Last week’s Healthcare Commission report into patient deaths at the Maidstone and Tunbridge Wells NHS trust is truly shocking.
Between April 2004 and September 2006, more than 1,170 patients were infected with the Clostridium difficile bug across the trust’s three hospitals.
At least 90 elderly patients died as a direct result. The infection was a definite contributing factor in the deaths of a further 124 and a probable factor in another 55.
A “shortage of nurses contributed to the spread of infection”, the report states. Patients were left lying in their own excrement – and were told by staff to soil their beds because there weren’t enough nursing staff or assistants to take them to the toilet or fetch them bed pans.
The hospital was filthy because management had cut down on cleaners. Beds were a few inches apart to save money – fewer wards meant fewer nurses, but it also led to a lethal spread of infection.
The Maidstone and Tunbridge trust’s board was “preoccupied with finance”, according to the Healthcare Commission.
Exactly the same preoccupation existed at Stoke Mandeville hospital in Buckinghamshire, where at least 33 patients died of C difficile between October 2003 and June 2005.
The Commission found that both trusts “had undergone difficult mergers, were preoccupied with finances, and had a demanding agenda for reconfiguration and private finance initiative (PFI), all of which consumed much management time and effort”.
Furthermore, “the impact of financial pressures was to reduce further already low numbers of nurses” and trigger “unrelenting pressure to reduce the number of beds”. The conclusion is that the trust “failed to protect the interests of patients”.
The immediate backdrop to the catastrophic cuts at Maidstone and Tunbridge was New Labour’s creation of a fake financial crisis in the NHS in the 12 months from April 2005.
The NHS was broadly breaking even, with a minor overall deficit of around £500 million – less than 1 percent of the overall budget.
Nevertheless, the health secretary Patricia Hewitt – with the full support of Tony Blair – deliberately plunged the NHS in England into chaos.
She instructed every individual hospital and primary care trust to break even by the end of the financial year.
This led to disaster at the Maidstone and Tunbridge trust, which was running a deficit of around £17 million. Hospital bosses attempted to drive through horrific cuts – and patients paid the price.
The other side of Labour’s attacks on the NHS is privatisation and “marketisation”. Hospitals have been forced to operate as businesses competing with one another – instead of working together for the good of patients.
At the same time, their income is slashed through changes to the national tariff. They are stuck with massive bills from 30 year PFI contracts, and patients are channelled away from hospitals and into “independent sector treatment centres” that have their own funding guaranteed.
Big business rakes in the money – and the NHS falls apart.We’ve also seen massive privatisation of cleaning services. Unison, the main health worker’s union, estimates that the number of NHS cleaners has been halved over the last 20 years.
Over the same period, hospital acquired infections have soared. Private companies cut staff, cut corners and increase their own profit margins, all at the expense of patient care.
But all New Labour offers is yet more privatisation – as the Darzi Report and Gordon Brown’s plans to privatise commissioning make clear.
Brown’s solution to the spread of MRSA and C difficile is to give all hospitals a “deep clean” over the next 12 months. But health campaigners say such one-off measures will do nothing to tackle the spread of infection.
The campaigning organisation Health Emergency says NHS bed capacity has been cut to such levels that “hot bedding” – close to 100 percent occupancy – is now the norm in many parts of the country.
It points out that this increases cross-infection risks and barely gives staff a chance to change sheets, let alone clean properly.
Maidstone and Tunbridge ran with a bed occupancy rate of 98 percent. The trust board knew this increased the risk of infection – and chose to live with it.
Kent police are now investigating senior managers at Maidstone and Tunbridge for manslaughter. Paul Carter, leader of Kent County Council, has called for the entire board of Maidstone and Tunbridge Wells NHS trust to resign.
Few of us will have any sympathy for NHS managers who consign patients to death in order to meet financial targets.
However, let’s be clear about the real culprits. Here’s a quote from the Guardian in November 2005 – the time when patients were dying at Maidstone and Tunbridge Wells:
“Patricia Hewitt has ordered a winter round of NHS cuts to eliminate the deficit of up to £700 million being forecast this year by hospitals and NHS trusts across England.
“The Guardian has learned that the Department of Health is imposing a policy of zero tolerance to overspending on NHS trusts. The cuts will hit hospitals at the worst possible time.”
It’s fine to put the chief executive of the trust in the dock – but she should be joined by Hewitt, Blair and Brown. When you order cuts in NHS spending, people die. It’s that simple.
Gill George is a health worker and a member of the Unite (Amicus section) national executive. She writes here in a personal capacity
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