Last week, the Chief Executive of Maidstone & Tunbridge Wells Hospital Trust resigned. It wasn't before time. She had presided over four years of chaos and failure. I know, because I live there and saw at first hand what was going on. Local MPs' postbags were full of complaints about what was happening, with terrible tales of the standard of care received by them or their relatives. Today's Healthcare Commission report shows that 90 people died in the hospitals run by this Trust over the last few years. So there are ninety families who put their relative in the care of the NHS and it let them down in the most terrible way possible. We have to ask ourselves why this is.
In the same way that the first duty of any government is the defence of the realm, surely the first duty of a hospital is to protect its patients from harm. Yet patients in Maidstone hosptial were allowed to lie in their own excrement and staff were "too rushed" to even wash their hands regularly. Why? Well, in part it was down to government targets.
Helen Wood, the author of the Healthcare Commission report published today said this morning: "I would think the lessons, not just about cleanliness, hygiene and infection control, but the care provided to patients who contract C.difficile is something that has wider lessons for the NHS." She might have added that there are lessons on targets for the Health Secretary, Alan Johnson, too.
Nigel Ellis, head of investigations at the Healthcare Commission, told BBC One's Breakfast: "The hospital trust didn't even pick up the first of the two outbreaks... wasn't aware that it was an outbreak at the time. And when the second outbreak came about, they were still not quick enough to act to take the steps that we would consider to be reasonable." He said the commission concluded that "presumably their priorities were elsewhere". He added: "There is no reason that the safety of patients in this way can be considered to be a secondary consideration."
Commenting on Alan Johnson’s denial today in the media that his government’s financial mismanagement of our NHS and its centrally imposed targets are in any way accountable, Shadow Health Secretary Andrew Lansley said: “Listening to Alan Johnson this morning makes me even more worried than I was before. He is a health secretary in denial refusing to face up to the facts. But this report is clear. Unprecedented cuts in the number of acute hospital beds, the government’s target culture, financial mismanagement and deficits leading to a shortage of nursing staff have blighted the fight against infection in our hospitals."
Because I live in the area this concerns me quite a lot. Many people here now regard Maidstone Hospital in particular with huge suspicion. Some people refuse to be admitted because they are worried about contracting c-difficile. This report will merely confirm their worries. There's a huge task ahead for the new Trust Chief Executive.
More on BBC Online HERE.
49 comments:
Thank you for the post Iain. I am shocked at the lack of responsibility taken by the Dept of Health. in what other organisation could 300 people be killed and the top man, in this case Johnson, keep their jobs? It is a national disgrace.
I call upon Johnson to resign today to recognise the governments role in this affair. surely the relatives of those who died deserve that. given the disgraceful record of this government i will not be holding my breath!
What I am staggered about was that she 'resigned', rather than was sacked. I heard the Health Minister on R4 this morning, and of course he was distancing himself from the situation, he is a former Postman, with no clinical training, if Health professionals are prepared to tolerate this situation for not just one year but five years there is something very badly wrong. Central State planning always leads to this sort of abuse, from tractor Factories to Hospitals, it is always easier to point the finger at the State,the local management etc etc. As a supporter of localism, these Health Trusts must be subject to elected CEO's and board members, if they cannot do the job, and people end up dying, they have to be removed pdq, not allowed to resign
Although the Maidstone outbreak is by far the serious that we know about I wouldn't be surprised if this is just the tip of the iceberg.
It probably needs someone to face criminal charges before the problem is actually properly dealt with throughout the NHS
Dangerous places, hospitals, when you're sick. More people die in hospitals than anywhere else, so I'd certainly not recommend you go to one if you're feeling ill!
Why do politicians even try to run hospitals? What on Earth does Johnson/Hewitt/whoever know about medicine or management?
The NHS is having its best year ever - for killing patients.....
