Friday, October 12, 2007

When Hospitals Kill: An Explosive Open Letter from David Lidington MP

Dear Iain,

You are right to be angry about what has happened at Maidstone. Whatever the failures of the local management may have been, the Government's handling of C. Diff. has been a scandal.

As you probably know, between 2003 and 2005 there was an outbreak of C.Diff. at Stoke Mandeville Hospital in my constituency. More than 30 people died and more than 300 were infected. The source was a particularly virulent strain of C. Diff. known as 027. It cannot be eradicated by hand gels. Prevention requires hand washing. Patients need to be nursed in isolation and wards and rooms vacated and cleansed to get rid of the 027 spores.

The Healthcare Commission published a report into Stoke Mandeville. It was very critical of the local management and both the Chairman and Chief Executive stepped down shortly before the report was published. However, when I read the report what stuck out a mile was that the hospital managers were working on the assumption that the Department's financial and waiting time targets had to be put before everything else and pressure on beds (to meet those targets) meant that it was not possible to isolate patients or vacate infected rooms as should have been routinely done.

The Government knows that this tension existed. In April 2005, the Public Accounts Committee reported that :


10. There is evidence that wider factors such as bed management policies and the
need to meet waiting times targets can compromise infection prevention and
control. Seven out of ten trusts are still operating with bed occupancy levels higher than the 82% that the Department told our predecessors it hoped to achieve by 2003–04. Trusts need to reduce bed occupancy levels and to adopt more effective bed management practices which avoid patients moving too
frequently.

11. In 2001 the Department assured our predecessors that the need for isolation
facilities was being addressed, yet only a quarter of the 56% of trusts that had
undertaken a risk assessment to determine the number and quality of isolation
7 facilities had obtained the required facilities. Strategic health authorities should
ensure that all NHS Trusts have carried out a risk assessment of their isolation
facilities, in line with Health and Safety legislation, and work with them to determine a timetable and resourcing strategy to address identified shortfalls in requirements.

12. The Comptroller and Auditor General’s Report noted that 12% of infection
control teams reported that their recommendation to close a ward or hospital
to admissions for the purpose of infection control had been refused or discouraged by their Chief Executive. NHS trusts should inform their strategic health authorities when a recommendation to close a ward is refused. Strategic health authorities should ensure that these incidents are recorded and should work with trusts to identify ways of minimising the impact of such closures.

(PAC 24th Report of 2004/2005 Session, HC 554, "Improving Patient Care by Reducing the Risk of Hospital Acquired Infection: A Progress Report")

Yet even last year, Ministers were still telling me in Written Answers that they did not collect information on whether patients were routinely isolated in C. Diff. cases.

Soon after the Stoke Mandeville outbreak was made public, I was tipped off by senior NHS staff that Stoke's case was far from unique and that C. Diff. was a growing problem throughout the Health Service. In June 2005, I asked Patricia Hewitt to extend the scope of the inquiry into Stoke Mandeville to cover every hospital in England where the 027 strain had been found. The Government declined to do so but said it "hopes best practice would be shared across the NHS".

We now know that C. Diff. is a serious threat to patient safety in many NHS hospitals. Even after many years in politics, I have been shocked by the Government's complacency about this crisis, and its sloth in taking effective action.

In 2006, there was still only one laboratory in the country, the Anaerobe Reference Laboratory in Cardiff, that was able to analyse C. Diff. samples and identify particular strains. There only a random selection of patient samples were being analysed. There was no comprehensive analysis of samples from patients who displayed C. Diff. symptoms. I would like to believe that things have now improved, but I fear that it takes a scandal as great as that at Maidstone to shake the Department of Health out of its obsession with targets.

Yours ever,

David


My comment: So there we have it. The Government knew and failed to act. It was government targets for patient throughput that were at least in large part to blame. Who is going to take political responsibility for this?

61 comments:

judith said...

