I have checked out the unweighted polling numbers. I can reassure Plato and Charles that all Tories have not decamped to the beaches !
But I did notice that something has changed markedly. 9/10 of 2010 Labour voters now say that they will vote Labour whereas for the Tories the figure is 7/10. Exactly the opposite prior to Budget 2012 ! 30% of 2010 LD voters will now vote Labour against 37% staying with the Liberals. 20% of 2010 Tories are now kippers. If I took the PBTory sub-sample that figure is probably an underestimate !
Fair enough. I take it that's a Labour increase rather than a Tory decline in CtV? The union story? Can't think of anything else major?
To be fair, it's not really much of anything. YouGov polls do tend to jump around. Perhaps the safest conclusion is that there may be a slight tendency to a slight fall in the Labour lead from the start of the year, but that recent events have not had too much of an effect on voting intentions. Labour's current range looks to be 35% to 40%; whereas previously it may have been 35% to 42%. I'd argue that the lower figure is the most significant. Should we get a few polls that show Labour dropping below 35%, that will be noteworthy.
"I'd wait and see how last years "3,500 excess deaths" are calculated before asking Lansley and Hunt to confess if I were you."
There's something rather grotesque about a Minister leaking this report to the Mail Telegraph and Sunday Times if indeed that is what's happened. !3,000 deaths isn't something you leak to newspapers.
I think I might have been privy to a brief sighting of Jack's ARSE. It looks like there's been a leak!
The big news is that ED WILL NEVER BE PRIME MINISTER!
(Or I'm I mistaking it with last months poll?)
More likely you've just come out of the privy having just found some of Ed's PMQ briefing notes.
Sad to say my dear old Rog you appear to be falling into the trap of those who disparage my ARSE because they don't like the news.
This sad condition has had many deluded patients over the years who in the end only find salvation and robust recovered political health by recanting on their dire and desperate folly in failing to be in awe of my most wonderful organ.
And this is a question for [the likes of] Professor Nabavi [sp?], JJ (or, ideally, Mrs JJ), EiT or Dr Plank:
On another web-site I am having great fun reading the battles between Red Trousers and the-late-and-lamented HurstLlama (once of this parish). Being an informed software-engineer/analyst the following comment by RT got me thinking....
....whatever the state of the art is. In discussion with one of our network solutions architects yesterday, he informed me that processors are now getting to the point of non-improvability in electronic terms: they can cycle so quickly that the real bottleneck is now waiting for electrons to jump the gap. Only optical connections can do better.
So - and to keep it simple - are photons faster than electrons? If so, how (and why) does e=mc^2 hold...?
Fluffy , you should advise them to get a life , sounds like two sad tefal heads. What does it matter , just throw another server on the barbie , they are as cheap as chips. It is all down to storage in any case and will be how you float your cloud.
I do however wish that the NHS was renamed the English HS and the Scottish HS and the Welsh HS etc. That is the reality.
Agree - it would also help highlight the differing outcomes between them - for all to learn from. Like why relative life expectancy has declined under the Scottish Health Service....
So - and to keep it simple - are photons faster than electrons? If so, how (and why) does e=mc^2 hold...?
Electrons themselves move relatively slowly, several tens of meters per second, but the signal propagated by them is transmitted a lot quicker. Think of it like a tube of ball bearings....
Thanks,
That makes more sense then the after-thought I had.* So it is like forcing water though a pipe; drivers along the M25: More due to Newtonian resistence then pure Einstein (I think)...?
* I sort-of-wondered if it was due to the chemical-electrical interface between the gates. I stopped studying physics in 1984; a move I now much regret...!
37% of people now think Miliband is too close to the Unions, up from 29% last week. His figures on being a strong leader are slightly more positive than a week ago, but not by much - he is still seen as a weak leader by 46% of people, a strong leader by only 12%.
However, there is a more positive reaction to his actual proposals. , and people think he is right to try and reduce Labour's links to the unions by 44% to 13% (22% think he is not actually trying to reduce links at all). People are evenly split over whether the changes actually will reduce the Unions' influence over Labour - 35% think they will, 33% think they won't, 33% don't know.
62% of people agree that MPs should be working full time on their main jobs, and that second jobs risk corruption or conflicts of interest. In comparison, 21% think that MPs doing second jobs keeps them in touch with ordinary people and is better than just having full-time politicians. 56% would support a ban on MPs having second jobs.
A very good summary. The rot did not start with New Labours target culture, but it certainly did not help. I said on here previously that mid Staffs was not an isolated incident.
What it also shows is how poor the Department of Health is at collecting information. Most of these SMR figures have been on the Dr Foster website for years, and the CQC still rated Basildon and Thurrock good over this period!
The hospitals named do not surprise me. The medical bush telegraph knows which hospitals have supportive management and which are dysfunctional. Hospitals that medical staff do not want to work in go into a spiral of decline that is not easy to reverse.
I would not think private medical insurance an adequate remedy. There are no private hospitals that operate emergency departments for you to flash your cash at. When that apolexy strikes we are at the mercy of the Emergency dept at the local NHS hospital.
Is the NHS better or worse under the coalition? To be honest I think it no different. The Lansley reforms only started 3 months ago, and do not appear to alter much, other than create confusion.
IIRC, there tends to be a holiday effect that dosen't help the Tories - when does that start usually (or is it only bank holidays?). Certainly my impression is that summer has come early.
Not great polls anyway - although IMHO, process issues/attacks on union leader influence is more of a "rally the troops" topic than something that gets much wider traction
Where does that theory come from and what is the evidence for it?
Mike has certainly talked about being wary dering whether there was
I have checked out the unweighted polling numbers. I can reassure Plato and Charles that all Tories have not decamped to the beaches !
But I did notice that something has changed markedly. 9/10 of 2010 Labour voters now say that they will vote Labour whereas for the Tories the figure is 7/10. Exactly the opposite prior to Budget 2012 ! 30% of 2010 LD voters will now vote Labour against 37% staying with the Liberals. 20% of 2010 Tories are now kippers. If I took the PBTory sub-sample that figure is probably an underestimate !
Fair enough. I take it that's a Labour increase rather than a Tory decline in CtV? The union story? Can't think of anything else major?
To be fair, it's not really much of anything. YouGov polls do tend to jump around. Perhaps the safest conclusion is that there may be a slight tendency to a slight fall in the Labour lead from the start of the year, but that recent events have not had too much of an effect on voting intentions. Labour's current range looks to be 35% to 40%; whereas previously it may have been 35% to 42%. I'd argue that the lower figure is the most significant. Should we get a few polls that show Labour dropping below 35%, that will be noteworthy.
Agree - from all the polls over the weekend, two things stand out for me - UKIP hasn't fizzled, and the LibDems are still at the bottom of a very deep hole - and if a lot can change in 6 months (UKIP), even more can change in 22....
I do however wish that the NHS was renamed the English HS and the Scottish HS and the Welsh HS etc. That is the reality.
Agree - it would also help highlight the differing outcomes between them - for all to learn from. Like why relative life expectancy has declined under the Scottish Health Service....
How does that work when life expectancy has been rising for a long time
The hospitals named do not surprise me. The medical bush telegraph knows which hospitals have supportive management and which are dysfunctional. Hospitals that medical staff do not want to work in go into a spiral of decline that is not easy to reverse.
From the STimes - it appears that the culprits named as excess deathers are having real problems recruiting and things are getting worse as the good staff leave/no one will replace them for fear of being associated with the scandal on their CV.
It's inevitable but true that very few will choose to work for an organisation that has a reputation for bullying, ignoring problems, terrible morale and HMG inspectors all over it like a rash.
I do however wish that the NHS was renamed the English HS and the Scottish HS and the Welsh HS etc. That is the reality.
Agree - it would also help highlight the differing outcomes between them - for all to learn from. Like why relative life expectancy has declined under the Scottish Health Service....
How does that work when life expectancy has been rising for a long time
Since devolution life expectancy has risen faster in England than it has in Scotland.
ALISTAIR Darling received a standing ovation from Scottish Conservative activists yesterday – to the SNP's delight and the former Labour chancellor's apparent embarrassment.
Oh and I see The STimes has some appalling stats for weekend admissions. Why its ever been custom and practice for office hours to be done in the NHS is beyond me.