Our Hospital Trust CE resigned 18 months ago, presiding over many similar problems. Having a deficit of £35+ millions he had little choice but to resign. It has recently come to light that he received a six figure sum (hidden in the latest set of accounts), being, apparently the normal payoff for a high ranking NHS executive. So look out for similar payout for this CE. It seems that grime pays!!
A vote for Labour is vote for death. Vote Labour vote the Russian roulette of going into hospital! Bring back Nusre Nightingale please! A vote for Labour is a vote for murder! How many people have died since Labour came to power as a result of their sympathetic ideas as regards the fluffy wuffy wabbits who just happen to be mindlesly violent crims? I could go on but use your memories, you'll think of loads more examples. A vote for Labour is a vote for death.
Investigation into outbreaks of Clostridium difficile at Maidstone and Tunbridge Wells NHS Trust.
Page 9
"We are concerned that where trusts are struggling with a number of problems that consume senior managers’ time, and are under severe pressure to meet targets relating to finance and access, concern for infection control may be undermined."
I also heard on R4 Today I think that the Trust was in the process of a PFI application / implementation - Foundation Status application and was undergoing major reorganisations.
Lessons for all I suggest
im so annoyed about this. 300 people have died from something entirely preventable and the minister in charge doesnt resign??? how many need to die before a government minister resigns?? 500, 1000, 10,000???
I am disgusted by this government
A manslaughter charge would be appropriate for the Chief Executive.
Por encourager les autres.
It's all very well to blame targets... BUT the first priority of all NHS staff should be patients. And the second , third and fourth.
The Chief Executive was by all accounts negligent: knowing ofr 6 months of a problem and doing nothing..
I am sure that this is the tip of the iceberg.My elderly mother refuses to have a knee operation at our local hospital for fear of MRSA.When the figures for it were first announced,she merely observed that she must have known every case personally.Of course,it subsequently transpired that the number of cases had been massively underdeclared.
I can't think of any other set of circumstances where you could KILL 90 people and not face a manslaughter charge. Until recently I have been a supporter of the NHS, believing it to be the best way to ensure a "free at the point of delivery" service but surely, surely politicians have to be brave and start looking into private sector solutions. Unfortunately, we get the politicians we deserve and Cameron knows that if he dares go down that path he will be finished. It is a national disgrace, but not of just politicians and NHS managers, but of the voters too.
As my MP explained to me when I raised a question about the lack of a particular service locally in the NHS:
When performance was good, it was the result of the wonderful government 'reforms' of the NHS. When things were bad, it was the fault of the Trust or local health authority, "to whom responsibility had been given" for service delivery.
Tosser.
cath dibble
I think I'm with you on the "private sector solutions" as long as the free at the point of need principle remains - the whole "voucher" idea, as applied to NHS and Education turned me off, as did the hiving off of cleaning duties to profit driven private contractors. I have American friends who scare me with stories about a fully prvaised system - just as bad as a socialistic one, in my view. The point is how best to motivate staff, and improve standards? I believe in setting setting teams free,throw away the league table, and employ big personality managers who can write reports, and incentivise their team. And report to the taxpayer (through the Govt) There's nothing that a UK Tory voter would disagree with there, I hope, but if you do, I'd love to know why.
Guthrum said...
"I heard the Health Minister on R4 this morning, and of course he was distancing himself from the situation, he is a former Postman, with no clinical training ...."
Did you sneer at Kenneth Clarke, a former lawyer, when he was Health Minister?
Anon 10.43 PM "Bring back Nurse Nightingale please!"
The death rate at Florence Nightingale's hospital at Scutari was the highest of any in the Crimea during the time Florence Nightingale was their; mainly due to hospital-contracted infections resulting from poor sanitation.
It seems to me that it is easy to blame targets, but the truth is that if there was a realistic chance that management could go to prison for such total and repeated negligence this probably would never have happened - targets or not.
The DoH has a lot of questions to answer - lets be clear about that -but it is the hospital management who must be the focus of this piece.
