In the NHS all Britons are Equal only some Britons are more Equal than Others

Posted by PITHOCRATES - February 23rd, 2013

Week in Review

One of the driving forces behind Obamacare was equality.  Everyone was to have equal access to quality health care.  Not just the rich.  That’s why the United States needed to move towards what the British have.  Their National Health Service (NHS) provides equality.  In Britain it doesn’t matter if you’re rich or poor.  Everyone gets access to quality health care (see Ministers pledge to reduce child mortality by Press Association posted 2/18/2013 on the guardian).

A new national pledge to reduce child deaths is to be announced by the government.

The all-cause mortality rate for children aged between 0 and 14 years has moved from the average to among the worst in Europe, figures show, while more than a quarter (26%) of children’s deaths showed “identifiable failure in the child’s direct care”…

New measures include increasing data so the NHS and local authorities can obtain better information to improve the health of young people; piloting a survey to generate details of local health problems such as drug and alcohol use; and launching colour coded health maps to highlight trends for conditions such as asthma and diabetes.

The health minister, Dr Dan Poulter, said: “For too long, Britain’s childhood mortality rates have been amongst the worst in Europe when compared to similar countries.

“In particular, there is unacceptable variation across the country in the quality of care for children – for example in the treatment of long-term conditions such as asthma and diabetes.

Apparently some people are more equal than others in Britain.  With children being the least equal.  Apparently.

Now does this show Britain hates children?  No.  They don’t.  Remember the 2012 Summer Olympic Games?  In London?  Where they celebrated their NHS with lots of happy kids in hospital beds?  Britain loves their children.  It’s just that national health care is not as great as people think it is.

Britain’s aging population is producing great cost pressures on the NHS.  As it will on Obamacare.  Forcing the British to do more with less.  Just as it will force the Americans to do more with less.  And when you try to do more with less people fall through the cracks.  As these children have.  As American children will.  For one thing for certain is that the more government is involved the worse things tend to get.  Just compare renewing your driver’s license to going to the store.  Which is a more enjoyable experience?  Which provides a better value for the money.  Which has more courteous people?  Which satisfies your needs more?  The answer is the one with less government.  Going to the store.  For many people love shopping.  While no one enjoys renewing their driver’s license.

People don’t like dealing with their insurance companies.  They don’t mind seeing their doctors.  But they hate fighting the insurance companies to pay for their health care.  Now imagine your doctors and nurses becoming more like the insurance companies.  Which they will under Obamacare.  For they will all have to answer to a government bureaucrat.  And one thing for certain is the more government is involved the worse things tend to get.


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Cost Pressures in the NHS cause Ambulances to Wait for a Half Hour or more to Unload their Patients at a Hospital

Posted by PITHOCRATES - November 18th, 2012

Week in Review

National health care is very expensive.  And it’s more expensive if your population is aging.  Which the British population began doing after the inception of the National Health Service (NHS).  So fewer people were paying for more people as time went on.  Making it very difficult to provide health care for everyone.  As the population aged further the British had to ration service.  And increase wait times.  As the cost pressures of an aging population weighed heavily on the NHS.  Struggling under these cost pressures, the NHS had no choice but to make massive budget costs through increased efficiencies.  Looking for some £20 billion ($31.8 billion) in savings.  How has that worked?  It’s turning police cars intro ambulances (see Shocking state of the NHS: Half a million patients forced to wait 30 minutes on trolleys before admission to A&E by Jo Macfarlane and Brendan Carlin posted 11/17/2012 on the Daily Mail).

The number of seriously ill patients forced to wait more than half an hour on trolleys and in ambulances before being admitted to accident and emergency has rocketed by up to 300 per cent in just 12 months.

Figures uncovered in an investigation by The Mail on Sunday reveal mounting delays for 999 patients at hospitals across the country as casualty units struggle to cope with Government cuts and the closure and downgrading of other A&E wards.

Nearly half a million patients brought into casualty by ambulance last year were left for half an hour or more in vehicles or in corridors before they were officially admitted.

Several hundred waited longer than two hours. Guidelines state that patients should be handed over to A&E staff within 15 minutes of arrival at a hospital…

Most trusts said the number of patients waiting more than 30 minutes had soared by an average of  25 per cent in the past year.

But in the North East the numbers increased by 294 per cent, and in London by nearly 50 per cent…

‘The long waits are bad news for patients and for ambulance crews who are stuck outside hospitals where they are unavailable for new emergency calls.

‘The Government needs to think about the consequences of their demand for £20 billion in so-called efficiency savings from the NHS because the result is clear – patients are suffering.’