You do realise this phenomenon is also observed in other countries, including the United States? It is a real problem but not one that is unique to, or caused by, the NHS.
And let us hope for his sake, George Osborne is not -- on a Sunday! -- choking on his cornflakes at Sir Bruce's (and your?) call for a 20 per cent increase in the number of consultants.
I do however wish that the NHS was renamed the English HS and the Scottish HS and the Welsh HS etc. That is the reality.
Agree - it would also help highlight the differing outcomes between them - for all to learn from. Like why relative life expectancy has declined under the Scottish Health Service....
How does that work when life expectancy has been rising for a long time
Since devolution life expectancy has risen faster in England than it has in Scotland.
Which only goes to prove that YES is the only way to go to ensure that we are not funding higher life expectancy in England at the expense of our own people dying prematurely. It is impossible for the union to be beneficial for Scotland given the difference in size and priorities required for both countries. Scotland will never be a priority in the union, anyone expecting that to be the case or trying to promote it is a liar or a fool or both.
I think I might have been privy to a brief sighting of Jack's ARSE. It looks like there's been a leak!
The big news is that ED WILL NEVER BE PRIME MINISTER!
(Or I'm I mistaking it with last months poll?)
He always says that .
I would be more convinced if he piled his money on a Conservative majority at 4/1 or even Conservative as largest party and showed us the betting slip.
Rather than stick his finger in the air guessing or alternatively up his ARSE.
"People who work in tne NHS know which party improves the NHS and which party pretends not to hate it.
Put it this way in my 30 years the patient safety issues have never been worse than now.
Of course in 1996 waiting lists and times were killing millions before they could afford to be seen.
Massive investment and improvements followed for the next decade and a half. At that point patient satisfaction was highest ever."
I'm sure that's right and with the NHS my guess the reason these stories pass people by is because so many of us use and have family who use the service regularly that our own experiences are really all we make judgements on. Anyone who thinks hospitals were better pre '97 than post weren't using the service
What a curious post - that in some hospitals you're 25% more likely to die than on a Wednesday afternoon tells me that there is a problem.
Changing consultants contracts would go some way - and of course junior doctors who work the weekends don't get to shadow anyone as their consultants aren't working.
It's a self-fulfilling cycle and one where a powerful block of staff demand more gold before being willing to do anything. Frankly, I'd be surprised if many consultants would work the weekends at all since its a perk not to do so.
Randomly citing another country with a total different healthcare system doesn't cut any ice with me.
Oh and I see The STimes has some appalling stats for weekend admissions. Why its ever been custom and practice for office hours to be done in the NHS is beyond me.
You do realise this phenomenon is also observed in other countries, including the United States? It is a real problem but not one that is unique to, or caused by, the NHS.
And let us hope for his sake, George Osborne is not -- on a Sunday! -- choking on his cornflakes at Sir Bruce's (and your?) call for a 20 per cent increase in the number of consultants.
I do however wish that the NHS was renamed the English HS and the Scottish HS and the Welsh HS etc. That is the reality.
Agree - it would also help highlight the differing outcomes between them - for all to learn from. Like why relative life expectancy has declined under the Scottish Health Service....
How does that work when life expectancy has been rising for a long time
Since devolution life expectancy has risen faster in England than it has in Scotland.
Which only goes to prove that YES is the only way to go to ensure that we are not funding higher life expectancy in England at the expense of our own people dying prematurely. It is impossible for the union to be beneficial for Scotland given the difference in size and priorities required for both countries. Scotland will never be a priority in the union, anyone expecting that to be the case or trying to promote it is a liar or a fool or both.
David Wooding @DavidWooding Ex Labour healthsec Andy Burnham insists he received no warning about Morecambe Bay hospital - despite 386 letters to ministers. #murnaghan
Why did he accept a Shadow DH job? This is an accident waiting to happen. Surely he can't keep this post in the run up to the GE2015
David Wooding @DavidWooding Andy Burnham says he's "fed up" with general accusations being hurled in his directions over shoddy hospitals on his watch. #murnaghan
He's lost it completely on Sky - he's getting really stroppy.
David Wooding @DavidWooding I haven't seen Andy Burnham quite so rattled before. He's usually very cool. #Murnaghan
I have worked in the NHS from the late eighties and do not agree with you.
The best period was probably 1997 -9 when the internal market was in reverse, spending stable and we had Dobson as Health Sec. Almost immediately after Milburn took over with his Blairite target agenda and vast expansion of privatisation things started to get worse, with a "lick up and kick down" management, the introduction of Commissioning once more. Things got worse under the evil witch Hewitt and were only marginally better under Burnham.
It is not a question of public or private provision being better. If you set targets then either will meet them rather than other aspects of provision. Either you wind up with targets for everything and a stalinist central direction, or you go back to the older system of negotiating locally about priorities with a re invented local health authority.
There have been as many steps backwards as forwards over the years and little to show for the money spent under either government.
@malcolmg - you do know that Health is a devolved power, don't you?
If the separatists argument is "give Edinburgh the power to run things better than Westminster" surely the logical corollary is that things Edinburgh has run worse than Westminster should be returned to Westminster?
I think I might have been privy to a brief sighting of Jack's ARSE. It looks like there's been a leak!
The big news is that ED WILL NEVER BE PRIME MINISTER!
(Or I'm I mistaking it with last months poll?)
He always says that .
I would be more convinced if he piled his money on a Conservative majority at 4/1 or even Conservative as largest party and showed us the betting slip.
Rather than stick his finger in the air guessing or alternatively up his ARSE.
Ah another sad patient, just as well that NHS spending is up !!
But for the avoidance of doubt the latest 2015 GE ARSE projection, to be superseded tomorrow, is for a hung parliament with the Conservatives as largest party.
Isabel Oakeshott tweets: "@GuidoFawkes my p2 story today reveals it was civil servants who urged a cover up. Burnham overruled them. He's a very unlikely villain."
I imagine that most letters to ministers get diverted by civil servants and they never get to see them. Plus, ministers usually say they "cannot comment on individual cases". I bet they have been told this by their civil servants. Actually, investigating individual cases is a good way to find out what is actually going on.
I do not think most people hold this view against front line emergency workers in the public sector.
However within the Police NHS Fire service there is some terrible sickness levels and for example police retiring at 48 does seem generous to other workers not in the public sector.
"Since devolution life expectancy has risen faster in England than it has in Scotland."
And are you saying that's because of devolution or is it just a ghoulish non-sequitur?
I'm saying we don't know - and the lack of curiosity is disappointing.
But the English and Scottish Health Services have adopted different approaches so there should be plenty to learn from - on both sides, as life expectancy is itself a very crude measure.
That data-wrapper graph purports to show a data-series. For obvious reasons June 30th is not present.
If you wish to support bi-daily information then at least show the break in data-collection. I still maintain that a weekday-to-weekday analysis will be more informative (but this site will need to collate such data reliably first)....
Isabel Oakeshott tweets: "@GuidoFawkes my p2 story today reveals it was civil servants who urged a cover up. Burnham overruled them. He's a very unlikely villain."
Burnham made the fatal mistake of not accepting that a public inq was needed - just like Hillsborough needed one. There are some scandals that are better faced than done half-arsed.
Burnham should never have taken on Sh HSec - it happened on Labour's watch and he was the last one carrying the ball, or in this case a hospital pass. Trying to say it was nothing to do with him and getting all stroppy is missing the point.
I've been on the beach for a few days (now that we've broken up from school, as Charles may have mentioned...) and, as you do, spent about half a minute thinking about the MPs salaries-and-second jobs debacle. Here's a question, and apologies if it's been discussed to death while I've been looking away: why don't we just give MPs a means-tested stipend plus living expenses, travel expenses and an office cost allowance?
As far as I can see, there are two aims with MPs' pay: to prevent it being such a lucrative career job that people are motivated to seek office for the financial benefits, whilst preventing it from being so poorly paid that only those with independent wealth are able to afford to serve. It's a difficult balance to strike because of the extreme polarisation of income and wealth distribution in the UK as seen with the current pay review debate: modestly paid lawyers are saying that they'd never be MPs because they can't afford the pay cut, while the 90-something percent of the population who earn under £60k think any discussion of a pay rise is disgraceful.
