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NHS Trust that oversaw the hospital focused on reducing expenses and not on patient care

A Look at the UK’s NHS—A Cautionary Tale



The head of the United Kingdom's National Health Service (NHS), Sir David Nicholson, has refused to accept responsibility for the needless deaths that occur daily at NHS hospitals by claiming that these deaths are not a result of mismanagement but instead are due to inherent "systemic" failings.
A single payer health care system was the original goal of President Obama, and from his perspective while the Affordable Care Act was a step in the right direction, it fell short of what was needed. Should the Democrats regain control of the House in 2014, the President is likely to get the single payer system he desires. But some among his followers, and perhaps even the President himself, want to go even further and create a US National Health Service (NHS). In view of this, it is worth taking a look at the current state of the United Kingdom’s NHS. The final report of the inquiry into the UK’s Stafford Hospital scandal was published on February 6 and contained 290 recommendations for improvement in hospital operations and staff training. It is generally accepted that between the years 2005 and 2008 as many as 1,200 persons died needlessly at the hospital, and that these deaths were due to shocking lapses in patient care. The horror stories do not need repeating, but what is clear is that the NHS Trust that oversaw the hospital focused on reducing expenses and not on patient care.

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Prime Minister Cameron has ordered an investigation into the operations at five other trusts that oversee NHS hospitals, but Sir Brian Jarman, OBE, PhD, FRCP, FFPH, FmedSci, Emeritus Professor, Faculty of Medicine, Imperial College, London, the man who first raised concerns about what was happening at Stafford Hospital, believes the number of trusts overseeing hospitals with higher than expected mortality rates that should be investigated is 26 not 5. The Royal College of Nursing (RCN) has blamed dangerously low staffing levels for the higher than expected mortality rates at the hospitals run by the five trusts being investigated. Dr. Peter Carter, the general secretary of the RCN, claims that 1,700 nursing positions have been cut by the five trusts alone because their boards care more about their finances than they do about their patients. According to Dr. Carter, “Trusts cannot be allowed to let staffing levels, particularly clinical posts such as nurses, fall to unsafe levels. Trusts cannot keep cutting posts without disastrous consequences” And the consequences of having understaffed overworked doctors and nurses is all too clear. While British press reports that there are as many as 4,000 needless deaths per year in NHS hospitals may or may not be exaggerated, there can be no doubt that people are dying unnecessarily as a result of mismanagement by NHS bureaucrats. There have been calls for Sir David Nicholson, the head of the NHS, to resign. Sir David has acknowledged that he considered resigning, but decided not to when he concluded that the NHS’ problems were “systemic.” Men and women in leadership positions often rely on two excuses to avoid taking responsibility. They blame their predecessor, as President Obama has done repeatedly since taking office, or they blame the system as Sir David has done. However, if Sir David is correct and the problems with the NHS are inherent in the organization’s conceptual design, then anyone who thinks implementing a national health service would be a good idea, and looks to the UK’s NHS as a possible model for the United States, should look again.


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Al Kaltman -- Bio and Archives

Al Kaltman is a political science professor who teaches a leadership studies course at George Washington University.  He is the author of Cigars, Whiskey and Winning: Leadership Lessons from General Ulysses S. Grant.


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