NHS Wait Times grow so long that the NHS farms out Health Care to Private Providers

Posted by PITHOCRATES - June 8th, 2013

Week in Review

Nationalizing health care will lead to longer wait times and a rationing of services due to a shortage of doctors, nurses and support staff that will be needed to treat more people.  This is what the opponents of Obamacare said.  While the proponents told the opponents that they were full of [deleted expletive].  Figuratively, of course.

But national health care does increase wait times and rations services.  And to see this all you have to do is look to Britain’s National Health Service (see NHS waiting scandal leads to private healthcare spend by Eleanor Bradford posted 6/4/2013 on BBC News Scotland).

NHS spending on private healthcare has risen dramatically since waiting time scandals came to light, BBC Scotland can reveal.

Spending across Scotland rose by nearly 60% last year to more than £40m, compared with £25m per year in the two previous years…

NHS Lothian admitted it would have to spend £10m clearing a backlog of patients after it emerged it had been manipulating its waiting time figures in order to meet Scottish government targets.

NHS Grampian consistently denied any wrongdoing but its spending on private healthcare increased as closer scrutiny was given to the way health boards were meeting government targets.

Last year its spending nearly tripled to £6.3m. NHS Grampian has the highest number of patients marked down as “unavailable” for treatment out of all 14 Scottish health boards.

Health boards are allowed to stop the waiting time “clock” if patients say they are unavailable, but the number of unavailable patients in Grampian is seven times higher than the average for mainland health boards…

“We understand that waiting times are important to patients and that most patients prefer to be treated as close to home as possible.

“The NHS Grampian Board recently agreed a £16m investment programme that will increase capacity by building new theatres and employing more doctors, nurses and support staff. The additional local capacity will be available in 2014.”

The NHS pays private sector health care providers outside of the NHS to provide the care they cannot.  A shortage of “theatres…doctors, nurses and support staff” has made it impossible for some health boards to meet the mandated NHS wait times.  Their wait times have grown so long that they fudge their reports to hide how poorly they’re doing.  One group of bureaucrats lying to another group of bureaucrats.  As one sets unrealistic goals the other cannot meet.  But the private sector can.  Because when people pay for their health care health care providers have the money to build theatres and hire doctors, nurses and support staff.

So what are the official wait time targets?  The above article links to another describing them.  Here are some excerpts (see Waiting time targets: What they mean for you by Eleanor Bradford posted 1/21/2013 on BBC News Scotland).

Legislation passed by the Scottish Parliament last year means that, from the start of this year, you have a legal right to be treated within 12 weeks, unless you’re waiting for diagnostic scans or waiting for one of the excluded treatments outlined below…

Since December 2011, no-one should have waited longer than 18 weeks from the point they were referred for treatment until that treatment occurs. This includes all scans and diagnostic tests…

You should wait no longer than six weeks for eight types of scans and tests.

These are: upper endoscopy, lower endoscopy, colonoscopy, cytoscopy, CT scans, MRI scans, barium studies and ultrasound scans (unrelated to obstetrics)…

You should wait no longer than 62 days for treatment if your referral is “urgent”.

Once a definite diagnosis of cancer is made (eg following a scan) you should wait no longer than 31 days for treatment. However, this is only the first treatment…

The waiting time “clock” stops if you are unavailable for any reason, but you should specifically agree to a period of “unavailability” being applied to your case and a letter should be sent to you confirming this to be the case.

If you can’t make the first appointment offered, you should be offered a second one.

Both should be “reasonable” – in a location you can get to and in a timescale that is possible, but it is considered reasonable to offer you an appointment in another health board area…

If you miss your appointment and don’t ring in advance then you will be referred back to your GP.

If you still need treatment your GP will need to make a new referral and the whole process starts again.

So, to summarize, you go to see a general practitioner (GP).  That’s like the doctor you make an appointment to see when you think you have the flu so you can get some antibiotics.  The GP refers you to a specialist if you have something serious.  The specialists then refer you someplace for treatment.  And when he or she does the clock starts running.  And some time in the next 18 weeks you should start your treatment.  Unless they note you as ‘urgent’.  Then your treatment is in the next 62 days.  Which is 2 months.  But if they find that you have cancer they cut that in half.

This is why their emergency rooms are overflowing in Britain.  People don’t want to wait these long wait times.  So they go to the emergency room (A/E in Britain).  Funny, really.  For this is the very thing Obamacare was going to stop in the United States.  Uninsured people going to the emergency room.  And here they are in Britain with all the free health care they could want.  Still going to the emergency room to escape those horrendous long wait times.

Perhaps the opponents of Obamacare were not full of [deleted expletive] after all.

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Doctor Shortages in the NHS force some Hospitals to adopt Banker Hours when treating Stroke Patients

Posted by PITHOCRATES - April 14th, 2013

Week in Review

We hear it all the time how to recognize the early symptoms of a stroke.  Here.  And in the UK.  The sudden headache.  The numbness in an arm or a leg.  The slurred speech.  For if we identified these symptoms early enough we can get to the hospital in time to prevent a massive stroke.  As long as we get there during banker hours (see Mother, 30, suffered massive stroke after being ‘sent home from hospital because a specialist was unavailable’ by Liz Hull posted 4/13/2013 on the Daily Mail).

A young mother suffered a massive stroke after she was wrongly sent home from hospital because there were no specialists on duty over the weekend to assess a brain scan.

Ruth Stanton was aged just 30 when she was admitted to hospital after suffering two mini-strokes over 48 hours.

Doctors carried out two brain scans, but failed to give her a diagnosis because it was a Friday evening and the specialist neurologist was not on site…

Because it was a Friday evening the specialist wasn’t available and, although the scans showed signs of abnormality, medics made the decision to discharge Mrs Stanton, who was told to wait for an out patient’s appointment, instead.

She returned home and went to bed but suffered the stroke in the middle of the night.

A medical expert provided evidence to the couple’s solicitor that prescribing a simple dose of aspirin for Mrs Stanton, now 36, would have prevented it occurring.

We can learn the early warning signs of a stroke but the on-call doctors and nurses in a NHS hospital can’t?  This after she suffered two mini-stokes over a 48-hour period that were in her medical records?  And there were signs of abnormality in two brain scans?  What does it take for someone to call in a specialist?  A flashing neon sign over a patient’s head saying “I’m a having a stroke.  Please call in a specialist.  Help.”  Apparently so.  For they will discharge you on a Friday afternoon and ask you to come back during office hours on Monday otherwise.

There’s a running gag in American television about a busy doctor telling a patient to “take two aspirins and call me in the morning.”  So they don’t have to cancel their evening plans by staying late to see a patient.  Apparently they didn’t give this woman anything.  And asked her to come back sometime after the weekend.  As an outpatient.  Despite having had 2 mini-strokes.  And signs of abnormality in her brain scans.  Is this what we have to look forward to under Obamacare?  Health care resources so stretched that they can’t be bothered to call in a specialist.  Or give a woman about to have a massive stroke a couple of aspirins?

It may very well be.  For Obamacare will take us in the direction of the NHS.  A more top-down managed health care system trying to take care of an aging population.  Where the only way to cut costs will be to force health care providers to work for less.  Leading to the kind of doctor shortages where they ask a patient to come back after the weekend during banking hours when someone will be available to see them.  If they don’t die or suffer a debilitating stroke over the weekend.

Moving in the direction of the NHS may provide health care to more people.  But the quality of that health care will fall so much that there may be more deaths in the long run from substandard care.  More of that fair-share sacrifice President Obama is always talking about.  If people are dying because they don’t have health insurance than some of those who have it need to die, too.  To make things more fair.  Apparently.

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