So, adopt the same approach as successive governments have applied for an increasing range of benefits and educational funding areas, and simply require any MP to declare their gross income annually. Start with a stipend of £80k per annum, reduce it pound for pound by the MP's level of employment, savings and investment income. Expenses are separate and not means-tested. The excess over the current salary is to allow MPs to contribute to a private money-purchase pension scheme, allowing the existing pension scheme to be closed.
Sounds fair enough... unless we want to go down the student finance route and means test their parents' income too...
I imagine that most letters to ministers get diverted by civil servants and they never get to see them. Plus, ministers usually say they "cannot comment on individual cases". I bet they have been told this by their civil servants. Actually, investigating individual cases is a good way to find out what is actually going on.
IME - particularly re scandals [in my direct experience at DoH re Baby P] - the ministers, Perm Sec and everyone with a serious pay grade was in on the discussions. We had them every other day when the crisis was in full throat.
There is no way that all the calls for a public inq were lost in the wash or 300+ letters filed without it ever being raised, it's not credible - the DoH were very defensive about their PR, if anything Alan Johnson was a more sensible voice than most of the civil servants who were desperate to shut everything down.
It is truly amazing that the Cheshire Farmer can state quite categorically what The SOS for Health is thinking ..an awesome talent..and its not even his opinion but stated as fact
We seem to be obsessing about one day's polling, with changes within the margin of error. If the margin of error for each party's vote share is up to 3% then I imagine the margin of error fro the lead is up to 6% (actually it's probably not quite that as the figures aren't independent of each other).
If we average the YouGov labour lead over the last week, using a 5-day rolling average, the average lead has been around 7% so actually - not much change.
Increasingly consultants are in the hospital when on call. I was in most of the weekend the other weekend, and that was despite having a fairly senior Trainee as first on call. I saw a lot of my consultant colleagues in other specialities about the place.
What a curious post - that in some hospitals you're 25% more likely to die than on a Wednesday afternoon tells me that there is a problem.
Changing consultants contracts would go some way - and of course junior doctors who work the weekends don't get to shadow anyone as their consultants aren't working.
It's a self-fulfilling cycle and one where a powerful block of staff demand more gold before being willing to do anything. Frankly, I'd be surprised if many consultants would work the weekends at all since its a perk not to do so.
Randomly citing another country with a total different healthcare system doesn't cut any ice with me.
Oh and I see The STimes has some appalling stats for weekend admissions. Why its ever been custom and practice for office hours to be done in the NHS is beyond me.
You do realise this phenomenon is also observed in other countries, including the United States? It is a real problem but not one that is unique to, or caused by, the NHS.
And let us hope for his sake, George Osborne is not -- on a Sunday! -- choking on his cornflakes at Sir Bruce's (and your?) call for a 20 per cent increase in the number of consultants.
John Sargeant on Sky made a reference to 'the wrong leg being amputated' I was so WTF? that I Googled it, here's the story from 2006. Is there more up to date Never Event data available anywhere?
"Horrifying medical blunders in which patients have had the wrong body part removed have soared in just two years, according to new figures. Incredibly the number of patients who have woken from surgery to find themselves victims of terrible blunders almost doubled last year. Meanwhile compensation payouts to victim have risen by more than 100 per cent to just over £1 million in the year 2005 to 2006 alone.
The soaring tally of errors is revealed in figures released under the Freedom of Information Act.
Among the clinical mishaps last year were eight incidents of the wrong disc being removed, five cases of the wrong leg being amputated and four cases of the wrong hip being taken.
It follows revelations of doctors removing the wrong testicle and a woman given a hysterectomy in error after a records mix up. Other mistakes include the wrong set of lungs being transplanted into a patient and a child who was mistakenly circumcised after doctors visited the wrong home.
Isabel Oakeshott @IsabelOakeshott 4m Fact is those 14 hospitals have been getting worse under the coalition, according to the official performance stats @DavidWooding
Thats what the leaking by Hunt is about, distracting from that fact which he knows the report will show.
Welcome aboard Wee-Timmy!
An ever-expanding and expensive NHS (England) model is doomed to failure. It's staff feel that they should be the beneficiaries and that the clients - those sickening patients - are a drain on resources. Given your known vested interests you should be campaigning for the end of the this monolithic monster, no?
The current NHS model may be fine for Wales and The Province: It may - just - be managable for Scotland (but I anticipate and East/West split come Engerlisch-independence 2016). It cannot work within a statist market of 54-million that is expected to support the value of individuals over cults (NHS, Mohammedian, Alex Ferguson, &c.)
Being a Sarf-Luhndahnah I remember when the Lambeth-Southwark-and-Lewisham 'Ealth Authourity was the largest within the nation: That was a market of around 750,000 patients. Times have changed: My London flat is built over the ruins of Hither Green Hospital (not lamented)....
Plato, any NHS discussion ultimately will help Labour. Because, the public in their hearts believe the Tories don't like the NHS> That is why Cameron has to use his personal experiences to reassure.
Simple question: how many Tory MP's have private health cover ?
Perhaps Labour posters would like to address the NHS stories rather than attempt to divert from them.
The monster won't go away because you don't look at it.
RT @PeterWatt123: The left is going to have to find a much better response to the series of NHS scandals than 'I love the NHS'
Will be a cold day in hell - Burnham coulld be caught on camera signing a order for more Zyklon B and the left would simply shout I love nurses and Danny Boyle.
I imagine what you say is correct about a scandal of the magnitude of Baby P, but what about if I write to the Minister complaining that my granny was treated poorly at Frimley Park Hospital? Would that land on the Minister's desk? Even if it did I guess it would be booted back down to a fairly junior official, I would get an anodyne response and it would never see the light of day.
Another problem, which you allude to, is the desperate need of ministers to have good PR and "defend their department". Which should NOT be their job. A minister is there to deliver public services. This should include auditing, investigating and putting the boot up their department when necessary.
Look at the recent problems with tagging contracts - discrepancies were raised 5 years ago but brushed under the carpet. This would have been the desire to show that Government policy was working.
Alan Clarke's diaries are instructive here. They show how the civil servants keep their minister on a fast treadmill of official engagements, appointments and reports. The minister is never allowed the time to take the initiative and start implementing policy. They are often simply too busy and become worn down.
Isabel Oakeshott tweets: "@GuidoFawkes my p2 story today reveals it was civil servants who urged a cover up. Burnham overruled them. He's a very unlikely villain."
Isabel Oakeshott @IsabelOakeshott 4m Fact is those 14 hospitals have been getting worse under the coalition, according to the official performance stats @DavidWooding
Thats what the leaking by Hunt is about, distracting from that fact which he knows the report will show.
"Boris shelves airport plan Boris Johnson has backed down from plans for a Thames estuary airport, admitting that it would be too far from central London.
Instead the Mayor of London is backing a plan from architect Lord Foster for a new hub on the Isle of Grain in north Kent.
Speaking to the Sunday Times, Mr Johnson claims a four-runway airport could make London the "global capital" of aviation."
Well I guess he's halfway there. Now someone just needs to tell him that the Isle of Grain is on the wrong side of London and maybe he'll shut up about it.
Isn't the idea to develop a European hub? The Isle of Grain is on the right side of London for that, it's just on the wrong side of the North Sea.
The economist who produced the report on alternative sites for a 3rd and 4th runway at Heathrow used to be an occasional poster here. How long before Labour's u-u-turn to take up his proposals?
John Sargeant on Sky made a reference to 'the wrong leg being amputated' I was so WTF? that I Googled it, here's the story from 2006. Is there more up to date Never Event data available anywhere?
Again, this problem is not unique to the NHS but is universal. It is one reason the WHO recommends worldwide use of checklists at the start of operations. Here, the impetus came from Lord Darzi (from Wikipedia: On 29 June 2007 Darzi was appointed Parliamentary Under-Secretary of State in the House of Lords at the Department of Health by the Prime Minister, Gordon Brown). There is a well-written, non-technical account in the book, The Checklist Manifesto, by the American surgeon Atul Gawande.
A rare enough Lib Dem who should get a good swing to her at the next GE!
Indeed Neil, she seems keen to highlight green issues.
"To promote the wonderful environment of Montgomeryshire – this is a wonderful area, and it is a special place to live and work. Jane will work to make sure our environment is looked after, and that we have cleaner, greener and safer communities."
