Blair to tackle the NHS?
No answers to this crisis
By Hazel Croft
NEW LABOUR says it is going to solve the problems of the NHS. Tony Blair is threatening to tackle the power of unaccountable consultants. And health secretary Alan Milburn launched the government's questionnaire last week to find out what staff and patients think about the NHS. The whole exercise was ludicrous.
The government already knows what people think-staff and patients don't like waiting lists, they don't like the desperate shortage of beds, doctors and nurses. Patients certainly don't want to have to wait for hours in a hospital corridor on a trolley.
Almost as soon as it was launched, the "consultation" exercise turned into a fiasco. The government was forced to apologise after it discovered people had less than a week to fill in and return their forms.
The �500,000 the government spent on distributing 12 million leaflets could have paid for 83 heart bypass operations, 555 cataract operations or 125 hip replacements. The money might have saved Mavis Skeet, who died last week.
She had her operation for throat cancer cancelled four times due to a shortage of intensive care beds earlier this year. Or it might have saved deputy head teacher Bob Golightly from Country Durham. He died last week after waiting eight months for a triple heart bypass operation.
Cost cutting dressed up
THE fundamental problem with the NHS is that it needs more money. "The crisis in the health service is not due to consultants, but to lack of resources," says Dr Kambiz Boomla. The government wants to set up special units to do non-urgent surgery, like operations for cataracts or hip replacements. "At the moment these operations are often cancelled because more urgent cases arise. These new units can only work if they are well resourced. Will there be new nurses to staff the units, or will nurses be taken out of other parts of the NHS, causing a knock-on effect elsewhere? The government also wants to change what it calls the 'skill mix' of the NHS. But what happens is they take a job done by one nurse and get someone on a lower grade, and lower pay, to do the same job. In other words it is about saving money rather than fundamentally changing the health service."
Blair is also pushing on with Private Finance Initiative (PFI) schemes. For example, a nurse in Dudley says, "The PFI scheme we face means losing 70 beds. That means we can treat fewer patients. The government is concentrating on surgery provision. But elderly people, for example, don't just need surgery-they need other forms of care. You don't have surgery for a stroke, a chest infection or pneumonia. Even if they set up a system where operating theatres run at weekends it will not solve the problems these patients face. In Dudley we are nearby to Kidderminster Hospital. Many people use Kidderminster's accident and emergency department because Dudley is so busy. Yet because of another PFI project the accident and emergency department at Kidderminster is being shut down. So now they will have to come to Dudley, and that will have an even greater knock-on effect on beds. These decisions have all been made on a market basis. Trusts are competing with each other instead of taking into account what people really need."
Who dares challenge consultant 'gods'?
TONY BLAIR promised to crack down on elitist consultants in the NHS this week. His pledge followed the Ritchie report into gynaecology consultant Rodney Ledward.
The �200,000 a year consultant was responsible for botching the operations of over 400 women who he left maimed, suffering liver, kidney, bowel and bladder problems. The report, like the Bristol child death scandal two years ago, highlighted the elitism which dominates the NHS. It accused consultants of "acting like gods". It found:
- Ledward pressurised women to have private operations and, even if they did not, he billed them for NHS work.
- He boasted of being "the fastest gynaecologist in the south east", spending 15 minutes on hysterectomies which would usually take two hours.
- He treated patients while dressed in riding clothes, tapping his boots and cracking his riding whip.
- Nurses and junior doctors were too scared to blow the whistle on Ledward because of "a climate of fear and retribution".
- was protected by "failures in senior NHS management" and "the old boys' network".
But what is Blair going to do about this "consultants are gods" culture? GP Kambiz Boomla, chair of the East London GPs' Forum, says, "Consultants have always been elitist. This stems from the compromises the Labour government made when the health service was first set up in 1948. The government allowed consultants to continue with private practice. Is New Labour going to end that right? I very much doubt it. After all, that would mean them saying to someone like Rupert Murdoch that you can't go private."
Manchester junior doctor Ruth James agrees. She says, "The whole system is hierarchical. Consultants have a lot of power. "It is common for consultants, particularly surgeons, to do work in private hospitals at least for a couple of afternoons a week. Junior and other doctors have to take over, or a patient has to wait for treatment, while the consultant is off at a private hospital. You really notice the difference in the way consultants treat private patients. They spend far more time with each patient and bend over backwards for them. Private practice goes against the whole way the NHS is supposed to work. The NHS is not supposed to be a money-making organisation. But consultants start with a few patients and end up drumming up trade. It's like a business. An orthopaedic surgeon, for example, can make a quarter of a million pounds a year. I have heard horror stories about how consultants have done operations which will not lengthen or improve the quality of a patient's life, but it will make a mint for them."
Like a film running on fast foward
By Audrey Farrell
I WAS on holiday when the crumbling cancer bone in my leg meant I could not walk without pain. I was admitted to Airedale Hospital in West Yorkshire. My first impressions were good. But everyone seemed to be moving too fast. This terrible speed of work has its effect on patients.
Nurses want to care for patients, but understaffing and overwork mean they have to keep going with a glazed look on their faces to get each job done. When I rested my bad leg on the floor, the cancerous bone snapped. There was hideous pain. There were 29 patients on the ward, but just two trained nurses and one auxiliary.
My emergency involved over ten staff, plus the bone team, including one doctor, two sisters and two staff nurses. Who was left on the wards to deal with any other emergency? It's frightening. I loved the nursing and ancillary staff at Airedale, not because they saved my life, which they undoubtedly did, and not because they are angels, which they definitely are not. Angels can live on hymns and heavenly air.
One nurse told me her take-home pay isn't enough to take her home. On the day when the ministry of health sent out its pseudo-questionnaire, nobody here believed any of Blair's talk of shiny new packages. Everybody knows the health service needs money for better pay and conditions, an end to understaffing and speed-ups, and money for equipment and research.