There has been a fascinating discussion on a blog – https://skwalker1964.wordpress.com/2013/02/26/the-real-mid-staffs-story-one-excess-death-if-that/- about the manipulation of statistics in the Mid Staffs story and whether or not there have been between 400 and 1,200 additional and unnecessary deaths. The argument has been going on for some time with those agreeing with the figures tending to quote from Daily Mail or other sources for their legitimisation. I sent the blog to a local GP of my acquaintance and he said this:
- The central thesis that the Hospital Standardised Mortality Ratios are a relative guide only, cannot demonstrate real numbers and are highly vulnerable to a whole series of biases is very convincing and has been echoed in recent BMJ editorials
- I am quite certain that the 400 – 1200 deaths are political not real numbers and are part of policy to discredit the NHS – a campaign being led by the government, the BBC (especially the Today programme) and, sadly, most of the press
- The real scandal is that poor care was demonstrated in Mid-Staffs – and I don’t think that this can be denied. Some criticisms were most dubious such as the drinking out of of a flower vase story – flowers have been banned from wards for decades and confused elderly patients do strange things even with the best of care. It is also extremely unfair to site the evidence of bereaved relatives as proving poor care. That is not to say that patients opinions do not matter, but their essentially subjective nature must make interpretation difficult
- This poor care has a multitude of causes – to mention just a few:
- Chronic current spending underfunding
- Insistence on high bed occupancy
- Obsession with targets
- Central government control with micro- management
- Government inspired management reform (since the 80’s) that has seen management at loggerheads with clinicians
- Nurse training changes in association with the employment of poorly trained “health care assistants” – under the umbrella of that appalling term “skill mix”
- Lack of investment in NHS IT that results in poor performance stats
- Overbearing management that either refuses to listen or tries to gag dissenting voices
- All these things apply to all the NHS. Mid Staffs was probably worse than most but not nearly as bad as has been made out. It is being used as a scapegoat and as a way of justifying the privatisation agenda.
Summary of successive governments’ policies:We have a great model in the NHS which on the whole works extremely well. We have, however, deliberately tried to undermine over the years with a whole series of right wing inspired so called reforms. We have finally got to the stage that we have almost persuaded the population that their most precious possession is falling apart so that we should sell it off to the private sector. So ends the great model and one of the last vestiges of the post war social contract.
Other reading:
Rigging the Death Rate – quite simply the most fascinating and revealing article we have found on this topic to date.