Certainly in my Trust area - consultants are almost entirely absent on the weekend. If you're admitted after 2pm on a Friday - you're there until at least noon on Monday.
I've been on the Medical Assessment Unit many times as an emergency admission [I fell into the House category of unexplained illness] surrounded by every other sort of patient. I've waited 3 days for a consult from a heart, endocrin, or neuro specialist. If a condition wasn't pretty clear - we were in there for the duration all wondering if we'd been forgotten about. It's insane.
Bar the on-call consultant who had a bash at everything - there were only junior docs and nurses who did virtually nothing but fire-fight.
Increasingly consultants are in the hospital when on call. I was in most of the weekend the other weekend, and that was despite having a fairly senior Trainee as first on call. I saw a lot of my consultant colleagues in other specialities about the place.
Do the advanced leaks show that Lansley and Hunt have been directly causing problems? Have they been standing in as thoracic surgeons, perhaps?
There will always be problems in public services. What is important is that the Government identifies them, publicises them and deals with them. But all we get is finger pointing "ner ner ner ner there's been a problem and you're in charge". That leads to cover-up, and conniving at poor performance. Which in the NHS means patient deaths. We need a more open system of government where problems are flushed out and dealt with.
If a group of Joe Public could covertly watch a DoH daily press briefing, I'm sure they'd be gobsmacked. Ditto every public body I've ever worked at. It's a constant fight to spot the next horror coming at you and trying to find a credible way to explain it away, make it sound routine or rubbish it.
Very rarely do issues get an honest response which is what the people in the meeting really think about it. Usually accompanied by a lot of swearing and disbelief.
For a story to get an honest response - it has to be so bad that no one can speak or come up with a pat answer. In those circumstances - it takes a special talent like Sharon Shoesmith to get it wrong.
@taffys Re AJ - the staff loved him, he was house-trained within weeks of becoming SoS at DoH.
I imagine what you say is correct about a scandal of the magnitude of Baby P, but what about if I write to the Minister complaining that my granny was treated poorly at Frimley Park Hospital? Would that land on the Minister's desk? Even if it did I guess it would be booted back down to a fairly junior official, I would get an anodyne response and it would never see the light of day.
Another problem, which you allude to, is the desperate need of ministers to have good PR and "defend their department". Which should NOT be their job. A minister is there to deliver public services. This should include auditing, investigating and putting the boot up their department when necessary.
Look at the recent problems with tagging contracts - discrepancies were raised 5 years ago but brushed under the carpet. This would have been the desire to show that Government policy was working.
An ever-expanding and expensive NHS (England) model is doomed to failure.
Expensive and yet still cheaper than healthcare systems in the United States (obviously) but also France, Germany and pretty much everywhere else the doom-mongers look for inspiration.
Increasingly consultants are in the hospital when on call. I was in most of the weekend the other weekend, and that was despite having a fairly senior Trainee as first on call. I saw a lot of my consultant colleagues in other specialities about the place.
Weekend admissions are different in many ways.
Yes, differences in patients admitted at weekends may be a large factor.
Isn't the idea to develop a European hub? The Isle of Grain is on the right side of London for that, it's just on the wrong side of the North Sea.
Gaijin,
Come-home! City, Stansted and Gatwick cover that. Then you have the hell-holes in Brum, Manckie-land and John-Lennon.
What London needs is an East-Asia hub. Sadly I doubt that the Isle-of-Grain will be suitable (City Airport corridors and what-not); A six-lane Heathrow (over reserviors) will be a patch-job....
The Houses of Charliement (So that's why they need the pay rise)
EVIDENCE of widespread drug use inside the Houses of Parliament is exposed by The Sun today.
Undercover reporters found traces of cocaine in NINE different toilets in the historic palace where our laws are made.
They included cubicles just yards from MPs’ offices — in areas where public visitors have no access.
Traces of the Class A drug were also found in toilets shared with guests enjoying receptions at Parliament’s riverside bars.
The findings suggest the drug is regularly being snorted at both the Commons and the Lords — with users defying airport-style security checks and a 500-strong team of cops and security officers.
The revelations come just days after watchdogs sparked outrage by recommending MPs receive a whopping £7,500 or 11 per cent pay rise, taking salaries to £74,000 a year.
All of Parliament’s toilets are cleaned on a regular basis, suggesting the white powder had been snorted in the past few hours.
Our undercover team wiped cocaine indicator swabs against toilet seats, loo roll holders and hand dryers in dozens of locations.
Expensive and yet still cheaper than healthcare systems in the United States (obviously) but also France, Germany and pretty much everywhere else the doom-mongers look for inspiration.
Dec':
None of them are state-owned/run. None of them will give EU citizens free-access to more than basic-services (if that). None of them will badge themselves as "The World's (especially for Barry's randy father's other ex-wives [Islam branch]) Health Service". None of them would be stupid enough to fund a lawyers'-charter of 'Umans'-Rijtz' (c.f. Labour's internal machinations).
Apart from that; Yes you are correct! It's the....
What a curious post - that in some hospitals you're 25% more likely to die than on a Wednesday afternoon tells me that there is a problem.
Randomly citing another country with a total different healthcare system doesn't cut any ice with me.
What is curious is your unwillingness to acknowledge this is a worldwide phenomenon and not one confined to the NHS. As Dr foxinsoxuk points out, nor can it be explained solely in terms of staffing arrangements. There are differences in patients too.
Of course, if it turns out you are not a humble seeker after truth but just another pb Tory shill, it is easier to understand why your extensive Google searches find examples only from Britain.
So in the spirit of your complaint, why don't you cite countries where there is no higher weekend mortality, and no medical or surgical errors? There must be lots to choose from: all of the rest of the world, in fact, if you are right and only the NHS is to blame.
Specialists all have their niche expertise. The role of the Medical admissions unit is more generalist and it sounds as if you were seen and the condition stabilised by the generalist before review by the sub specialist the following week. Sounds pretty reasonable to me. No sub specialist sould be expected to never have a weekend off.
There is always a tension between providing services locally, and thereby by generalists, and centralised mega hospitals miles away with all subspecialities on site.
It is noticeable that these underperforming hospitals are smaller DGHs though. But if you suggest closing Pilgrim Hospital in Boston and Grantham hospital and centralising services on one site for Lincolnshire you will get a lot of opposition.
Certainly in my Trust area - consultants are almost entirely absent on the weekend. If you're admitted after 2pm on a Friday - you're there until at least noon on Monday.
I've been on the Medical Assessment Unit many times as an emergency admission [I fell into the House category of unexplained illness] surrounded by every other sort of patient. I've waited 3 days for a consult from a heart, endocrin, or neuro specialist. If a condition wasn't pretty clear - we were in there for the duration all wondering if we'd been forgotten about. It's insane.
Bar the on-call consultant who had a bash at everything - there were only junior docs and nurses who did virtually nothing but fire-fight.
Increasingly consultants are in the hospital when on call. I was in most of the weekend the other weekend, and that was despite having a fairly senior Trainee as first on call. I saw a lot of my consultant colleagues in other specialities about the place.
Camilla Cavendish has been tasked with reporting on what needs to be changed to improve NHS care - this is worth reading in full
"Three years ago an Oxford University study claimed that healthcare assistants were doing twice as much direct patient care on the wards as registered nurses. This was never the intention when the old state enrolled nurse grade was abolished. It is partly a consequence of the diabolical growth in back-covering, box-ticking paperwork that is taking nurses away from the front line. Nor was it ever envisaged that some healthcare assistants would end up carrying out — as we discovered — invasive procedures such as inserting catheters and drips or taking blood. These are things that used to be the preserve of nurses, even doctors...
The most junior staff can be the vital link in the safety chain. This is something the airlines figured out long ago... Many of those errors were caused by failures of communication and teamwork... This approach is now standard for airlines. But not in the NHS. Individuals are blamed for mistakes but clinical teams are rarely held accountable. Many healthcare assistants are excluded from debriefings. Nurses and healthcare assistants are not trained together, despite needing to know the same fundamentals. Which is why one of my review’s recommendations is that they train together for a new Certificate of Fundamental Care.
