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A reign of error

The UK government has come up with a novel way to improve efficiencies within the National Health Service.  It's planning to pay a bonus to surgeons whose patients survive and recover. 

The annoucement comes as a surprise to those of us who had naively assumed that that is what they're paid to do anyway, and it's just one of a raft of measures that incentivises hospitals to reduce rates of infections, readmissions and post-operative mobility.

This suggests that the UK taxpayer is currently paying for a sub-standard service, and this is exactly what he is getting.  The USA health system, which is funded by health insurers, is going through a similar exercise.  From next October, insurers are refusing to pay out on eight hospital errors that they consider are avoidable. These errors are costing insurance firms around $40 bn a year and, as a spokesperson for the industry pointed out, they are rewarding inefficiencies.

The UK government is taking a different line.  Instead of penalising hospitals for their errors and poor work, it is instead paying out even more to those that provide a reasonable service.

This is yet another ineffective response from a Gordon Brown administration that is looking ever more indecisive and out-of-touch by the day. 

It's administering a healthcare system that is failing badly.  In the UK alone, 40,000 Britons die every year in hospital from avoidable errors, and this is based on a very conservative 2.2 times error rate for all admissions.  A separate study put the rate at more like 4.75 per cent, which, if true, suggests a figure closer to 90,000 deaths a year.

Overall, 850,000 errors occur in UK hospitals every year, and it's a problem that is not going to go away by paying bonuses and incentives to hospitals that care to better that.

*  Medical Mistakes: Who's Paying? is the special report in August's 'What Doctors Don't Tell You'.  It will be with subscribers on Saturday, July 26.  If you would like to subscribe, please click here. 

Published 21 July 2008 11:59 by Bryan Hubbard
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Bob Gooch-USA said:

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.

July 22, 2008 21:00
 

graham said:

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

July 23, 2008 11:06
 

Serbian Health practicioner said:

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

July 23, 2008 19:09

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