Govt incompetence leads to multiple deaths in the NHS, slaughter of thousands of animals and suicide of farmers, death and mutilation in Iraq and Afghanistan, falling standards in education, increase in teenage killings ....

Do you know, I can't understand why Labour are falling behind in the polls.

C4' said...

Patrica Hewitt, John Reid and Tony Blair should take the blame, but notice how have already left the cabinet?

Anthoninus said...

Gordon Brown's public policy approach of top-down targets that he brought into Whitehall through his dominance of domestic agenda from 1997 as a delayed result of the Granita Pact has a lot to do with this. The target structure is damaging the effectiveness of all our public services - from hospitals, to schools, the police and beyond. People aren't robots so they should be allowed to get on with their job instead of doing pointless Whitehall mandated paperwork, which incidentally would save more than a few trees! MPs should really take Gordon Brown to task on this!

nick said...

Take political responsibility? Surely it's obvious this is the fault of
- the previous Tory administration
- some civil servant who we'll find later
- asylum seekers
- David Cameron personally

delete as applicable

Anonymous said...

Perhaps they are still on 38% because no coherent policies on the NHS have been put forward by the Conservative Party?

Kafka said...

One thing's for sure -- it won't be the one man who ultimately drove all this -- the one holding all the purse strings -- the one, the only the slipperiest, our Great Leader, Macavity Brown.

Malcolm said...

In answer to your question Iain, no one. They never do.

Madasafish said...

If you google "Rose Gibb" you will see that she has been associated with ongoing problems from 2004 at Maidstone including a BBC Secret Camera report and Professor Hugh Pennington saying the hospital - in my words - was the worst he had ever seen.

In my opinion, ignoring the possible criminal case, the bodies responsible for the oversight of the Trust have been guilty of clear and obvious complicity in a saga of incompetence, dirt and filth lasting years.

Patient care? None of that.

If this was a private organisation, I would expect a wholsale culling of all Medical Directors in the Trust, etc.

Why don't the NHS just use Health Auditors: like accountants.. checking basic procedures unannounced.?

It's motherhood and apple pie stuff. Not rocket science. Basic management.

This is Thrird World stuff except in the Third World they TRY to be clean. It's obvious there they did not even try.

Management incompetence.

Sounds familiar See Northern Rock., DEFRA Pirbright, etc.


Bring back the stocks say I.. And with senior managers on over £100k pa, time for some firing...

Anonymous said...

I am not Nadine Dorries' biggest fan, but she has them bang to rights on this issue.

As for who to blame ?

Let me see...

A_@_ J*__$*_

A little puzzle for a Friday PM.

But he is more worried about appearing on Desert Friggin Discs.

verity said...

What an excellent letter.

Patricia Hewitt should be charged with manslaughter. This isn't written lightly. She knew and she was the responsible party and she did nothing rather than compromise Labour's "success" with the NHS.

Has Britain ever suffered a more vile, wicked government than the Blair and Brown administrations?

Colin D said...

If this were not such a serious situation, it would be laughable. Non-entity busybodies running around hospitals giving media interviews. The shambles is appalling!! Alan Johnson has the temerity to call it "scandalous". In any former decade, they would have been hounded out of existence. Today left to kill another day. For mercy's sake someone needs to get a grip, real soon!!!!

The Last Boy Scout said...

Ouch. That is pretty damning.

John Coles said...

Patricia Hewitt should be charged with Corporate Manslaughter.
I've e-mailed her suggesting that she report to her local Police Station to await being charged.

Sonicdeathmonkey said...

Bloody Hell....

Considering the huge amounts of public funds which have been put into the NHS...has it been worth it?

I just don't know what to say about this government...

Madasafish said...

In April 2006 Ms Hewitt said " NHS had saved more lives than ever before this year."

I am sure that was misreported and she meant "ended" rather than "saved "



http://news.bbc.co.uk/1/hi/health/4935358.stm

Elby the Berserk said...