It is striking that organisations that accept the importance of junior staff also place much more emphasis on recruiting people with the right attitudes. You can train people to be competent, I have been told again and again, but you can’t teach them to be caring..." http://www.thesundaytimes.co.uk/sto/comment/columns/CamillaCavendish/article1286962.ece
I guess there is a difference in patients - only the more serious/urgent cases will be hospitalised over the weekend or overnight, the rest will wait to see our doctor during normal business hours, or will be planned admissions.
But are there countries with smaller differences in weekend mortality rates and, if so, how do they do it? Your response implies there is no problem, we shouldn't investigate it and shouldn't try to mitigate it.
Not quite right to say that politics winds down. *Westminster press led politics* winds down. Summer is a hugely important part of ground game politics. Any decent MP should be out campaigning every single day bar a two week holiday.
"Nor was it ever envisaged that some healthcare assistants would end up carrying out — as we discovered — invasive procedures such as inserting catheters and drips or taking blood. These are things that used to be the preserve of nurses, even doctors..."
That's crap. Not sure about catheters and drips, but taking blood used to be the preserve of staff called Phlebotomists. They were low grade staff, but very well trained in a small range of procedures which they did every day. You really don't want your consultant taking your blood, if he's a physician he probably hardly ever does it.
But are there countries with smaller differences in weekend mortality rates and, if so, how do they do it? Your response implies there is no problem, we shouldn't investigate it and shouldn't try to mitigate it.
Earlier in this thread, I described it as "a real problem" but not one confined to these shores. Of course we should investigate and, where possible, mitigate.
To a certain extent the underperforming trusts are affected by smaller numbers. It is a statistical phenomenon that should be familiar to those who study the entrails of political polls on here concerning sample size and subsamples. In the Doctor Foster SMR tables the bigger hospitals are much closer to the average.
There are some smaller DGHs with good figures, and if we want to know what to put right it would be worth looking at these.
There are also a lot of chickens coming home to roost over the expansion of medical schools, the lack of teaching of anatomy, pathophysiology and pharmacology in favour of softer subjects, and the disatrous changes in postgraduate training in 2005-6.
Some of my colleagues strongly prefer working with overseas trained doctors as they have had more rigorous scientific training than our local graduates. It is a similar phenomenon of dumbing down that has affected secondary and university education in the UK.
What a curious post - that in some hospitals you're 25% more likely to die than on a Wednesday afternoon tells me that there is a problem..
Randomly citing another country with a total different healthcare system doesn't cut any ice with me.
What is curious is your unwillingness to acknowledge this is a worldwide phenomenon and not one confined to the NHS. As Dr foxinsoxuk points out, nor can it be explained solely in terms of staffing arrangements. There are differences in patients too.
Of course, if it turns out you are not a humble seeker after truth but just another pb Tory shill, it is easier to understand why your extensive Google searches find examples only from Britain.
So in the spirit of your complaint, why don't you cite countries where there is no higher weekend mortality, and no medical or surgical errors? There must be lots to choose from: all of the rest of the world, in fact, if you are right and only the NHS is to blame.
During one of my stints in my local DGH, I asked a junior doctor what made me vomit uncontrollably at a physiological level, what nerve caused it - he had no idea.
Is it one of those unknowns? I assumed it'd be well known as its a common symptom that drugs have found a way of halting.
To a certain extent the underperforming trusts are affected by smaller numbers. It is a statistical phenomenon that should be familiar to those who study the entrails of political polls on here concerning sample size and subsamples. In the Doctor Foster SMR tables the bigger hospitals are much closer to the average.
There are some smaller DGHs with good figures, and if we want to know what to put right it would be worth looking at these.
There are also a lot of chickens coming home to roost over the expansion of medical schools, the lack of teaching of anatomy, pathophysiology and pharmacology in favour of softer subjects, and the disatrous changes in postgraduate training in 2005-6.
Some of my colleagues strongly prefer working with overseas trained doctors as they have had more rigorous scientific training than our local graduates. It is a similar phenomenon of dumbing down that has affected secondary and university education in the UK.
What a curious post - that in some hospitals you're 25% more likely to die than on a Wednesday afternoon tells me that there is a problem..
Randomly citing another country with a total different healthcare system doesn't cut any ice with me.
What is curious is your unwillingness to acknowledge this is a worldwide phenomenon and not one confined to the NHS. As Dr foxinsoxuk points out, nor can it be explained solely in terms of staffing arrangements. There are differences in patients too.
Of course, if it turns out you are not a humble seeker after truth but just another pb Tory shill, it is easier to understand why your extensive Google searches find examples only from Britain.
So in the spirit of your complaint, why don't you cite countries where there is no higher weekend mortality, and no medical or surgical errors? There must be lots to choose from: all of the rest of the world, in fact, if you are right and only the NHS is to blame.
I have checked out the unweighted polling numbers. I can reassure Plato and Charles that all Tories have not decamped to the beaches !
Fair enough. I take it that's a Labour increase rather than a Tory decline in CtV? The union story? Can't think of anything else major?
To be fair, it's not really much of anything. YouGov polls do tend to jump around. Perhaps the safest conclusion is that there may be a slight tendency to a slight fall in the Labour lead from the start of the year, but that recent events have not had too much of an effect on voting intentions. Labour's current range looks to be 35% to 40%; whereas previously it may have been 35% to 42%. I'd argue that the lower figure is the most significant. Should we get a few polls that show Labour dropping below 35%, that will be noteworthy.
Agree - from all the polls over the weekend, two things stand out for me - UKIP hasn't fizzled, and the LibDems are still at the bottom of a very deep hole - and if a lot can change in 6 months (UKIP), even more can change in 22....
Agreed - curiously, one can trust polls better if they don't show a big shift in secondaries but just in voting inteniton, since that suggests a change in opinion in a similar sample. My guess is that Labour's lead remains at around 8. That said, it's been pretty stable for a long time now, and the months are ticking away.
It's not strictly true that we need more 11 leads to balance previous 5 leads if the "true" figure is 8 - random sampling doesn't work like that, going out of its way to even out past samples. What is true is that there should be equal numbers of 5s and 11s going forward.
"NHS England, in a report last month, calculated that at least 4,400 lives could be saved each year if weekend death rates were the same as those on weekdays. Another report, from the College of Emergency Medicine, found that a fifth of accident and emergency units rely entirely on junior doctors at evenings and weekends...
... Fortunately, a seven-day NHS need not cost a penny more. Indeed, in the right circumstances it could save money. Sir Bruce points out, correctly, that the current system means that for two days a week expensive and sophisticated equipment lies idle and outpatients’ departments are unused. When inexperienced staff take decisions, including those which involve patients occupying hospital beds for longer than they need to, it costs money. The absence of weekend care, apart from the safety aspect, also results in lost days at work for those needing minor treatments or routine appointments.
These are not theoretical claims. As Camilla Cavendish writes today, they are being proved by the Salford Royal NHS Foundation Trust. It set itself the target of reducing its higher death rate at weekends, with the aim of providing safe care “whatever the hour of the day or the day of the week”. It worked. The weekend death rate has dropped from 84% to 79% of the national average and so, importantly, have the urgent care costs, down by £4.5m. Salford and other trusts are showing it can be done. It is time the rest of the NHS did it, too..."
Camilla Cavendish has been tasked with reporting on what needs to be changed to improve NHS care - this is worth reading in full
This illustrates what is wrong with public services and no doubt large swathes of the UK private sector as well.
A well-intentioned individual, with or without a small committee, looks at an area outwith their own expertise and writes a report, at whose validity we can only guess in the absence of any real evidence beyond the odd, illustrative anecdote ("I was repeatedly told ..."). Perhaps decades ago, this was inevitable but in the 21st Century it should be unacceptable.
Cavendish, like many, deplores box-ticking. You know what box-ticking leads to? It leads to a metric shit-ton of data. We have data, we have statisticians, we have computers. Do we use these tools to analyse what goes wrong, which factors improve outcomes?
No, we appoint a journalist who just happens to have studied PPE at Brasenose at roughly the same time David Cameron studied PPE at Brasenose. What are the chances?
What a pity that you chose to make an ad hom attack on Ms Cavendish who has become a non-exec dir of the CQC because of her expertise gained through her work as a journalist.
