Tuesday, 11 November 2014

NHS: The best in the world?

I have had three conversations in three days that are all linked. Three days ago I was chatting about the NHS and the person with whom I was speaking agreed that it is not popular to criticise the NHS. It is seen as the best provider of health care in the world, looks after us from cradle to grave and is free at the point of access. My point was that the NHS is great if your experience is great but the opposite is also true, and I have heard and read about many bad examples of care.

Just yesterday I was speaking with a mother who was concerned about her daughter who had moved to another county. She had informed all the relevant authorities that she was moving and had even asked for evidence from some of them that they were aware of her change of address due to previous bad experiences. Needless to say things had gone wrong again. Her daughter has a chronic condition which is obvious to even the most casual observer. There is no doubt that treatment is necessary but she was told that there was a question of funding for her treatment.

The treatment is essential. Someone has to pay for it but she was now being told that there was a doubt over funding. Why had she even heard this comment? It had raised her stress levels on top of her medical condition. It also raised the stress levels of her mother, and this is from a service which has 'national' in its title.

My third conversation was earlier today and I was speaking with a doctor. I didn't know he was a doctor at the time but it came into the conversation because he was talking about someone who had been injured and gone to hospital. We also spoke about how maternity procedures had changed in twenty years. When my children were born it was common for mother and baby to stay in hospital six days. Now it is not even a day. This may be seen as a great improvement in efficiency and if this is true then it also makes you consider how inefficient things were not so long ago.

The conversation went on to consider the strengths of the local NHS service. He felt that we had a great maternity service. I was surprised to hear this view because of the recent maternity scandal and subsequent suppression of the CQC report.  I was also aware that earlier this year my local Trust had been placed in special measures. The reply I received was that this was almost entirely due to poor management. However I also know that mortality rates were high and I remembered something about the maternity department at Furness General Hospital, FGH having the highest death rate in the country. I had read that in 2011 "leaked figures revealed that FGH had the worst mortality rate of any hospital in England".

There is a lot of good and excellent work that is carried out within the NHS. The trouble is that there is also a lot of bad work. I couldn't sum up my feeling any better than by quoting Jackie Daniel, my Trust's chief executive. "The reports reflect the fact we are part-way through a process of significant improvement which is still going to take a number of years to complete...It isn't an overnight job to change the culture of a large, complex organisation." There's something wrong with the NHS culture.

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