DT has her record for all to see. This isn't the first shambles to be laid at her door either ...,

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/10/12/nbugs212.xml

Hubby also runs another NHS area/PCT.whatever they are called to day. MAJOR financial problems there.

Assume they are both buddies of the late lamented Bliar, given their clear incompetence and they levels that have risen to (been raised to) to exercise said incompetence.

Bet a court of Human Rights rules she must get her severance payment.

Longgggg deepppp sighhhhhh

Anonymous said...

24 hours to save the NHS ..from NuLiebour's incompetence.

verity said...

Surely there must be some movement in Britain to bring the people responsible for these mass deaths to account?

What about Patricia Pol Pot Hewitt, for example?

revinkevin said...

The health secretary at the time has to answer some very tough questions about this cover up.

I think whoever was the health secretary at the time should face corporate manslaughter charges.

Anonymous said...

The Labour Party was responsible for the NHS being created in 1947 and on the 60th anniversary of that fact it is an enduring shame on a Labour Prime Minster;Health Minister and Government that despite billions of pounds spent we seem incapable of actually cleaning hospitals and patients are left stinking in their own ordure whilst filth accumulates and lethal bacteria is rampant!

This would put a third world country to shame let alone Britain in the is 21st Century. Labour have turned the clock back to the Crimea and before.

Romsey Rapid said...

I am staggered by this. Whatever happened to ministerial responsibility?

Is this letter going to be aired on the news tonight because it damn well should be.

Ten years of tax-payers money going down the drain. The relatives of those that have died because of this should get together behind one legal firm and press for a corporate manslaughter charge.

Remember "...the NHS has had it's best year ever"; at what, killing people!!

Anonymous said...

A "fair cow" in Australia means something which is a real bother (no swearing); in England it means Patricia Hewitt.

The Remittance Man said...

Political responsibility? This sorry shower of Richard III's?

Sorry Iain, I would go on but jokes about military intelligent and other oxymorons just keep interrupting my train of thought.

Johnny Norfolk said...

Can you imagine the BBCs reaction to this if the Tories were in power.

It was not raised on question time but I feel sure it was put forward.

I just dont know how Labour can get away with it.

verity said...

Revinkevin - Yes, absolutely corporate manslaughter charges! To be responsible for over 300 deaths in peacetime is awesome.

Hewitt needs to be charged, as do the administrators of the hospital.

In addition, the relatives of these poor souls who were in hospital to be healed need to get together for a gigantic mass damages action against the NHS.

I don't know whether Hewitt can be sued personally, as well as being charged with corporate manslaughter, but if so, they should sue her for everything she was paid for her grim behaviour. She cannot be allowed to benefit financially, from her salary, for all those years, for running an outfit that was killing patients.

What an extremely serious (no swearing)nightmare!

Anonymous said...

I repeat my call for Johnson to resign. not because it is his personal fault but government MUST take responsibility. Why are we paying these useless politicians to tax us heavily in return for no service and no accountability. it simply must stop. Gordon brown where is your 'kin moral compass you coward??

Anonymous said...

Ah, verity, nice of you to grace us with your presence on the day that your friend and countryman Al Gore becomes a Nobel Laureate for his great contribution to world peace.

Anonymous said...

this must be brought to the attention of MSM. The government cannot get be allowed to get away with yet another scandal.

Come on Iain use your influence

Anonymous said...

judith said...
"Govt incompetence leads to multiple deaths in the NHS, slaughter of thousands of animals and suicide of farmers, death and mutilation in Iraq and Afghanistan, falling standards in education, increase in teenage killings ...."

Apart from the mention of Afghanistan that could have been written in 1991, following BSE, the first Iraq war, etc., etc.

hatfield girl said...