Camilla Cavendish has been tasked with reporting on what needs to be changed to improve NHS care - this is worth reading in full
This illustrates what is wrong with public services and no doubt large swathes of the UK private sector as well.
A well-intentioned individual, with or without a small committee, looks at an area outwith their own expertise and writes a report, at whose validity we can only guess in the absence of any real evidence beyond the odd, illustrative anecdote ("I was repeatedly told ..."). Perhaps decades ago, this was inevitable but in the 21st Century it should be unacceptable.
Cavendish, like many, deplores box-ticking. You know what box-ticking leads to? It leads to a metric shit-ton of data. We have data, we have statisticians, we have computers. Do we use these tools to analyse what goes wrong, which factors improve outcomes?
No, we appoint a journalist who just happens to have studied PPE at Brasenose at roughly the same time David Cameron studied PPE at Brasenose. What are the chances?
During one of my stints in my local DGH, I asked a junior doctor what made me vomit uncontrollably at a physiological level, what nerve caused it - he had no idea.
Is it one of those unknowns? I assumed it'd be well known
A leading neurosurgeon of my very vague acquaintance appeared on daytime television to talk about a new surgical technique. There may have been some light-hearted ribbing back at the hospital after he appeared to know less about one particular function of the vagus nerve than his inquisitor, Richard Madeley.
During one of my stints in my local DGH, I asked a junior doctor what made me vomit uncontrollably at a physiological level, what nerve caused it - he had no idea.
Is it one of those unknowns? I assumed it'd be well known
A leading neurosurgeon of my very vague acquaintance appeared on daytime television to talk about a new surgical technique. There may have been some light-hearted ribbing back at the hospital after he appeared to know less about one particular function of the vagus nerve than his inquisitor, Richard Madeley.
I suggested the vagus nerve to my junior doc - he looked at me quizzically and said he had no idea. I made an educated guess at it whilst prone and being sick every 30secs. He was very handsome though :^ )
Going completely off topic - I have been thinking about RWC in 2015, and strongly suggest putting some money on Wales for the final. Firstly Wales are drawn in same group as England and Australia. Having destroyed England in 6N earlier this year and a Welsh dominated Lions team stuffing the Ozzies, Wales have strong chance of topping the group if they can maintain their form. The group winners would probably face Scotland or Samoa in QF then France or Argentina in SF. Must be worth a few quid - any bookies taking bets yet?
Just watching Ed Davey being hard pressed by Mr Neil - he seems to be willing to accept that others don't agree with him and global warming, but only if you actually agree with 99% of what he thinks is happening.
Can those who are a vested interest - directly, retired or via a relationship - "wiv' dah' En' Haitch' Ess" - please articulate prior to posting? It would be a shame if they had to be shamed into demonstrating which and why they argue against decency and logic....*
Chahs,
* Ofcourse Wee-Timmy and DJL could STFU: Which path will they choose...?
There are also a lot of chickens coming home to roost over the expansion of medical schools, the lack of teaching of anatomy, pathophysiology and pharmacology in favour of softer subjects, and the disatrous changes in postgraduate training in 2005-6.
Some of my colleagues strongly prefer working with overseas trained doctors as they have had more rigorous scientific training than our local graduates.
There was recently an article in Forbes Magazine (aimed at American captains of industry and billionaires -- not a group noted for their left-wing leanings) deploring the increasing use of patient satisfaction surveys in hospitals, since it was becoming apparent these were inversely correlated with outcomes.
Patients, and politicians, might want Dr Finlay but perhaps they need Sir Lancelot Spratt.
Can those who are a vested interest - directly, retired or via a relationship - "wiv' dah' En' Haitch' Ess" - please articulate prior to posting? It would be a shame if they had to be shamed into demonstrating which and why they argue against decency and logic....*
Chahs,
* Ofcourse Wee-Timmy and DJL could STFU: Which path will they choose...?
Well, I've worked all my life in the private sector and am not related to any doctors, nurses, or any other health professionals. And I think you will find, if you look very closely at this thread and others, it is generally those who defend the NHS who are calling for proper data collection and analysis and, in your words, decency and logic.
Comments
"It's not just J K Rowling. For over a decade Will Self has been writing crime novels using the pseudonym Dan Brown."
Not sure who should be more upset - Will Self or Dan Brown!
"I'd wait and see how last years "3,500 excess deaths" are calculated before asking Lansley and Hunt to confess if I were you."
There's something rather grotesque about a Minister leaking this report to the Mail Telegraph and Sunday Times if indeed that is what's happened. !3,000 deaths isn't something you leak to newspapers.
Sad to say my dear old Rog you appear to be falling into the trap of those who disparage my ARSE because they don't like the news.
This sad condition has had many deluded patients over the years who in the end only find salvation and robust recovered political health by recanting on their dire and desperate folly in failing to be in awe of my most wonderful organ.
Fluffy , you should advise them to get a life , sounds like two sad tefal heads. What does it matter , just throw another server on the barbie , they are as cheap as chips. It is all down to storage in any case and will be how you float your cloud.
That makes more sense then the after-thought I had.* So it is like forcing water though a pipe; drivers along the M25: More due to Newtonian resistence then pure Einstein (I think)...?
* I sort-of-wondered if it was due to the chemical-electrical interface between the gates. I stopped studying physics in 1984; a move I now much regret...!
Put it this way in my 30 years the patient safety issues have never been worse than now.
Of course in 1996 waiting lists and times were killing millions before they could afford to be seen.
Massive investment and improvements followed for the next decade and a half. At that point patient satisfaction was highest ever.
The newspapers that hate the NHS always have just now being orchestrated by their political chums
37% of people now think Miliband is too close to the Unions, up from 29% last week. His figures on being a strong leader are slightly more positive than a week ago, but not by much - he is still seen as a weak leader by 46% of people, a strong leader by only 12%.
However, there is a more positive reaction to his actual proposals. , and people think he is right to try and reduce Labour's links to the unions by 44% to 13% (22% think he is not actually trying to reduce links at all). People are evenly split over whether the changes actually will reduce the Unions' influence over Labour - 35% think they will, 33% think they won't, 33% don't know.
62% of people agree that MPs should be working full time on their main jobs, and that second jobs risk corruption or conflicts of interest. In comparison, 21% think that MPs doing second jobs keeps them in touch with ordinary people and is better than just having full-time politicians. 56% would support a ban on MPs having second jobs.
What it also shows is how poor the Department of Health is at collecting information. Most of these SMR figures have been on the Dr Foster website for years, and the CQC still rated Basildon and Thurrock good over this period!
The hospitals named do not surprise me. The medical bush telegraph knows which hospitals have supportive management and which are dysfunctional. Hospitals that medical staff do not want to work in go into a spiral of decline that is not easy to reverse.
I would not think private medical insurance an adequate remedy. There are no private hospitals that operate emergency departments for you to flash your cash at. When that apolexy strikes we are at the mercy of the Emergency dept at the local NHS hospital.
Is the NHS better or worse under the coalition? To be honest I think it no different. The Lansley reforms only started 3 months ago, and do not appear to alter much, other than create confusion.
http://www.bbc.co.uk/news/uk-england-manchester-23304526
It's inevitable but true that very few will choose to work for an organisation that has a reputation for bullying, ignoring problems, terrible morale and HMG inspectors all over it like a rash.
And let us hope for his sake, George Osborne is not -- on a Sunday! -- choking on his cornflakes at Sir Bruce's (and your?) call for a 20 per cent increase in the number of consultants.
"LABOUR is drawing up a “scroungers’ charter” that could make state benefits a human right."
Read more: http://www.thesun.co.uk/sol/homepage/news/politics/5012493/Labour-drawing-up-plans-to-make-benefits-a-human-right.html#ixzz2Z0cn6rXy
I would be more convinced if he piled his money on a Conservative majority at 4/1 or even Conservative as largest party and showed us the betting slip.
Rather than stick his finger in the air guessing or alternatively up his ARSE.
"People who work in tne NHS know which party improves the NHS and which party pretends not to hate it.
Put it this way in my 30 years the patient safety issues have never been worse than now.
Of course in 1996 waiting lists and times were killing millions before they could afford to be seen.
Massive investment and improvements followed for the next decade and a half. At that point patient satisfaction was highest ever."