This situation is unforgivable. even the most basic aspects of cleanliness were not attended to. My wife was at another hospital for just over 2 weeks. She did not contract diarrhoea but constipation since she had to try to keep away from the filthy toilets.
I really cannot see that it requires some new quantum leap in science to be clean in hospitals. We used to be able to manage it 40 years ago.
The Conservative administrations are not blameless here. I seem to remember that it was their witless idea to put hospital cleaning out to tender. At that moment ward sisters lost control of the cleaning processes.
Victor
I work in the NHS and this exemplifies in a grotesque way the problem with today's NHS. NHS Trusts will only take issues seriously when they are Governemnt targets. If it is not a target it is not important, however loud local docs and nurses may complain. NHS Trusts are becoming incapable of sorting problems out unless they are told to do so by Big Brother. They do not know how to act independantly of the state. They are then not given incentives to acheive these targets (some of which are actually quite reasonable)but are threatened with punishment (huge fines) if they do not acheive them. It is all unbeleivably demoralising to the people who work in the NHS and clearly often lethal for the vulnerable patients. How difficult is it for the Tories to annunciate this to the british People. They should quote this Healthcare commission report again and again until polling day.
It doesn't look as though Kent County Council's health scrutiny committee can have been doing their job terribly well. Now remind us please which party controls Kent?
Local decision making and scrutiny, don't you just love it?
Perhaps Alan Johnson should put his own house in order before spouting off with criticism of the Prime Minister.
That's if he wants to keep his job in the next reshuffle.
Anon- I sure did complain about politicians like Clarke imposing central targets and intiatives when they are not clinicians ! If the State has to be involved in Healthcare, it should restrict itself to the funding of Hospitals, not crowing about achievements and then putting in cleanliness Czars- what utter craziness. Hospitals should be run by people who understand clinical need locally. The Hospital Boards should be elected, not appointees of the State. The NHS as a concept has been turned into a political football, as has education before that. Hospitals that do not kill people will get patients, Hospitals that kill will be avoided like the plague pits they are.
Any middle-rank NHS managers who want to complain about the way the Trusts are run are threatened with the sack. I was told this face-to-face 2 yrs ago by a Hospital Trust Director of Nursing at a private meeting, and have had it confirmed as still happening now.
Would you risk your job, your mortgage repayments, your family's welfare to try and fight the Dept of Health?
John T - Why on earth should health care be "free at the point of need"?? Explain the thinking behind this extraordinary statement, if you please.
Is food "free at the point of need"?
This is insane. The tax paid to keep the vile NHS running should be abolished and people should have a legal requirement to provide coverage for themselves. Believe me, with what you people pay for your NHS tax, you could get very good private coverage. Actually, you could get it for less than you pay by force.
Privatisation is the only solution that will ensure appropriate treatment amid comfortable (no vile mixed wards!)and sterile surroundings. The French system, which I experienced myself, is excellent, but it is going bust and they are panicking trying to find a solution. Meanwhile, inevitably, they are cutting back on prescriptions and treatment to keep their show on the road.
Privatisation is always the answer. Managers respond well to the profit motive. So do rank and file employees respond well to bonuses.
Verity, I welcome your input!
"Under a Conservative government, the NHS will remain free at the point of need and available to everyone, regardless of how much money they have in the bank."
I'm afraid I was just parrotting the thoughts of Cameron.
For your sake, I'm pleased you don't suffer the American system, where the Govt has obtained new powers to take your property upon death to pay for (uninsurable) long-term medical care when alive.
I myself experienced the Chinese system - the Ditan Hospital ward was cleaned three times a day by suitably clothed cleaners, and thankfully my insurance paid, but befor I could get them to, I had to agree to pay £150 a day, presumably to cover the cost of my stay. When the insurance company came through, the cost had risen to £800 per day. You see, the hospital knew the insurance company was a commercial organisation, and treated it like one. Likewise, insurance companies would offer its customers (us) a range of products, some more comprehensive and more expensive than others. The reason why most people want it to be free at the point of need is more to do with wanting equality of access, and suspicion that the worst would befall those least able to pay.
