The NHS in 2017BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j28 (Published 05 January 2017) Cite this as: BMJ 2017;356:j28
All rapid responses
This morning’s news that the PM was blaming GPs for the current crisis in the NHS annoyed me intensely.
The real problem in the NHS is due simply to incompetent management and very poor personnel management and equally incompetent DoH management
First NHS personnel management. I want to know their explanation of:
1) early GP retirement,
2) the reason why doctors are not becoming GPs,
3) the reason for competent well trained doctors leaving the NHS and
4) the reasons for those doctors that are leaving the UK.
From what I see of the NHS personnel management it is very medical staff unfriendly with conditions that certainly I would not be prepared to work under. I find the fact that so many doctors remain a credit to their commitment to patients, something the NHS administration is not. I have complained to the NHS and DoH on this before.
The DoH with its rash political decision to implement a “24/7" with all that means at what might be described as “at the drop of a hat” and without proper, cogent planning is also to blame for the crisis. Of course the DoH mandarins in their 9-5, low stress honour securing sinecures, know nothing of the stress of having to deal with life and death problems.
The behaviour of both the NHS administration and the DoH remind me a sketch in the “Yes Minister” series. How true a rendering that was.
On top of that there is the problem of “Medical Error” (Starbridge B JAMA, July 26, 2000—Vol 284, No. 4 http://www.ncbi.nlm.nih.gov/pubmed/?term=JAMA+2000+284%2C+4+483 ,BMJ 2016;353:i2139 doi: 10.1136/bmj.i2139 (Published 3 May 2016) ). In large part where errors/mistakes are made, they are the consequence of stress and work pressure and are due to a "safety policy" that hides adverse event, medical errors and denigrates whistle blowers who try to draw attention to problems; in short, the total absence of a coherent safety policy. The deaths due to "properly prescribed and properly used pharmaceuticals" is an issue for Big Pharma, the authorizing agencies and guideline authors to resolve but probably won't.
I came across the following report by EU-WHO data and statistics ON MEDICAL ERROR which was most interesting.
Data and statistics
Some excerpts :
European data, mostly from European Union Member States, consistently show that medical errors and health-care related adverse events occur in 8% to 12% of hospitalizations.
For example, the United Kingdom Department of Health, in its 2000 report An organisation with a memory, estimated about 850 000 adverse events a year (10% of hospital admissions).
Infections associated with health care affect an estimated 1 in 20 hospital patients on average every year (estimated at 4.1 million patients) with the four most common types being: urinary tract infections (27%), lower respiratory tract infections (24%), surgical site infections (17%) and bloodstream infections (10.5%). Multiresistant Staphylococcus aureus (MRSA) is isolated in about 5% of all infections associated with health care. The United Kingdom National Audit Office estimates the cost of such infections at £1 billion per year.
There is a saving of £1 billion for the want of a proper safety policy.
Another massive saving could also be achieved with a proper, friendly personnel management policy. Dr. Jauhar ( author of the book, “Doctored: The Disillusionment of an American Physician) was recently described as "a compelling writer" and "an astute critic of the wasteful, mercenary, cronyistic and often corrupt practice of medicine today"
(ie Big Pharma, their KOLs and authors of guidelines)." This too refers to many of those hard working, very stressed GPs who were so roundly condemned by the PM today
The following may be of interest:
Last modified on Friday 25 September 2015 12.48 BST
This article is 1 year old
This was published several years ago, and what has resulted? Nothing except possibly numerous meetings and reports.
Could this really be presented as “good management” by anyone other than the responsible managers?
It really is time for the NHS and DoH administrators to properly resolve these issues or resign.
Competing interests: No competing interests