I'm sure that's right and with the NHS my guess the reason these stories pass people by is because so many of us use and have family who use the service regularly that our own experiences are really all we make judgements on. Anyone who thinks hospitals were better pre '97 than post weren't using the service
Changing consultants contracts would go some way - and of course junior doctors who work the weekends don't get to shadow anyone as their consultants aren't working.
It's a self-fulfilling cycle and one where a powerful block of staff demand more gold before being willing to do anything. Frankly, I'd be surprised if many consultants would work the weekends at all since its a perk not to do so.
Randomly citing another country with a total different healthcare system doesn't cut any ice with me.
http://www.dailymail.co.uk/news/article-2031543/UK-government-spending-Scots-1-600-year-spent-English.html
malcolmg ; liar , fool or both ?
Ex Labour healthsec Andy Burnham insists he received no warning about Morecambe Bay hospital - despite 386 letters to ministers. #murnaghan
Why did he accept a Shadow DH job? This is an accident waiting to happen. Surely he can't keep this post in the run up to the GE2015
David Wooding @DavidWooding
Andy Burnham says he's "fed up" with general accusations being hurled in his directions over shoddy hospitals on his watch. #murnaghan
He's lost it completely on Sky - he's getting really stroppy.
David Wooding @DavidWooding
I haven't seen Andy Burnham quite so rattled before. He's usually very cool. #Murnaghan
The best period was probably 1997 -9 when the internal market was in reverse, spending stable and we had Dobson as Health Sec. Almost immediately after Milburn took over with his Blairite target agenda and vast expansion of privatisation things started to get worse, with a "lick up and kick down" management, the introduction of Commissioning once more. Things got worse under the evil witch Hewitt and were only marginally better under Burnham.
It is not a question of public or private provision being better. If you set targets then either will meet them rather than other aspects of provision. Either you wind up with targets for everything and a stalinist central direction, or you go back to the older system of negotiating locally about priorities with a re invented local health authority.
There have been as many steps backwards as forwards over the years and little to show for the money spent under either government.
If the separatists argument is "give Edinburgh the power to run things better than Westminster" surely the logical corollary is that things Edinburgh has run worse than Westminster should be returned to Westminster?
Or is it only a one way street?
"Since devolution life expectancy has risen faster in England than it has in Scotland."
And are you saying that's because of devolution or is it just a ghoulish non-sequitur?
But for the avoidance of doubt the latest 2015 GE ARSE projection, to be superseded tomorrow, is for a hung parliament with the Conservatives as largest party.
I imagine that most letters to ministers get diverted by civil servants and they never get to see them. Plus, ministers usually say they "cannot comment on individual cases". I bet they have been told this by their civil servants. Actually, investigating individual cases is a good way to find out what is actually going on.
I do not think most people hold this view against front line emergency workers in the public sector.
However within the Police NHS Fire service there is some terrible sickness levels and for example police retiring at 48 does seem generous to other workers not in the public sector.
But the English and Scottish Health Services have adopted different approaches so there should be plenty to learn from - on both sides, as life expectancy is itself a very crude measure.
That data-wrapper graph purports to show a data-series. For obvious reasons June 30th is not present.
If you wish to support bi-daily information then at least show the break in data-collection. I still maintain that a weekday-to-weekday analysis will be more informative (but this site will need to collate such data reliably first)....
Grade: C.
Burnham should never have taken on Sh HSec - it happened on Labour's watch and he was the last one carrying the ball, or in this case a hospital pass. Trying to say it was nothing to do with him and getting all stroppy is missing the point.
As far as I can see, there are two aims with MPs' pay: to prevent it being such a lucrative career job that people are motivated to seek office for the financial benefits, whilst preventing it from being so poorly paid that only those with independent wealth are able to afford to serve. It's a difficult balance to strike because of the extreme polarisation of income and wealth distribution in the UK as seen with the current pay review debate: modestly paid lawyers are saying that they'd never be MPs because they can't afford the pay cut, while the 90-something percent of the population who earn under £60k think any discussion of a pay rise is disgraceful.
So, adopt the same approach as successive governments have applied for an increasing range of benefits and educational funding areas, and simply require any MP to declare their gross income annually. Start with a stipend of £80k per annum, reduce it pound for pound by the MP's level of employment, savings and investment income. Expenses are separate and not means-tested. The excess over the current salary is to allow MPs to contribute to a private money-purchase pension scheme, allowing the existing pension scheme to be closed.
Sounds fair enough... unless we want to go down the student finance route and means test their parents' income too...
There is no way that all the calls for a public inq were lost in the wash or 300+ letters filed without it ever being raised, it's not credible - the DoH were very defensive about their PR, if anything Alan Johnson was a more sensible voice than most of the civil servants who were desperate to shut everything down.
If we average the YouGov labour lead over the last week, using a 5-day rolling average, the average lead has been around 7% so actually - not much change.
http://www.bmj.com/content/344/bmj.e67?tab=responses
Increasingly consultants are in the hospital when on call. I was in most of the weekend the other weekend, and that was despite having a fairly senior Trainee as first on call. I saw a lot of my consultant colleagues in other specialities about the place.
Weekend admissions are different in many ways.
"Horrifying medical blunders in which patients have had the wrong body part removed have soared in just two years, according to new figures. Incredibly the number of patients who have woken from surgery to find themselves victims of terrible blunders almost doubled last year. Meanwhile compensation payouts to victim have risen by more than 100 per cent to just over £1 million in the year 2005 to 2006 alone.
The soaring tally of errors is revealed in figures released under the Freedom of Information Act.
Among the clinical mishaps last year were eight incidents of the wrong disc being removed, five cases of the wrong leg being amputated and four cases of the wrong hip being taken.
It follows revelations of doctors removing the wrong testicle and a woman given a hysterectomy in error after a records mix up. Other mistakes include the wrong set of lungs being transplanted into a patient and a child who was mistakenly circumcised after doctors visited the wrong home.
Read more: http://www.dailymail.co.uk/news/article-408163/Doctors-removed-40-body-parts-wrongly-say-official-figures.html#ixzz2Z0jJIPea
An ever-expanding and expensive NHS (England) model is doomed to failure. It's staff feel that they should be the beneficiaries and that the clients - those sickening patients - are a drain on resources. Given your known vested interests you should be campaigning for the end of the this monolithic monster, no?
The current NHS model may be fine for Wales and The Province: It may - just - be managable for Scotland (but I anticipate and East/West split come Engerlisch-independence 2016). It cannot work within a statist market of 54-million that is expected to support the value of individuals over cults (NHS, Mohammedian, Alex Ferguson, &c.)
Being a Sarf-Luhndahnah I remember when the Lambeth-Southwark-and-Lewisham 'Ealth Authourity was the largest within the nation: That was a market of around 750,000 patients. Times have changed: My London flat is built over the ruins of Hither Green Hospital (not lamented)....
http://www.janedodds.co.uk/
nhs problems -> nhs sucks
instead of
nhs problems -> labour sucks.
They will never apologise for anything ever.
I imagine what you say is correct about a scandal of the magnitude of Baby P, but what about if I write to the Minister complaining that my granny was treated poorly at Frimley Park Hospital? Would that land on the Minister's desk? Even if it did I guess it would be booted back down to a fairly junior official, I would get an anodyne response and it would never see the light of day.
Another problem, which you allude to, is the desperate need of ministers to have good PR and "defend their department". Which should NOT be their job. A minister is there to deliver public services. This should include auditing, investigating and putting the boot up their department when necessary.
Look at the recent problems with tagging contracts - discrepancies were raised 5 years ago but brushed under the carpet. This would have been the desire to show that Government policy was working.
Alan Clarke's diaries are instructive here. They show how the civil servants keep their minister on a fast treadmill of official engagements, appointments and reports. The minister is never allowed the time to take the initiative and start implementing policy. They are often simply too busy and become worn down.
A rare enough Lib Dem who should get a good swing to her at the next GE!
"The wrong side of London" in what way? Surely it simply depends on where the dedicated transport links take you.
The economist who produced the report on alternative sites for a 3rd and 4th runway at Heathrow used to be an occasional poster here. How long before Labour's u-u-turn to take up his proposals?
"To promote the wonderful environment of Montgomeryshire – this is a wonderful area, and it is a special place to live and work. Jane will work to make sure our environment is looked after, and that we have cleaner, greener and safer communities."