In London, one of the worst affected areas, campaigners are warning that the situation will get worse if proposals to close eight A&Es are approved, sending patients to already-struggling departments elsewhere. The London Ambulance Service revealed that 42,248  patients waited outside hospitals for longer than 30 minutes during 2011/12 – a rise of 47 per cent in 12 months – and 10,053 waited more than 45 minutes.

With ambulances stuck at hospitals for 30 minutes or more to unload their patients the police have been picking up the slack.  Some transporting people after waiting for an ambulance that never arrived.  Or being called upon to respond in the place of an ambulance.  Because all ambulances were parked at some hospital with a patient in back waiting for admission into an A/E department.

So this is the ultimate future of national health care.  Budget cuts, rationing and long waiting times.  And ambulances parked at hospitals with patients in back waiting for a half hour or more for admission.  This is what Obamacare will give us.  Or whatever Obamacare will evolve into.  For when it comes to national health care few can do it as well as the British.  So if the masters of national health care are having such difficulties so will some new young upstart when they enter the world of national health care.  Who also has an aging population.  So if you think things are bad now remember these times well.  For they will soon be known as the good old days.


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Baby Boom causes new Short-Term Cost Pressures for NHS but offers Long-Term Hope

Posted by PITHOCRATES - November 17th, 2012

Week in Review

Now that President Obama won reelection and the Democrats retained the Senate Obamacare is here to stay.  Unless something happens in the 2014 midterm elections that turns Congress over to the Republicans with supermajorities that will allow them other ways to defund or otherwise shutdown Obamacare.  Or the states stand together on their end and refuse to implement Obamacare.  But unless these things happen Obamacare is here to stay.  Perhaps one day evolving into a full blown national health care system.  Which they designed it to do.  By putting in requirements that encourage employers to drop health care.  Opening the door for the government to step in to save the day from the health care crisis they created.

So what will life be like under Obamacare?  Start following what’s happening in the British National Health Service (NHS).  And you’ll get an idea of what national health care is like (see New baby boom to put ‘enormous’ strain on NHS by Stephen Adams posted 11/12/2012 on The Telegraph).

In the first three months of this year alone, 4,600 more babies were born than during the same period last year, according to official figures

Midwives are warning that the trend is continuing and will swell births to more than 700,000 in England this year – the first time that level has been reached since 1971.

Birth rates have been on the rise for a decade, due principally to immigration, with the number growing by about 12,000 a year…

Professor Cathy Warwick, chief executive of the Royal College of Midwives, said the increase was putting “enormous” strain on the NHS…

Before David Cameron came to power, he promised another 3,000 midwives across the NHS, but to date only an extra 900 have been employed.

The RCM is arguing another 5,000 are needed across England, to keep pace with the rising number of births…

A recent RCM poll of more than 2,000 midwives found nine in 10 did not feel they could give women all the care and support they needed.

A lack of midwives has been cited as one reason for the high proportion of caesareans in Britain, with mothers sometimes opting for surgery to avoid repeating a traumatic first birth.

The NHS is struggling to slash its budget.  For before this current baby boom birthrates had been falling after the establishment of the NHS.  Shrinking the tax base.  And the funding for the NHS.  At a time when people were living longer thanks to advances in health care.  So the NHS finds itself chronically underfunded thanks to that shrinking tax base.  And overburdened by more elderly people living longer after retirement consuming a lot of health care resources.  Which is why the NHS relies on midwives to deliver babies.  Often in the mother’s home.  To relieve the hospital of an enormous expense of handling something so mundane and routine as delivering a baby.  Midwives are a way to cut costs.  Without sacrificing quality health care.  As most births proceed without any complications.  When there are complications they take the mother to a hospital.

Midwives help the NHS spread their limited resources over as many people as possible.  Much like the quasi death panel Liverpool Care Pathway.  By encouraging people to let their loved dies instead of trying to prolong their lives with costly health care resources.  Of course, the NHS is currently revising their constitution to make sure those decisions are based on the patient’s best interests and not the hospital’s bottom line.

And speaking of bottom lines there is nothing like a baby boom to solve a government-funded organization’s chronic underfunding.  Because babies become taxpayers.  When they join the workforce.  And if they sustain this baby boom long enough it may bring the age of the British population down.  By having more people entering the workforce than leaving it.  Provided there are jobs for them when they are ready to enter the workforce.  So a rising population growth rate can’t fix all of their problems alone.  They also need a business-friendly environment that will create jobs to employ these new taxpayers.