The National Health Service is a Soviet-style planned socialist monolith in the middle of an advanced capitalist economy; as such it offers many of the problems of transition displayed in ex-socialist economies of the east of Europe, and suffers from all the problems of deeply discredited socialist planned provision. It acts as employer of last resort in many economically collapsed areas of the country, and displays provider- rather than patient- concerned attitudes. It acts too as an ideal means of transferring tax-raised income from the economically functioning parts of the country, mostly in the south and east, to the Labour heartlands of the dependency, tax funded regional economies.

The National Health Sevice has functions infinitely more important than providing decent health care free at the point of use.

Wrinkled Weasel said...

"In 2006, there was still only one laboratory in the country, the Anaerobe Reference Laboratory in Cardiff, that was able to analyse C. Diff. samples and identify particular strains." writes David Lidington.

Whilst being factually correct this is irrelevant.

Mrs Weasel, (aka Dr Weasel, Clinical Microbiologist), writes:
Any district general hospital lab can analyse patient samples and tell whether they have C. diff or not. Patient management is only dependent on this information and not on which strain is present. The actual strain is only required for epidemiological purposes."

So let's not let a good story get ahead of the facts, eh?

Anonymous said...

My mother died eight weeks ago - she had C Diff for the last week or so and it made her final days horrid, thoguh it did not appear on the death certificate. The worst thing about my daily visits was having to pass a plaque stating that the hospital wing had been opened by the smug Patricia Hewitt. Enough said

verity said...

Dear anonymous moron 6:21 - Al Gore's British? I hadn't realised that! How did he manage to stand for the presidency? They don't even allow naturalised Americans to stand. They have to be native born!

Re Al Gore and the absurd Nobel Prize - he was a shoo-in. A confirmed rich, New World Order lefty, just like the Nobel Prize committees. No one has taken the Nobel Prize seriously for years.

HG - Agreed. One of its important functions is mopping up immigrants and giving them employment. The presence of so many doctors who have nothing culturally in common with us also serves to discomfit the native population, especially at its most vulnervable, when sick.

The New World Order marches bravely on.

Sea Shanty Irish said...

Speaking as a Labour supporter, where the Blair-Brown administration has TRULY failed to deliver is on delivery. And after a decade of Labour govt, blaming the Tories is NOT persuasive. If Gordon Brown and other ministers want to point fingers, they should take a long look into the mirror.

Personally think there ought to be a law requiring all MPs, apparatchiks & senior civil servants to receive their own health care from the 20% of NHS facilities with the worst ratings. Bet you THAT would result in some real reform.

Of course, I live in a counrty where we DREAM of having a national health care service. A nation where our Fearless Leader doesn't believe in basic health care coverage for all CHILDREN, let alone adults.

W actually said that families & kids without health insurance could rely on hospital emergency rooms . . . this coming from a guy whose own health care is fully funded by the federal government.

So much for "compassionate conservatism" Bush style.

Where is Charles Dickens when we need him???

RE: Hatfield Girl, first time I read her comment above, thought she was a mean as W. But re-read it, and she actually makes some good points.

Of course it is also true that the benighted regions she references are places like my own home state of West Virginia, where people and communities were sucked into the maw of the Industrial Revolution, used up and then spit out into the equally tender mercies of post-industrialism. And in the process left with above-average rates of sickness and unwellness.

So it seems only fair - and sensible policy for the entire nation - to develop QUALITY health care services, facilities, expertise AND incomes for such areas. Especially since the alternative in many cases is drug running and other unpalatable examples of the underground economy for the locals . . . and draining the 3rd world of the medical professionals so desperately needed in their own homelands.

Alistair Watson said...

Hospital Infections
On the BBC HYS thread I posted the following 24 hours ago

Why does Alan Johnson think we believe a word he says on this issue? In the case of the NHS Labour have demonstrated they are a bunch of incompetents. They have tipped in vast sums of money and got very little out. Their method of imposing thoughtless policies decided upon by people who have little understanding of the NHS and less understanding of the consequences of what they do has resulted in many deaths. Yet they deny responsibility. Shame on them.