You must be shocked.
I've been on the Medical Assessment Unit many times as an emergency admission [I fell into the House category of unexplained illness] surrounded by every other sort of patient. I've waited 3 days for a consult from a heart, endocrin, or neuro specialist. If a condition wasn't pretty clear - we were in there for the duration all wondering if we'd been forgotten about. It's insane.
Bar the on-call consultant who had a bash at everything - there were only junior docs and nurses who did virtually nothing but fire-fight.
Do the advanced leaks show that Lansley and Hunt have been directly causing problems? Have they been standing in as thoracic surgeons, perhaps?
There will always be problems in public services. What is important is that the Government identifies them, publicises them and deals with them. But all we get is finger pointing "ner ner ner ner there's been a problem and you're in charge". That leads to cover-up, and conniving at poor performance. Which in the NHS means patient deaths. We need a more open system of government where problems are flushed out and dealt with.
Very rarely do issues get an honest response which is what the people in the meeting really think about it. Usually accompanied by a lot of swearing and disbelief.
For a story to get an honest response - it has to be so bad that no one can speak or come up with a pat answer. In those circumstances - it takes a special talent like Sharon Shoesmith to get it wrong.
@taffys Re AJ - the staff loved him, he was house-trained within weeks of becoming SoS at DoH.
http://www.youtube.com/watch?v=W8a72e7KoFQ
Come-home! City, Stansted and Gatwick cover that. Then you have the hell-holes in Brum, Manckie-land and John-Lennon.
What London needs is an East-Asia hub. Sadly I doubt that the Isle-of-Grain will be suitable (City Airport corridors and what-not); A six-lane Heathrow (over reserviors) will be a patch-job....
Not unless it involves copious yellow data tables.
None of them are state-owned/run. None of them will give EU citizens free-access to more than basic-services (if that). None of them will badge themselves as "The World's (especially for Barry's randy father's other ex-wives [Islam branch]) Health Service". None of them would be stupid enough to fund a lawyers'-charter of 'Umans'-Rijtz' (c.f. Labour's internal machinations).
Apart from that; Yes you are correct! It's the....
http://www.youtube.com/watch?v=9THwnQg-vEw
Of course, if it turns out you are not a humble seeker after truth but just another pb Tory shill, it is easier to understand why your extensive Google searches find examples only from Britain.
So in the spirit of your complaint, why don't you cite countries where there is no higher weekend mortality, and no medical or surgical errors? There must be lots to choose from: all of the rest of the world, in fact, if you are right and only the NHS is to blame.
There is always a tension between providing services locally, and thereby by generalists, and centralised mega hospitals miles away with all subspecialities on site.
It is noticeable that these underperforming hospitals are smaller DGHs though. But if you suggest closing Pilgrim Hospital in Boston and Grantham hospital and centralising services on one site for Lincolnshire you will get a lot of opposition.
"Three years ago an Oxford University study claimed that healthcare assistants were doing twice as much direct patient care on the wards as registered nurses. This was never the intention when the old state enrolled nurse grade was abolished. It is partly a consequence of the diabolical growth in back-covering, box-ticking paperwork that is taking nurses away from the front line. Nor was it ever envisaged that some healthcare assistants would end up carrying out — as we discovered — invasive procedures such as inserting catheters and drips or taking blood. These are things that used to be the preserve of nurses, even doctors...
The most junior staff can be the vital link in the safety chain. This is something the airlines figured out long ago... Many of those errors were caused by failures of communication and teamwork... This approach is now standard for airlines. But not in the NHS. Individuals are blamed for mistakes but clinical teams are rarely held accountable. Many healthcare assistants are excluded from debriefings. Nurses and healthcare assistants are not trained together, despite needing to know the same fundamentals. Which is why one of my review’s recommendations is that they train together for a new Certificate of Fundamental Care.
It is striking that organisations that accept the importance of junior staff also place much more emphasis on recruiting people with the right attitudes. You can train people to be competent, I have been told again and again, but you can’t teach them to be caring..." http://www.thesundaytimes.co.uk/sto/comment/columns/CamillaCavendish/article1286962.ece
I guess there is a difference in patients - only the more serious/urgent cases will be hospitalised over the weekend or overnight, the rest will wait to see our doctor during normal business hours, or will be planned admissions.
But are there countries with smaller differences in weekend mortality rates and, if so, how do they do it? Your response implies there is no problem, we shouldn't investigate it and shouldn't try to mitigate it.
Not quite right to say that politics winds down. *Westminster press led politics* winds down. Summer is a hugely important part of ground game politics. Any decent MP should be out campaigning every single day bar a two week holiday.
That's crap. Not sure about catheters and drips, but taking blood used to be the preserve of staff called Phlebotomists. They were low grade staff, but very well trained in a small range of procedures which they did every day. You really don't want your consultant taking your blood, if he's a physician he probably hardly ever does it.
There are some smaller DGHs with good figures, and if we want to know what to put right it would be worth looking at these.
There are also a lot of chickens coming home to roost over the expansion of medical schools, the lack of teaching of anatomy, pathophysiology and pharmacology in favour of softer subjects, and the disatrous changes in postgraduate training in 2005-6.
Some of my colleagues strongly prefer working with overseas trained doctors as they have had more rigorous scientific training than our local graduates. It is a similar phenomenon of dumbing down that has affected secondary and university education in the UK.
During one of my stints in my local DGH, I asked a junior doctor what made me vomit uncontrollably at a physiological level, what nerve caused it - he had no idea.
Is it one of those unknowns? I assumed it'd be well known as its a common symptom that drugs have found a way of halting.
It's not strictly true that we need more 11 leads to balance previous 5 leads if the "true" figure is 8 - random sampling doesn't work like that, going out of its way to even out past samples. What is true is that there should be equal numbers of 5s and 11s going forward.
"NHS England, in a report last month, calculated that at least 4,400 lives could be saved each year if weekend death rates were the same as those on weekdays. Another report, from the College of Emergency Medicine, found that a fifth of accident and emergency units rely entirely on junior doctors at evenings and weekends...
... Fortunately, a seven-day NHS need not cost a penny more. Indeed, in the right circumstances it could save money. Sir Bruce points out, correctly, that the current system means that for two days a week expensive and sophisticated equipment lies idle and outpatients’ departments are unused. When inexperienced staff take decisions, including those which involve patients occupying hospital beds for longer than they need to, it costs money. The absence of weekend care, apart from the safety aspect, also results in lost days at work for those needing minor treatments or routine appointments.
These are not theoretical claims. As Camilla Cavendish writes today, they are being proved by the Salford Royal NHS Foundation Trust. It set itself the target of reducing its higher death rate at weekends, with the aim of providing safe care “whatever the hour of the day or the day of the week”. It worked. The weekend death rate has dropped from 84% to 79% of the national average and so, importantly, have the urgent care costs, down by £4.5m. Salford and other trusts are showing it can be done. It is time the rest of the NHS did it, too..."
I think the post speaks for itself.
A well-intentioned individual, with or without a small committee, looks at an area outwith their own expertise and writes a report, at whose validity we can only guess in the absence of any real evidence beyond the odd, illustrative anecdote ("I was repeatedly told ..."). Perhaps decades ago, this was inevitable but in the 21st Century it should be unacceptable.
Cavendish, like many, deplores box-ticking. You know what box-ticking leads to? It leads to a metric shit-ton of data. We have data, we have statisticians, we have computers. Do we use these tools to analyse what goes wrong, which factors improve outcomes?
No, we appoint a journalist who just happens to have studied PPE at Brasenose at roughly the same time David Cameron studied PPE at Brasenose. What are the chances?
Aussies must feel like a patient undergoing weekend surgery at an NHS hospital under Burn'em.
A most peculiar interview.
Can those who are a vested interest - directly, retired or via a relationship - "wiv' dah' En' Haitch' Ess" - please articulate prior to posting? It would be a shame if they had to be shamed into demonstrating which and why they argue against decency and logic....*
Chahs,
* Ofcourse Wee-Timmy and DJL could STFU: Which path will they choose...?
Patients, and politicians, might want Dr Finlay but perhaps they need Sir Lancelot Spratt.
Interesting. What was the reason for the inverse correlation?