Of course you know what will happen then.  After the baby boom creates a tax revenue boom the government will make more spending obligations it won’t be able to meet once their population ages again.  And they will be right back where they started from.  Only the spending obligations will be greater the next time around.  And here lies the problem.  It’s the spending that is the problem.  Always has been.  And always will be.  If governments stopped spending themselves into these kinds of messes they wouldn’t have these problems to begin with.  And the Americans have just given themselves a spending obligation that will create the mother of all messes.  Obamacare.  And whatever it will evolve into.  For the US has about 5 times the population of the UK.  So its cost pressures will probably be 5 times what the NHS is feeling.  Or more.  So the Americans can expect midwives to replace the maternity wards their mothers gave birth in.  And a Liverpool Care Pathway quasi death panel.  Why?  Because if the British couldn’t avoid these things than it isn’t likely the Americans will with 5 times the cost pressures.


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The NHS may be letting Elderly Patients Die to Help Cut Costs

Posted by PITHOCRATES - October 21st, 2012

Week in Review

There are few things more difficult than watching a loved one die a slow death.  Nothing prepares you for this.  Even if you work in the health care industry (see My diary of mum’s awful death on the Liverpool Care Pathway: Nurse’s heart-rending account of how doctors decided  to put her mother on ‘pathway to death’ by Tom Rawstorne posted 10/19/2012 on the Daily Mail).

As a nurse and health visitor with 25 years’ experience, Carole Jones thought she knew the workings of the NHS inside out.

But when her 85-year-old mother Maureen was admitted to Addenbrooke’s Hospital in Cambridge last year having suffered a stroke, she was totally unprepared for what followed.

Her mother’s chances of recovery having been written off by medics, a decision was taken — without Carole’s knowledge — to place Maureen on the controversial Liverpool Care Pathway (LCP).

This is a plan ostensibly designed to ease the suffering of the dying, which can involve the heavy sedation of a patient and the removal of tubes providing food and fluid.

Over the past week, families have contacted the Daily Mail saying they believe their loved ones were wrongly put on the LCP by hospitals when they were not in fact close to death, fuelling the suspicion that it is used to hasten deaths to save the NHS money and free up beds.

In June this year, Professor Patrick Pullicino, a consultant neurologist for East Kent Hospitals, and Professor of Clinical Neurosciences at Kent University, told a conference the LCP had become an ‘assisted death pathway’.

‘Very likely, many elderly patients who could live substantially longer are being killed by the LCP,’ he said.

It is so difficult when the roles reverse between parent and child.  When a parent consults with a doctor about his or her child you usually don’t have to worry whether the doctor is doing what’s best for the child.  When it is a daughter or son of a parent discussing an elderly parent’s treatment with a doctor it’s a different story.  Especially if that parent is suffering from dementia.  And the National Health Service is dealing with cost pressures from an aging population.

More people are leaving the workforce than entering it in the UK (as well as the US).  Which means two things.  Tax revenue is falling because of fewer workers (which means fewer taxpayers).  While at the same time a larger number of retirees are consuming a large share of health care services.  So that’s less money coming into the health service.  While the health service is spending more money on providing health care services.  Which is a problem.  If you spend more than you receive you will run deficits.  And if you can’t increase tax rates anymore that leaves only one other option.  Cost cutting.

Is this the reason why they are placing elderly patients in the controversial Liverpool Care Pathway (LCP)?  To help cut costs by having them die more efficiently?  Whether they are or not it would help cut costs.  Probably the largest cost savings they can make.  By removing the largest consumers of health care resources from the health care system.  A death panel, if you will.  Where some government bureaucrat makes a cold and calculated decision to let a person die because it’s the cost efficient thing to do.

It’s something to think about as they fully implement Obamacare.  For if the NHS is doing this it would follow that Obamacare will, too.  For both nations have aging populations.  Only the US has about five times the population of the UK so the US will probably have five times the cost pressures.  And will likely place five times the patients into the US equivalency of the Liverpool Care Pathway (LCP).

This is the bleak future of Obamacare.  Real death panels.  Despite what the proponents of Obamacare say.


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People going to the Accident and Emergency Departments for Routine Health Care in the NHS

Posted by PITHOCRATES - October 20th, 2012

Week in Review

One of the arguments for passing Obamacare in the US was that we were already paying for the uninsured via costly emergency room visits.  Overburdening our emergency departments.  And denying valuable resources to those who truly needed them.  For looking at a child with a sore throat diverts valuable health care resources from accident victims and people suffering medical emergencies like heart attacks.  Obamacare was going to fix that.  And make our health care system as perfect as it is in the NHS.