Its still “Awaiting Moderation” – This really is a scandal of monumental proportions but the thread has been starved of oxygen & others such as
Are today's children too stressed?
Nobel Peace Prize: Your Reaction
Are you affected by the postal strike?
Can US and Russia bridge their divide?
Should there be greater understanding between religions?
Have taken their place.
You are doing a great job – press on.

verity said...

Sea Shanty Irish - I also believe everyone should have health care and should make provision for themselves and their families. Your family's healthcare, and your own, are not the responsibility of anyone except you.

I would have thought that having witnessed the Soviet Union and the Eastern Bloc, and Britain, you people would run a mile from government-run health services.

"and draining the 3rd world of the medical professionals so desperately needed in their own homelands."

Oh, how sweet! And if you had nationalised medicine, there would be no need for all this drainage? How would that work?

Alfred of Wessex said...

Medical negligence on this scale is almost unbelievable! It is the medical hygiene equivalent of 'clogs to clogs in three generations'. Have our medical 'profession' forgotten everything that Florence Nightingale and subsequent generations of nursing pioneers learned the hard way?

The Nazis used gas chambers to eliminate people they had no use for, Stalin mass executions, mass deportations and the Gulags, Mao the Cultural Revolution, and Pol Pot the Killing Fields.

New Labour allows the sheer incompetence, greed and mendacity of Chief Executives of NHS Trusts and their managerial underlings to cut short the lives of those who have contributed most and longest to this country!

We are back to people being frightened of going into hospital for fear of what they might catch and die of. My wife's grandmother feared hospitals for the same reason: hospitals were places you went to die.

Have we forgotten everything the last two generations learned?

verity said...

Alfred of Essex makes a good point. At the NHS, it's been clogs to clogs in three generations, and hospitals in Britain have become, again, within 100 years, places you go and don't leave alive.

Newmania said...

What a superb thread

Hatfield Girl - Magnificent

...and many more but for quick right to the chin Johny Norfolk takes the Palm. I have been wondering why this isn`t a bigger story. Are people in shock ? Blair ran an election camapign on the back of one entirely random tragedy ( The Bulger case) .
Now Brown and Blair are responsible for mass murder and not for the first time . 27 dead in London in the sink estates they have created. Its emotive rhetoric and perhaps a little unfair but the left have flung the same sort of accusatons around with less reason for a long time now.

verity said...

Yes, indeed, Newmania. And as MP David Lidington said, 30 died in Stoke Mandeville, and now we have another 300 helpless old people who have died in Maidstone. This is mass murder on an unimaginable scale. And we don't know what mental torture they went through before they died. Old and helpless people are fearful of complaining in case they are treated cruelly by the young and strong.

This story alone should bring down Brown. And then, as Judith said above, there's the slaughter of thousands of animals and the consequent suicides of farmers. This is a government of sheer wickedness.

Trumpeter Lanfried said...

It is worth recording how Florence Nightingale got her results, i.e by haunting the wards at all hours of the day and night, and by sheer bloody-minded determination.

On one occasion she wanted some truculent Turkish orderlies to empty a urine tub. She stood by the tub for an hour, refusing to move until the job was done.

Not for her the excuse that the
Turkish Army was an independent contractor and she had no power to give their soldiers instructions.

How many NHS Chief Executives even venture out on to the wards? And how many of them have the bottle to tell the Government, "Your targets can only be achieved by putting patients's lives at risk, which I am not prepared to do."

aardvark said...

Trumpeter Lanfried said...
"It is worth recording how Florence Nightingale got her results, i.e by haunting the wards at all hours of the day and night, and by sheer bloody-minded determination."

Her hospital had the highest death rate of all the military hospitals in the Crimea due to hospital-contracted infections resulting from poor sanitation.

verity said...

Aardvark - and the "poor sanitation" was Florence Nightingale's fault? What was she - a civil engineer?

I hope the deaths of these people don't get wiped off the news because that is 300 people in psychological and physical misery, and another 30 at Stoke Mandeville. This is such an outrage, it beggars belief.