I hope that explains the thinking (I can't speak for Cameron), and would point out that the French system is more expensive than ours, for the moment.
I do respect the principles of private involvement, and your views are rationally expressed, so thanks
John T - The French system is very good indeed and - were it not going bankrupt - would make a strong argument against what I have written.
The French patient is treated like a customer. If you need an Xray, your doctor gives you a prescription for an X-ray and you take it to whatever laboratory your friends and neighbours recommend. This keeps the labs on their toes. They're clean, the staff are friendly (although French)and appointments are kept to the split second.
Unlike in Britain, they don't assume any form of control. They hand you your X-ray and you take it back to your doctor; or, if you have decided you don't really like that doctor, you take it to a different doctor. Same with hospitals. Choice.
It is very cleverly organised and it works a treat. The only thing is, it's too expensive and it's going bankrupt. I have a friend whose husband is a doctor and another whose husband is a dentist, and both have had visits from the government to tell them they are prescribing too much medication. (Of course, computerised records are automatically transferred from the issuing pharmacies to the government department and they keep track of every pill prescribed by every doctor in the country.)
When I left France, there were commercials running telling people to stop asking for antibiotics. Etc.
Governments should not be in the health care business for many reasons. One is, it leads them to interfere with lifestyles under the guise of being prudent keepers of the public purse when they ought to be minding their own bloody business.
Keeping governments out of every area of human life is always a good plan.
And if you want superb medical treatment, privately, without waiting lists, with spotless hospitals and superb surgeons and nursing, book a ticket to India and go to one of the high-ranking private hospitals. They're so good that American Blue Cross and Blue Shield pay off for treatment received in them. It's around a third of the cost of private treatment in Britain, and you get curries.
Verity, I don't think we disgree muchon anything to do with the NHS apart from the idea that if we're going to spend £400bn on a health service, I think it's better to collect it in the tax system. You think it's better for insurance companies to collect it from individuals, add a profit margin, and hand it on to the hospitals. The experience of friends of mine in the USA inform my view, whereas your own sense/ideology(ideology is not meant as a pejorative, but I can't think of the word I mean)informs yours.
Your description of how the service should be carried out has put (in better words than I have) the case for motivating the staff and employing the techniques of the private sector. I don't see why that's so difficult to do with the taxpayer paying. What's clear is that it isn't happening at the moment, and I do hear stories of de-motivated, enervated staff and processes causing great distress to patients. Bloody targets, damn teh festering statistics, etc. Quite so.
I agree that it's the system that is at fault, but I don't agree that privatisation of the payment aspect would help, or make it cheaper without becoming unfair on teh patients who cabn't afford long-term uininsurable care.
I like the sound of the curry, and I've always believed in the "direct grant" hands-off approach to most public services.
apologies for my appalling typos!
So let me get this right. Alan johnson isnt responsible for what went on that the hospital but has now told them to withold severence payment from the outgoing chief exec pending legal advice.
typical nuLabour, take no responsibility at all for the F**k up, but feel free to play politics in search of some positive spin!!
he should be sacked on the spot. what a creep
John T - I have lived in the United States and received treatment there and it is superior to what is offered to British people, who are being scalped.
The French system delivered excellent service, but it is going bankrupt. Indeed,they have already just opted out of giving free treatment to British visitors (in other words, tourists; those not resident in France). Of course, they're obliged to cover all EU citizens under the EUSSR, but when did that ever stop the French from advancing their national interest,and good on them.
The NHS is a grim, Sovietesque construct and should have a stake driven firmly through its heart. Do you really want a vast medical system run by Alan Johnson? It's lunatic.
