Staffordshire NHS Death Camp For Some ?

by Art de Rivers | March 17, 2009 at 06:30 pm

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Staffordshire NHS Death Camp For Some ?

No , Its not an over dramatic headline at all, for up to 1200 people admitted to the Mid Staffordshire Hospitals Trust may have died as result of poor care .

The death rate there exceeded the expected range by quite a lot and the UK Health Care Commission investigated . The media in the UK is full of the story :

Telegraph
BBC
Independent

Its our studied opinion at UserWatch that the pressure that produced that situation of poor care was the great NHS Foundation Trust Status rush . Foundation Trusts have to prove they are "debt" free, hold surpluses and then they can enjoy greater autonomy - their status is then assured by a Watchdog named "Monitor" . These latest events in Stafford near the midlands have seen the Gov't. trying to side step its own part with its pushy ambitions in 2006 - 8 in trying to create these Foundation Trust hospitals all across the UK .

In Birmingham, UserWatch saw the rush too to "clear Debts" in the local Hospitals .. The Mental Health Trust was keen and tightly performance managed so that it cleared several million in one year before it then created a bankable 1+ Million surplus and was granted Foundation Trust Status . Its heading towards a projected £5 million surplus next year ..Is it good for patient care? That is very debatable .

"Debt" in Trusts was defined when a Trust exceeded the Dept of Health allowances it was given per annum and then it was expected and pressured to clear them.

So if Trusts were say , "£3 million in Debt" - they would have to save that £3 million by underspending on care the next year .. The underspending is not called that though. In reality it means not recruiting staff where you need them, and patient care goes by the wayside or is rationed tightly.

In Mental health Trusts this is probably more concealable and patients without therapy or support just suffer internally more .. Who is to see that, if the patient categories are not crisis ones ?

In the Stafford Trust, death was not concealable from physical manifestations of bad health and poor hospital care and staff rationing . Many deaths occured because as the Guardian states :

"Few patients were given the drug warfarin to help prevent blood clots despite deep vein thrombosis being a major cause of death in patients following surgery."

The Telegraph reports :

"The Trust - which was under pressure to save £10m from its annual budget - was more concerned with hitting targets, gaining Foundation Trust status and PR marketing and had "lost sight" of its responsibilities for patient care, the report said. "

A director of the local Patient Association said :

"Government targets have directly impaired safe clinical practice and money and greed for Foundation Trust benefits has taken priority over patients' lives."

UserWatch is mainly a Mental Health Watchblog and we know its easier to conceal what patients feel and what mental health pain they are in. That is the great sadness of mental health in so far as so much extra suffering can be caused and concealed by ambitious money saving Trusts and is left inside the mind of patients where its not easily seen ..

The terrible shock of Mid Staffordshire Trust though we feel has yet to run its full course and there may be other stories like this to come ..

New developments below :

The Department of Health today responded to the Healthcare Commission investigation at Mid Staffordshire NHS Foundation Trust.

Health Secretary Alan Johnson said:

"I would like to thank the Healthcare Commission for their extensive investigation and the thoroughness of their work.

"I have asked the National Quality Board to ensure that the early warning system for clinical underperformance is working effectively across the whole of the NHS. The Board was established to bring about improvements in all areas of patient care and is made up of clinical experts as well as independent representatives of Royal Colleges and patient groups. I have also asked Dr David Colin-Thome, National Director for Primary Care & Medical Adviser, to review the standards of care and treatment at the trust between 2002 and 2007, the period before the Healthcare Commission began its investigation, to determine how the obvious failings were allowed to continue for so long.

Comment : Nothing so far is being said by Gov't. about how they pressured Trusts across the country to create financial balancing acts to clear "debts" , and make surpluses for Foundation Status of ideally £1 million, whilst having to ration patient care too . There is some political dynamite embedded in this Stafford set of events - but the fuse is being elongated and blown upon by Gov't.

A regulator has said it would not have awarded Foundation status to a hospital with "appalling" emergency care had it known it was being investigated.

NHS watchdogs said Staffordshire General Hospital put the bid for Foundation status ahead of patient care and up to 400 people died needlessly.

The Healthcare Commission said Monitor, which approved the bid, had not asked if there were concerns about the trust.

Health Secretary Alan Johnson has apologised and launched an inquiry.

More Professional Opinion Emerges , Allyson Pollack :

The government has marketised the NHS, replacing an intergated public service with a market run by "purchasers" and commercially oriented providers under the same "light touch" regulatory system we have become familiar with in the banking sector. But ,according to Brown, bad care and neglect in mid-Staffordshire were the results not of this business model but of "low standards of management".

Not so, says the Healthcare Commission, a regulator established to carry out quality checks on the newly independent bodies that now form the NHS. It reports that while hospital board members said quality of care had always been a top priority, many staff said the trust's priorities had been "finance and achieving foundation trust status".

In other words, attention was focused on marketing, and the financial, business-oriented targets set by government.

And regarding mechanisms of accountability she says

And what of whistleblowers? The corporate structures and performance management frameworks within which they operate mean that doctors and nurses and managers may not speak. Prior to 1991, doctors felt able to and did regularly speak out about lack of funding, staff and quality of care; now there is an extraordinary culture of bullying and silence and fear.

Coupled with this the government abolished the community health councils, the local public watchdog which could appeal directly to the secretary of state for health and had rights of entry to all health services. Where are the watchdogs now?

In March 2007 Gov't abolished Patient and Public Involvement Forums which shadowed Trusts independently with public volunteers and then the Gov't replaced them with LINks (Local Involvement Networks) . Mainly consisting of volunteers and mixed up now with service personnel, LINks are so far an underperforming disaster. The cynics were probably right that the Dept Of Health UK cleared the effective PPI's out of the way because accountability means "whistleblowers" and now there are none to speak of ...

Further Developments 25th March 2009 :

Call for Mid Staffordshire Hospital Trust to axe chief executive
Mar 25 2009 by Jonathan Walker, Birmingham Mail

MID Staffordshire Hospital Trust must sack the chief executive who presided over “appalling” failings which may have led to hundreds of unnecessary death, MPs have demanded.

Martin Yeates continues to receive his full salary of around £160,000 a year despite being suspended.

He was sent home shortly before a damning report revealed a catalogue of failings at the trust, which runs Stafford and Cannock hospitals.