And that 300 was not even nationwide, which would have been heinous enough. It was in one tiny part of the country.

Who's the MP? Does anyone know, please?

Newmania said...

Its just Blair all over again. We know we still have a rolling news management team instead of a government. Why do we not draw the obvious conclusion, noone is minding the shop.

Take the simplification of the right of parents to challenge the selective status of Grammar schools. How much time was spent on that when in the last ten years there is one solitary example of parents trying to challenge selective status anyway. A dig at Cameron pure and simple. How much time was spent on a budget that hid its taxes( now being spotted) and on hiding the dropped academy scheme . The problem with having to misrepresent everything and spin everything is that it is bound to take up all your governing time .

Naturally no-one wants to ensure the NHS works or Tax credits works , or DEFRA works or NHS computers work , or the Police force works or the immigration system works or indeed anything else . Plenty of time is spent keeping PFI borrowing of the books and by the way , a hell of a lot of our money ,£13 billion, loaned to a favoured heartland bank who fell, entirely by their own incompetence .£13 billion !!! The welfare budget for next year is about £95 billion , the whole spend about £650 billion and they are spending this sort of our cash on this tiny little bank. We know why.

Douglas Herd pointed this out a while ago on question time when he went through everything the government had done , not on a political basis ,but simply on an ‘aim and delivery’ score card. As he said ,when nothing is ever got right you have to start to suspect there is a structural problem with the administration .

He diagnosed an arrogant and politicising attitude to the civil service , an inability to listen to advice and an obsession with deciding the policy and then spinning it come what may. If you want a small but perfectly formed example look no further than the emerging Olympic scandal

This is ,in other words, not an isolated tragedy , it is an inevitable result of the culture of bullying and from afar and ignoring warnings .


Blair and Brown should be in the dock for this neglect of duty. It isn`t just Ministerial responsibility;

its Prime ministerial responsibility.

Newmania said...

Douglas 'Hurd'....ouch

Johnny Norfolk said...

Again on Newnight tonight nothing about this. It was all about the polls that show that Brown is the same or worse than Blair on spin or the manipulation of the truth.

There is a cover up on behalf of the BBC. It does not want to upset Labour to much does it.

Downing St has altered the the footage of PMQs as well. It started like this in Nazi Germany. We have a big problem in Brown.

Sea Shanty Irish said...

Verity, you have a point about ADULTS needing to look out for their own welfare. (Though how can it be good for the rest of us if someone has a chronic, serious, untreated and COMMUNICABLE disease?)

BUT what about little bitty CHILDREN (or even not-so-tiny teenage minors) who are sick or injured? Is it right to make them suffer because their parents were lazy, shiftless, irresponsible, unlucky, whatever?

As for the adults, please note that in the USA, the traditional system of employer-based health care (with coverage as a work benefit) is crumbling, while the premiums for independent (non-employer) coverage are already extortionate and keep on skyrocketing.

Plus even if you HAVE coverage, many people find that the insurance companies simply won't pay up when you REALLY need it.

For example, in WA state there is the case of a fire fire fighter who died because the insurance company underwriting most of his workers compensation refused to pay for treatment that would almost certainly have saved his life. Why? Because the insurance company contended that the firefighter had not gotten his illness on the job . . . even though it was a condition that is very frequently job related. He put his own life on the line every shift . . . and died because some beancounter didn't want to pay the bill.

So how do you like THEM apples?

As for "3rd world drainage" of health care professionals, yours truly NEVER said that nationalized health care would solve that one. Indeed, health care system in BOTH the UK and US would collapse without constant infusion of doctors and nurses from the Third World.

verity said...

Sea Shanty Irish - Indeed, health care system in BOTH the UK and US would collapse without constant infusion of doctors and nurses from the Third World.

Incorrect.

