Patient safety is not a focus when the government calls the shots

For three years, a single British hospital that was obsessed with following government health care mandates to the letter, succeeded only in killing 1,200 patients unnecessarily:

Twelve NHS trusts are being investigated following a damning report which today slammed ‘appalling’ care at a single hospital.

Hundreds of patients may have died after bosses at Staffordshire General focused on Government targets rather than safety, the Healthcare Commission said.

A ‘shocking’ catalogue of failures over a three-year period were disclosed after an investigation found hospital managers had sought to save millions by adopting foundation status.

[snip]

Among the findings of yesterday’s report were:

● receptionists carrying out initial checks on emergency patients

● too few consultants, with junior doctors left in charge overnight

● two clinical decision units used as ‘dumping grounds’ for A&E patients to avoid breaching four-hour waiting targets, one of which had no staff

● nurses so ill-trained they turned off heart monitors because they didn’t understand them

● delays in operations, with some patients having surgery cancelled four days in a row and left without food, drink or medication

● vital equipment missing or not working

● doubling of life-threatening C diff infection rates, which were kept from the hospital board and the public

● a target of £10 million savings which was met at the expense of 150 posts, including nurses

● more debate by the board about becoming a foundation trust than about patient safety

[snip]

Investigators were inundated with complaints from patients and relatives, the most it had ever received, including Julie Bailey, 47, who set up a campaign group following the death of her mother in November 2007 at the hospital in Stafford.

She was so concerned about her 86-year-old mother Bella that she and her relatives slept in a chair at her hospital bedside for eight weeks.

‘What we saw in those eight weeks will haunt us for the rest of our lives’ she said.

Thirsty patients drank out of flower vases, while others were screaming in pain and falling out of bed.

[snip]

Director of the Patients Association Katherine Murphy said ‘Government targets have directly impaired safe clinical practice and money and greed for Foundation Trust benefits has taken priority over patient’s lives.’

As you can see, the above story does not relate one of those increasingly frequent situations in which the British government decided to withhold treatment or tests from a single class of patients because the patients are more expense than they are worth.  The government wasn’t directly involved here at all.

The problem, instead, was that a hospital, rather than seeing patients at its customers, saw the government as its patron, and redirected its energies accordingly.  And because there was no connection between the patients and the hospital in terms of complaints (that is, the hospital didn’t care about the patients, who were not paying the bills themselves, nor did they have a direct relationship with an insurance company that wanted to keep their custom), the hospital managed to go for years without having to react to criticism or complaints.  It was only when patients and their families were able to achieve a critical mass that made a noise loud enough to spur the government to action that the hospital’s conduct finally came under scrutiny.

It’s a reminder to us all that the market speaks loudly and quickly.  The government may ultimately have the loudest voice of all, but getting it to speak is often an agonizing task for a consumer who is deprived of a true marketplace and, instead, is utterly dependent on the government to give him a voice.