The government’s attempts to drive the free market ever deeper into the NHS aren’t just damaging the ethos of the health service. They are severely damaging patient care – and even costing lives.
That was the shocking judgement issued last week by the government-sponsored Healthcare Commission watchdog.
It came as the commission published reports on its inquiries into the Mid-Staffordshire Hospitals Trust and the Birmingham Children’s Hospital.
The Mid-Staffordshire Hospitals Trust inquiry showed how management were obsessed with cost-cutting in preparation for semi-privatisation. The report estimates that between 400 and 1,200 patients died needlessly over a three-year period.
The commission found that bosses were so focused on making £10 million in budget cuts and meeting government criteria for becoming a foundation trust that they “lost sight” of their responsibilities for patient care.
The government responded to the report with an apology, but claimed that Mid-Staffordshire was an “isolated case”. Yet just three days later, the report into Birmingham Children’s Hospital highlighted a similar pattern of staff cuts, bed shortages and lack of equipment.
The Healthcare Commission reported that in some cases brain surgery was performed without specialist theatre nurses present.
Both hospitals are now NHS foundation trusts – a form of semi-privatised hospital that is encouraged to behave more like a business than a public service.
At Mid-Staffordshire the commission found that mortality rates in emergency care were between 27 percent and 45 percent higher than expected, and that cutbacks meant that staff struggled to provide even a basic service.
The trust was found to be 120 nurses short in 2007-8. Bosses regularly told staff that their jobs were at risk because of the number of patients whose waiting time in accident and emergency (A&E) had breached the government’s four-hour target.
Nurses were often in tears after meetings with managers because of the pressure they were put under, the report says.
The commission’s investigation revealed a catalogue of horrors at Mid-Staffordshire, including:
- Overstretched and poorly trained staff who turned off equipment they didn’t know how to use, including heart monitors
- Newly qualified doctors left to care for patients recovering from surgery
- Patients left for hours in soiled bedclothes, without food and water, sometimes receiving the wrong medication and sometimes none at all
- Non-medical reception staff expected to judge the seriousness of patients arriving at A&E
The government has argued that the problems in Mid-Staffordshire are unusual and hold no wider implications for the rest of the health service.
But a nurse who works for a hospital that has also sought trust status told Socialist Worker a very different story.
“Anyone who says that the drive to privatise doesn’t damage patient care knows nothing about the NHS,” the nurse said.
“My hospital trust went for foundation status and around 18 months ago we started seeing major cutbacks.
“Whole wards were mothballed, only to be reopened when demand for beds became so high that the hospital could not cope.
“There was a freeze on recruitment, which meant that staff weren’t replaced when they left.
“Wards that would normally have five experienced nurses could sometimes find themselves with only two. Budget cuts often meant that we weren’t allowed to hire agency staff.
“That lack of staff means nurses don’t have the time to spend with patients who need their care. So of course patient care suffers.
“The drive to get the finances in shape to become a foundation trust dominates everything.”