Incidentally, there is free medical treatment for everyone in the US, but it's at county hospitals (paid for by the taxpayers of each county) and they offer a standard of service roughly equivalent to the NHS. They do force people to pay for the treatment they have received - and why not? - you can't walk into a store and take free TVs and bottles of whisky - but if you are unemployed and indigent, you do not have to pay. If you are employed in some low level job, you are forced to have a small amount taken out of your wages until the debt is cleared.
I cannot see anything wrong with this.
The state should get its nose out of everything except national defence and our armed services - the one area of its responsibility utterly ignored by the socialist One Worlders. If new airports are required, the airlines and the airline industry should pay for them. New roads - dedicated road tax, or road charging. Etc. Police, paid for by local taxes and adminstered by a local police chief.
Eric
The KCC has nothing to do with this - the problems are those of an NHS Trust (DoH).
It is not the cleaners fault either, but that of the doctors and nurses and other clinical staff who will not wash their hands.
The managers get the blame because they are supposed to be in charge but they are squeezed by the DoH, the doctors and other vested interests who resist change at every oportunity; so they are on a kick up the arse to nothing.
Would you like to be a Hospital CEO with all the responsibility for meeting targets (and risk being banged up) but with no real control over the medics who are to lazy to do the basics correctly?
I live in Kent and it is scary.
Verity, I'm not informed enough by the facts of the USA system to continue very much right now (I usually change the subject when it looks like I'm not going to prevail, pity my wife!). I would say, though (and I'll stick around an d acknowledge your last words to me on the subject) that the UK public (mostly) have always had a blind/soft spot when it comes to the NHS, ever since its inception, and despite its faults, so it'll be a long time before any PM will be in a position to adopt a USA-style, or even "best of the private systems" approach. The anecdotes ("you can afford to save one of your hands, you choose"), conjure images, whether true or not, that engender an emotional reaction, which affectsa how people vote.
Like I said earlier, the last word is yours, and I promise my thoughts on the subject are not as rigid as the might appear from my writing.
John
Verity - Just to deal with your point on defence - I'm totally with you, and I'd go further and say that it is a fundamental moral obligation of Governments to fund national defence and to co-operate wioth friendly neighbours.
The scaremongers write as though no one in Britain had access to medical treatment before they brought in the NHS. But everyone had doctors and there were provident funds and insurance programmes people to join. It's not as though universal access to medical care was invented by Aneurin Bevan. Or was it Clement Atlee? All those socialists look alike to me.
As I said in my previous post, I believe that the role of the government is protection of the citizen, his property and his rights. End of story. Everything else is up to the citizen, who presumably has free will, himself.
Therefore, the government should tax and fund our military services for our defence and to help in the defence of our allies who would, in turn, come to help us, our police services and our courts of law (but not barristers or solicitors; no legal aid unless a private charity).
That's it. The NHS is an obscenity.
Verity thanks - It was Bevan, and strangely enough, I have a feeling he would sympathise with you! He certainly didn't envisage what would happen to his creation to-day. I have no doubt he'd be turning in his grave.
The individuals concerned, including the nurses, cannot escape responsibility. They actually told patients to crap in their beds for God's sake. Some people died in their own excrement. And what were the nurses doing? Sitting at their 'work stations' filling out f*****g forms if my experience is anything to go by.
And still, still, after 50 years of slithering downhill, and falling behind the hygiene standards of India, people swear by the NHS. I swear AT it.
john T - Sorry, but rubbish. Socialists feel that aggrandisement of their interfering schemes is in accord with the way of the universe. Bevan most assuredly would not sympathise with my point of view.
Trumpeter, agree, as always. Every individual who came into contact with these deceased patients bears some responsibility for their deaths because they did nothing.
I hope the families contact a really vicious chambers and bring a gigantic class action against the NHS and against the individuals concerned. Every individual who was involved with any of these patients and did not raise the alarm and insist on their receiving proper treatment and respect is guilty.
And indeed, the chief executive and everyone else responsible should be charged with manslaughter.
