Do you think that we might consider privatizing Medicaid and Medicare, since we know that privatization is good for health care consumers and taxpayers? Of course not, because privatization is bad for politicians, who want to retain control of health care. Privatization is good, but we’re not going to get it unless we vote the socialists out.

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Government-run health care: starving sick babies and children to death

Here’s a scary story from the UK Daily Mail. (H/T Dan Mitchell)

Excerpt:

Now sick babies go on death pathway: Doctor’s haunting testimony reveals how children are put on end-of-life plan

  • Practice of withdrawing food and fluid by tube being used on young patients
  • Doctor admits starving and dehydrating ten babies to death in neonatal unit
  • Liverpool Care Pathway subject of independent inquiry ordered by ministers
  • Investigation, including child patients, will look at whether cash payments to hospitals to hit death pathway targets have influenced doctors’ decisions

Sick children are being discharged from NHS hospitals to die at home or in hospices on controversial ‘death pathways’.

Until now, end of life regime the Liverpool Care Pathway was thought to have involved only elderly and terminally-ill adults.

But the Mail can reveal the practice of withdrawing food and fluid by tube is being used on young patients as well as severely disabled newborn babies.

One doctor has admitted starving and dehydrating ten babies to death in the neonatal unit of one hospital alone.

Writing in a leading medical journal, the physician revealed the process can take an average of ten days during which a  baby becomes ‘smaller and shrunken’.

The LCP – on which 130,000 elderly and terminally-ill adult patients die each year – is now the subject of an independent inquiry ordered by ministers.

The investigation, which will include child patients, will look at whether cash payments to hospitals to hit death pathway targets have influenced doctors’ decisions.

Read the whole thing, but here’s a snip:

Bernadette Lloyd, a hospice paediatric nurse, has written to the Cabinet Office and the Department of Health to criticise the use of death pathways for children.

She said: ‘The parents feel coerced, at a very traumatic time, into agreeing that this is correct for their child whom they are told by doctors has only has a few days to live. It is very difficult to predict death. I have seen a “reasonable” number of children recover after being taken off the pathway.

‘I have also seen children die in terrible thirst because fluids are withdrawn from them until they die.

‘I witnessed a 14 year-old boy with cancer die with his tongue stuck to the roof of his mouth when doctors refused to give him liquids by tube. His death was agonising for him, and for us nurses to watch. This is euthanasia by the backdoor.’

This is what Democrats believe about health care. When the government runs health care, health stops being about curing sickness and starts being about buying votes. Suddenly, free abortions, breast enlargements, in vitro fertilization, drugs to calm down fatherless children, contraception, HIV/AIDS all become priorities. There are some people out there who want government to pay for the health effects of their own immoral / reckless choices, and that’s what government-run health care is really about. Enabling certain lifestyles that require health care subsidies so those people can live “as good as” traditional morality lifestyles. It’s interesting to note that in countries that have government-run health care, like Canada, doctors and nurses are regularly forced to act against their consciences to murder rather than cure. It’s no surprise because socialists in the Soviet Union and Nazi Germany have essentially the same view of conscience as modern leftists like the Democrat Party.

There isn’t enough money for us to pay people to voluntarily incur health care costs (and other social costs) with their immoral / irresponsible choices. But that’s exactly what happens when you make everything “health care” and then make it “free” in order to buy votes from people like Sandra Fluke. What Democrats do is look for groups that need subsidies or validation and they offer it to them with taxpayer money and laws prohibiting dissent. They essentially take the complete anti-freedom point of view on every question. They hate liberty, and love power. The want to control others and to be adored by those who depend on their benevolent redistribution of other people’s money.

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