Indigenous BRITISH doctors, trained in BRITAIN and their training paid for by BRITISH taxpayers are finding there are no jobs to apply for because they are all awarded ahead of time to third worlders who don't understand British mores. And even if they did seek an understanding of British mores, our own doctors should be at the head of the queue because they belong on our islands and we paid to for their education.

This is an intentional destabilisation of the Britain and has partly led to the horrible, pointless hundreds of deaths in British hospitals.

Some of these incomers - unneeded in any case - are ignorant, thick-headed and are not sympatico with advanced British culture. Some are resentful and cruel.

I wonder how we can find out how many of the nurses on these affected wards were from the third world.

Meanwhile, our British-trained doctors go to the United States.

I have a sincere lack of interest in your medical payment problems in the United States, including those for "little bitty children".

I don't care whether your insurance companies pay out because I believe that is a domestic problem better solved by representations to your senators rather than whining on a British blog.

Be assured, no one here gives a monkey's about your problems. We have too many of our own.

If you want nationalised medicine, be prepared for all the Sovietesque horrors, as are being currently witnessed in Britain.

I cannot imagine why on earth you are posting on a British political blog when you are so clearly ignorant of the politics and daily concerns of the British. Because we are members of the Anglosphere does not mean our political circumstances, or our problems, relate to one another.

This is a conservative blog. We don't believe in socialised anything. Go and whine at Harry's Place, but they won't care either. Neither will an Australian or Malaysian blog.

Go and solve your own problems.

verity said...

PS - Expecting to engage foreigners in a saga about a firefighter on the West Coast of the US and "little bitty children" of the United States tells us how ethnocentric the less educated Americans are. That is 7,000 miles away.

We all feel a pang when a firefighter dies in any country, including China or Poland (much closer to us) or wherever a hero has died or been injured trying to save another's life.

But that you feel you are unique and we should connect and take up your grievances because it happened in the United States endorses the general view that Americans are self-regarding.

Have you researched the number of our own British firefighters who have been horribly injured in the cause of saving the life of another?

For some reason, you just piss me off.

verity said...

Shanty Irish or whatever your handle is:

PPS - We are talking about over 300 of our own old people dying horribly and in indignity, which they did not deserve. We are addressing this question of our own folk and how we can get redress for them.

Bugger off.

SACKERSON said...

Sea Shanty Irish:

My brother lives across from you in Ohio so I have more sympathy for you than Verity, at least in his/her present mood.

But I think we're misled by the word "health" in the NHS. As my doctor friend has always said, it's the National Sickness Service. Far better not to need it at all.

Ivan Illich pointed out years ago that most of the improvement in life expectancy over the last generations has been down to better housing, food and plumbing.

I think we're in a new stage, where advances in health will come from finding ways not to get sick from surfeit (food), poisoning (alcohol, drugs) and sloth (TV, computers, the car).

Trumpeter Lanfried said...

ardvark [10.50 PM] You may be right about Florence Nightingale's infection rates, which some say haunted her till the end of her days. But I assume you would not criticise her methods; single-minded, hands-on determination to do the best she could for her patients.

One of her first reforms, at Scutari, was to have a dead horse removed from the water supply. So she was starting from a pretty low base.

Chuck Unsworth said...

Both Rose Gibb and her delightful consort, Mark Rees, have major form with regard to (mis)management of NHS Trusts. It's worth checking out their history for confirmation.

But in the case of Maidstone the real culprits are those who appointed her to that position without paying close attention to her previous 'career'. What did they do to satisfy themselves as to her suitability as a candidate, and what did they subsequently do to monitor her (lack of) activities? The Chairman and his fellow trustees/directors should all step down. But you can bet that they'll plead that they were misled - whilst giving her a major bung, with a silencing clause for both sides.

Trumpeter Lanfried said...

chuck unsworth [9.47 AM] You refer to severance, including 'a major bung, with a silencing clause for both sides.'

How often have we seen this! I would like to see a simple statute making all such clauses unenforceable in the case of public employees, except where national security or official secrets are involved.