It absolutely baffles me that people swear by the NHS. It can only be people who have never been treated outside Britain.
That Maidstone hospital sounds like something out of Cancer Ward.
Blaming targets is slightly off beam - the best way of extending patients stay in hospital and therefore costing the hospital lots of money and increasing the hospital deficit is to give patients avoidable complications ( pressure sores , c difficile , mrsa etc. What we have here is incompetant management who are divorced from how a clinical service should run - anyoone who understands hospitals will know that a high quality hospital with lower complications will have better finances .
The other point missed here is that the main drive to c difficile infection is the prescription and excess use of broad spectrum antibiotics - lots of infections in hospital are best not treated with antibiotics or treated with short courses of narrow spectrum drugs - this was therefore a medical practice failure.
Yes, anonymous, and I would imagine that ordering old people to lie in their own excrement wouldn't get top marks for hygiene. In addition to the terrible trauma for elderly people who have been scrupulously clean all their lives and brought up their children to be clean.
This is so shocking that even I am shocked that the NHS is so vile.
Strange that I stated on my earlier comment about this CE probably getting a six figure payout, only to learn that this has now been blocked. Someone acted with commonsense then.
Verity -
Bevan's vision was of a service that would help the whole country, not a stalinistic monolith that led to pensioners dying in their own excrement. That is why he would be turning in his grave, and sympathise with someone who is clearly frustrated at the very sight of the failure of this part of the welfare state. Perhaps I wasn't clear enough, but I have to say that dismissing my perfectly rational input as rubbish denudes your position of respectability.
Unfortunately Iain it was your heroine Margaret Thatcher who introduced the thin end of the wedge by outsourcing hospital cleaning to to get rich quick cheapskates. Control of cleaning left the ward sisters and moved to some hospital bureaucrat.
Of course Labour targets then made it worse by making the administrators take their eyes of this particular ball.
john t - You're a self serving communist bore,easily detectable from Post No 1.
By which I mean, you were easy.
You are finally drawn to write: "Perhaps I wasn't clear enough, but I have to say that dismissing my perfectly rational input as rubbish denudes your position of respectability."
You were easy.
Once you mentioned Bevan, you were easy.
Verity,
This might worry you, but I voted Tory in 83,LibDem in 87 and Labour since 1992. Cameron has to win people like me back if he is to gain any sort of power. Your gin-soaked invective isn't helping him, and nor is your false assertion that "food is not free at the point of need". The whole point is that it is, but if you can't understand that your welcome to stay in the pre-welfare state fug that you've wrapped yourself in.
John T - "This might worry you ...".
It doesn't. It is a predictable pattern that many people who lack political acuity have adopted.
"Gin-soaked invective" - oh, pulleaze - and "your false assertion that "food is not free at the point of need"."
I made no such assertion. I wrote: "Is food "free at the point of need"? The question mark indicates the interrogative.
I had you spotted for a chippy lefty the minute I read your first post and now you're sailing under your true colours.
"your welcome to stay in the pre-welfare state fug that you've wrapped yourself in."
I'm welcome to stay any bloody where I feel like staying without the permission of an uppity communist. The fug to which you refer came in with the welfare state, which blurred the boundaries between private and public.
The welfare state should be destroyed. If they could dynamite the BBC in the same week, that would be a bonus.
Verity, (if that is Verity and not some idiot)
I know a rhetorical question when I see one, and answered it.
I'm not a communist, as would be clear to anyone who defined themselves by anything other than their disrespect for others. Being rude doesn't win any arguments. "the welfare state should be destroyed" puts you in a very small minority, thank goodness. I and many others pool some of our money for the common good, and pay elected leaders to use it well.
I agree about the BBC, which IS a Stalinist monolith.
You have my permission to put me right again, however sober you are.
Beyond comment without breaking into helpless laughter: "I and many others pool some of our money for the common good, and pay elected leaders to use it well."
This is my last visit to this thread.
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