If the health care insurers are refusing to pay for those eight mistakes, who will pay that price?  I know that it will be the patient and they will hounded by the accts payable at the hospital to reimburse the hospital for the lack of payment by the insurer.  A legalized fine to the hospital/doctor would be better than having the patient pay for the error.

The current government is now in a complete panic about what to do to live up to the promises made in their manifesto.  They have not yet grasped the limitations of the doctor's or surgeon''s ability to deliver. The problem is a systemic problem in which the NHS system is dependent upon the prevailing level of understanding and hence the technologies which can be used to treat disease.

So far this government has doubled the wages of the doctor and has reduced their working hours.  The outcome is a service now micromanaged to meet statistical objectives. The huge increase in staff levels has reduced the waiting lists in many areas however the reality is of a service which does not yet know how to diagnose let alone treat many of the conditions with which they are regularly faced.

Who dreamt up this latest idea to pay them more for doing their job? Presumably the same set of idiots that decided to pay them more to do less.  

In the last weeks I have been faced with the best of the NHS but also some of the less impressive side.  It is worth stating that a surgeon kept me alive in 1977 by drilling a hole in my skull to relieve the pressure of a subdural haematoma.  In the last weeks they have delivered safely my wife and child from complications of pre-eclampsia and HELLP.  This is what they do well.  I was very satisfied the way they handled the situation however it is somewhat alarming to be advised that, when treating this condition, they only follow a set treatment regime which has been proven through time and experience to be effective. If the patient does not respond in the expected manner the doctors appear to have little idea what to do.  They simply do not understand what causes the condition.

Another example.........

In the last days my 6 week old daughter has been constipated for several days which causes no end of concern to a first-time mother. This involved going to the GP who took notes, and going to the hospital to see the nurses who took even more notes and finally we saw three doctors who all took even more detailed notes.  They were all doing their jobs well but this illustrates the huge amounts of duplication in the system. They could have written a book by the time they had finished! The first test by the nurse showed that our daughter had been running a slight fever but none of the doctors seemed interested in this.  I would have thought that this would have contributed to dehydration and hence to constipation.  My little daughter came home, still constipated. Her constipation eased that evening.

G

Successful bioenergy practice for sale.  Previously proprietor wishes hurried sale.  Long list of satisfied (gullible) customers.  

Send applications to the war crimes court, the Hague

Successful outputs/end results should be the focus of any performance measurement/reward scheme but to improve the outputs one does need to understand

what causes less than 10% successful treatments.

15 YEARS AGO I had two operations to remove and remove surrounding flesh/glands from a cancerous salivary gland. These were just in time but for two years a GP had told me that lumps were normal for persons in their 50's and later that the blood I was coughing up was most likely from d9iseased gums ..which I did not have.After insisting on specialist advice I had two operations within six weeks but only through my then private insurance.

Before the second operation the Anesthetsist visited me to tell me what was to be done with another patients notes!!

Luckily the surgeon was great and afterwards having taken advice from radio/chemo specialists suggested that by early retirement and a change to a Mediterranean diet I had at least as much chance as no recurrence than having medications. So with no post surgery treatments I retired to high Vitamin D Spain....lived healthily ever since ...now getting on for 72 am now with a new wife almost self sufficient with home grown eco vegs, fruit and poultry/rabbit  and an active open air life. We believe that our number one social responsibility to is to keep ourselves healthy to reduce the pressure on the medical profession. To me maximum bonuses should be given when THERE ARE NO PATIENTS FOR  A GP because his preventative advice has been effective and followed up.

This is just great isn't it?  People will now be paid a bonus for being reasonably competent at their job.  In what other industry would this be tolerated?  Will we decide to pay cooks extra if their food doesn't give us food poisoning?