Anonymous said...

Iain If you google bed occupancy rates and mrsa and hospital infection, you will find several studies showing a correlation between bed occupancy greater than 85% and higher rates of infection.

The 18 week targets mean that hospitals are working flat out (unlike private hospitals, the NHS has to cope with emergencies).

No amount of hand washing will prevent this. Beds have to be cleaned and aired. There needs to be more space between patients etc.

Alan Johnson 'not accepting' this, is like saying he doesn't 'accept' Newton's Laws of motion.

Angry Hospital Consultant

aardvark said...

verity said...
"Aardvark - and the "poor sanitation" was Florence Nightingale's fault? What was she - a civil engineer?

Florence Nightingale was what we would now call a Hospital Administrator and should have called on engineers to deal with the defective sewers. She was aware of the sewer problem at Scutari but refused to accept that it was the cause of the very high death rates. She was convinced that the deaths from cholera, dysentery, etc were due to poor nutrition.

Trumpeter Lanfried said...
ardvark [10.50 PM] You may be right about Florence Nightingale's infection rates, which some say haunted her till the end of her days. But I assume you would not criticise her methods; single-minded, hands-on determination to do the best she could for her patients.

We all owe a debt of gratitude to Florence Nightingale. She transformed standards of nursing care in this country. However, thousands of sick soldiers died at Scutari because of her refusal to accept that poor sewers and inadequate ventilation were major factors.

verity said...

Aardvark - I'm not being argumentative; this is a genuine question: Who told her that sewers and poor ventilation were dangerous?

I'm asking because I really would like to know if someone was thinking along those lines - especially the bad ventilation - so long ago. Whoever made that leap of understanding was brilliant for the time.

Anonymous said...

everyone is culpable just pay your taxes and automatically public services must be improved. NONSENSE labour have squandered billions of pounds. 100 BILLION per year on the NNDS alone and they cant even CLEAN the wards . PATHETIC

aardvark said...

verity said... "Who told her that sewers and poor ventilation were dangerous?

I'm asking because I really would like to know if someone was thinking along those lines - especially the bad ventilation - so long ago. Whoever made that leap of understanding was brilliant for the time.


I don’t know who told her about the health hazards of poor sanitation and inadequate ventilation in the mid 1850s. Some years previously it had become known in medical circles that many infections were air-borne or spread by contaminated water, but hardly any nurses would have been aware of that.

When government Sanitary Commissioners descended on the Scutari Hospital in 1855 they cleared the blocked sewers and improved the ventilation. There was a dramatic reduction in the mortality rate (from 40% down to 2%).

After returning to Britain Florence Nightingale carried out a statistical study comparing mortality rates at Scutari (which was actually in Turkey) with those in field hospitals during the Crimean War. She was horrified to find that (prior to the Sanitary Commissioners’ visit) the Scutari mortality rates were considerably higher than in the field hospitals. Only then did she fully accept the sewerage/ventilation arguments.

She was full of remorse for the excess deaths for which she felt responsible. The result was that she started her campaign for improved hospital standards and nursing training which subsequently saved millions of lives.

verity said...

Thank you, Aardvark. That was very interesting. It is interesting that people - without microscopes (I assume)and other modern means of detection - had determined that there were "germs" in the air, although they couldn't see them or identify them. But knew they were opportunistic.

This seems a great leap in Western medicine. My fugess (unfounded) is that the French would have made the same discovery at around the same time. It would be interesting to know whether the Greeks or the Romans had figured out that there were airborne infections.

Chuck Unsworth said...

And two days later the Chairman of Maidstone has 'stepped down' - having been leant on by Paul Carter 'Leader' of KCC.

But what about the payoffs? What about the other board members? Are they to cling on to their stipends and exalted positions?

And while we're at it Mr Carter has a very interesting history - take a look at his relationships, some of which are seen here: http://save-wye.org/