But it is not the utopia Americans think it is in the NHS.  As an aging population is causing enormous cost pressures on their limited resources leading to budget cuts, increasing wait times, rationing of services and doctor & nurse shortages that are making it difficult to staff both emergency and non-emergency health care facilities.  Causing people to still turn to the emergency department (A&E in the UK) for routine care (see Rise in child throat infections treated in hospital, study finds posted 10/19/2012 on BBC News Health).

Children admitted to hospital with throat infections have increased by 76% over the past 10 years, according to a study from Imperial College London…

Pressures on doctors and a maximum waiting time in A&E could be the reason behind the increase in admissions…

The researchers found no evidence of a link between tonsillectomy trends and admission rates for acute throat infections.

Instead, they suggest that the sharp rise in hospital cases of children with throat infections is probably explained by the large number of children being taken to A&E instead of to see their GP, especially if the infection flares up outside surgery hours.

Dr Elizabeth Koshy, lead study author from the school of public health at Imperial College London, said the rise in hospital admissions for this type of infection was concerning.

“Our findings relating to short hospital stays suggest that many of the children admitted with acute throat infections could have been effectively managed in the community.

“Our study highlights the need to urgently address the issue of healthcare access, with improved models of integrated care within primary and secondary care, to avoid potentially unnecessary hospital admissions for relatively minor infections in the future.”

The introduction of a four-hour maximum waiting time in A&E, in 2002, could have led under-pressure doctors to admit children with less serious throat infections, she said.

Even a national health care service doesn’t eliminate people using emergency departments for routine care.  Because with cuts in the NHS budget closing local facilities or reducing their hours of operation where else are the people to go?  To the only place that is open.  The emergency department.

So national health care has come full circle.  At least in the Obamacare argument.  We need national health care to get people to stop using emergency departments for their routine health care needs.  Trying to offer everything to everyone and an aging population has forced budget cuts and the closing of facilities that provide for routine health care needs.  Forcing these people right back to where the national health care service was trying to get them away from.  Thus they have the same problem as they did before.  And as they do in America.  Only with a massive national health care system on top of all their other problems.  Guaranteeing further cost pressures, closures and more crowded emergency departments.

Proponents of Obamacare should heed this lesson well.  For Obamacare will not be the utopia they think it will be.  In fact, it will be worse than the NHS.  Because America has about five times the population of the UK.  And will have about five times the cost pressures the UK has.  Calling for even more budget cuts, increasing wait times, rationing of services and doctor & nurse shortages that will make it more difficult to staff both emergency and non-emergency health care facilities.  Leading to even more overcrowded emergency departments.  Which will make health care more costly and less loved than it ever was before Obamacare.  Making the case for repealing Obamacare ever more appealing the more we learn about the reality of national health care from the NHS.


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Cost Cutting and Rationing in the NHS has Patients being Treated in Corridors where they Wait for a Bed

Posted by PITHOCRATES - May 12th, 2012

Week in Review

Yet another example of the cost pressures on a national health care system.  And the ill affect those cost pressures have on their patients (see Patients ‘treated in corridors’, claims Royal College of Nursing by Nick Triggle posted 5/12/2012 on BBC News Health).

Patients are being left stranded on trolleys for hours and forced to have treatment in corridors due in part to the loss of hospital beds, nurses say…

The RCN said that was putting patients at risk by potentially leaving them without access to essential equipment such as oxygen supplies and heart monitoring equipment as well as compromising their privacy and dignity.

Other problems highlighted included ambulances being forced to queue outside A&E units and patients being put in unsuitable wards.

The RCN said the crisis was being caused by a combination of staff shortages, the long-standing drive to reduce the number of beds in hospitals and the rise in A&E admissions…

Mike Farrar, chief executive of the NHS Confederation, which represents hospitals, said the problems identified should not be happening.

But he added hospitals were facing a struggle because of “growing financial pressure and significant structural upheaval”.

In other words the cost of Britain’s national health care is growing so great that they are cutting costs and rationing care.  To treat as many people as possible with their limited resources.  Which can be expected in a country with an aging population that is living longer. 

It took the National Health Service (NHS) awhile to get here.  Obamacare is starting with these dire statistics.  So there will even be more cost cutting and rationing under Obamacare.  Which will try to treat far more people with their limited resources.  Which begs the question whose bright idea was Obamacare?  And couldn’t they see the problems the NHS has been having these past few decades?


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