Poor Quality Standards uncovered in the NHS a Glimpse into Obamacare?

Posted by PITHOCRATES - April 1st, 2012

Week in Review

Do you want to know what Obamacare will be like when they fully implement it?  Yes?  Well, then, I give you the UK’s National Health Service (NHS).  Only it won’t be as good as the NHS.  For the United States has far more patients than the UK does.  But even with fewer patients than the US the NHS bureaucracy is still cold, detached and, at times, deadly (see Health regulator ‘gagged own staff against speaking of failures’ by Rebecca Smith posted 3/30/2012 on The Telegraph).

The Care Quality Commission has been criticised for failing to act on concerns of residents being abused by care home staff and reducing the number of inspections to focus on registering organisations instead, a report said.

One of the key ways that poor standards of care in residential homes and hospitals come to light is through staff blowing the whistle yet the CQC shut down a dedicated hotline, the Public Accounts Committee said.

At the same time the CQC gagged its own staff when they tried to raise concerns about the Commission’s work, it said.

One board member told MPs she had tired [sic]to speak publicly about her concerns over the way the CQC was run but had been “ostracised and vilified”.

The report did not name the board member but it is understood to be Kay Sheldon, a psychiatrist, who gave private evidence to the Mid-Staffordshire Inquiry, into dozens of deaths of patients amid appalling standards of care.

Whistleblower hotline?  Gag orders?  Ostracized?  Vilified?  Patient deaths?  Appalling standards?  These are not the things they led us to believe would happen under Obamacare.  But they have them in the NHS.  Which is full of excellent doctors, nurses and caregivers.  So we can expect them in Obamacare.  And far more of them.  Because Obamacare will have far more patients than the NHS.  And it’s not because ‘bad’ people are sneaking into a national health care system.  It’s just the nature of a great bureaucratic beast.  That must spread diminishing limited resources to an expanding and aging patient base.  That turns health care into a game of numbers.  Accounting entries.  Even in the area of quality control.

The CQC has been ‘struggling for some time’, the report said, and the Department of Health is ‘only now’ starting to take action…

The CQC was formed in 2009 under a Labour government led by Gordon Brown, taking over regulation of healthcare, social care and mental health services.

Reports from the Health Select Committee, the Department of Health and the National Audit Office have all been critical of the Commission.

The PAC report said it has been ‘poorly governed and led’ and ‘we have serious concerns about the leadership, governance and culture of the Commission’.

Cynthia Bower, chief executive of the Care Quality Commission, resigned last month from the £195,000 a year post as a review by the Department of Health found widespread failures including a lack of evidence it protected patients, it was too reactive and inspectors missed neglect of care home residents.

Lady Barbara Young who was chairman when the organisation was set up in 2009, left after the Basildon hospital scandal in which dozens of patients were thought to have died despite the hospital receiving a ‘good’ rating from the Commission.

Government does not make things better.  No matter how ‘smarter’ government bureaucrats are than everyone else.  For that’s the belief of politicians and government bureaucrats.  That the world would be a better place if these ‘smart’ people took control.  And that includes health care.  So they can give large salaries (based on the current exchange rate that £195,000 comes to $312,195 US) to their likeminded friends.  Who can put all of their enlightened ideas into practice.  And what happens after they start running things?  Continued patient neglect.  And more patient deaths.  Despite all of their good intentions.

Mrs Hodge said: “The CQC completed less than half its target number of inspections. That is a serious failure that lets down patients and users of care services who rely on the CQC to protect them from poor or unsafe care.”

The Commission now has to register all 10,000 GP practices in England by April next year and the process has been simplified to an online application form in which partners will declare if they meet 16 pre-set standards including cleanliness, medicines management, patient consent, complaints and record keeping.

In pilots a quarter of GPs said they did not meet all the standards.

The report said: “We are concerned, however, that the Commission will simply be a ‘postbox’ for self-certified applications and that the process will not be sufficiently robust to give the public meaningful assurance that registered GP practices are meeting the essential standards.”

Bureaucrats love paperwork.  The more the merrier.  Put it online and they’re in paperwork nirvana.  Because they never have to leave their offices.  They never have to work late.  They never have to travel to these disgusting health care facilities (where they neglect patients and cause many to die).   Out of sight out of mind.  Ergo their system works.  Thanks to the honor system.  And as long as bad care providers identify themselves to the regulators so the regulators can quickly and efficiently complete paperwork addressing the situation.  And then file it electronically.  Confidant that they did everything they could to increase the quality of patient care.  And then they go home.  Trusting that the other bureaucrats in the system will take the appropriate action.  Thus improving the quality of health care.  Efficiently.  And cost effectively.  Leaving more money available for those large salaries they so enjoy.

“But it is also important to keep this in perspective. The main responsibility for ensuring care standards are met lies with front line staff and hospital boards. We must be realistic about what the regulator can do – its role is to act as a backstop when they fail in this task.

“The Commission had a troubled beginning, exacerbated by a lack of clarity about its role and a failure to provide the resources needed for it to meet the enormous and complex task it was given. Politicians must bear some of the responsibility for this – it is no good preaching the virtues of light touch regulation, and then blaming the regulator for not taking a more interventionist approach when problems emerge.

But there is a problem relying on the frontline staff when they follow orders from on high.  Their health-care-providing hands are tied.  They can only do what some bureaucrat in a far distant office allows them to do.  They’re doing the best they can in a broken system.  But when care or treatment is denied based on cost accounting performed in some office that never sees a patient their patients will suffer neglect.  And some will die.  In part from the refusal to give them life-saving treatment.  And in part due to the apathy people will feel when the quality of their care doesn’t matter as much as their meeting cost-reduction targets.  When they see patients suffer and die because they can’t do anything for them.  Because their requested treatment was denied.  It’ll harden the best of people.  Making their patients just numbers.  And not people.

And this will be the world of Obamacare.  For the NHS is full of great people.  Yet even they can’t prevent the ill effects of a bad system.



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