'No-one joined the dots' – grandad who exposed an NHS scandal
bbc.co.uk
bbc.co.uk
The grand-father is: https://twitter.com/DerekRKENT - Derek Richford (in Kent)
Derek has indicated that he needs a break from this, and would not be the appropriate contact: "It is time for me to hand over the baton of maternity safety to others." - Oct 19, https://twitter.com/DerekRKENT/status/1582723405769740291
The website associated with Harry Richford, and Derek Richford's investigation and weblogging is: http://harrysstory.co.uk/
It looks like https://twitter.com/BBCMBuchanan and https://twitter.com/jamesmelley are the current BBC journalists investigating this issue.
I spent a few years of my early career working on software in US VA hospitals, in between contracts in Intel space, when working for Booz Allen (US defense contractor). The managers and executives at the VA were a particularly awful bunch. It's hard to emphasize how warped some of these bureaucrats are. The lack of accountability was breathtaking, along with the wanton obstruction of my work (project to better integrate VA and Military Health System to ease transitioning veterans).
The parent comment is about the accountability of public systems, not strictly about outcomes.
Also I would caution about using population level statistics to inform an individual choice about healthcare. India is a pretty poor country, but has a really good private medical system. If I travel to India for treatment I'm not exposing myself to the healthcare outcomes of the Indian population - despite the fact that I'm using their medical system.
The same thing applies to public vs private care for an individual within a country. You can tell me removing all private hospitals and healthcare will increase life expectancy for my population. But if I'm one of those people using the private system, I'm probably going to be worse off.
So now we have a story about lack of accountability causing the unfortunate needless death of infants, with a clear solution and clear cause and effect.
You can fix it by increasing accountability by telling the public hospital to "be more accountable" or you can require private hospital practicioners carry malpractice insurance.
Even a poorly run malpractice insurance market can produce positive results (read studies from 1975-onwards).
It's not so easy to make a public hospital accountable. You can't fire anyone, you can't sue them, and you can't reduce their budget if they don't perform.
No. The medically assisted dying legislation was expected to have a negligible impact on healthcare costs. Its introduction was driven by the Supreme Court ruling that all Canadians have a right to a full life, and denying assistance forces people with degenerative conditions to end their life earlier than they would wish (while they are still capable of doing it themselves), to avoid being trapped in an intolerable state of agony in their final days.
The budget analysis done by the Parliamentary Budget Office was just the standard procedure for any legislation. It described insignificant cost savings (~0.03%).
Yes you can. And there are no win, no fee lawyers who hope to make a profit at it.
https://www.nhsnegligence.co.uk/sue-hospital-for-negligence/
Maybe in the US, but nobody is going to question it in the UK, France, Germany, and the rest of most European countries.
Some bureaucrats are absolute trash when it comes to their ethics.
This is all people in general, saving face is part of self preservation. Losing face could mean losing ones life: job, house, family, etc.
I worked at a place where the policy was to lie to the customer if their goods were damaged by employee incompetence. Admitting your employees were responsible basically admits that the company is incompetent. So blame the customer, machine, contamination, act of god, etc. Just throw them some insurance money and continue about business! Always save face.
I've done this in Germany and I would have people come to my office and complain about the the board and then turn around and pretend nothing happened when I took the initiative on these things. I've seen 2 people die of heart attacks in that period multiple become permanently ill. Moreover out of the 350 employees the institution has most likely 100-200 or more will lose their jobs over the next years.
The biggest lie that people believe is that societies have come to believe is that they, the people, are powerless.
But then again, if that is what they choose, then they have to live with the consequences.
Basically. That's the third world in essence.
"It's only me, no one will know, lol" multiplied by millions through a couple generations; then it becomes "Why don't we have good institutions?", "How come we lack basic services like clean water and trash removal?", "Why is there so much corruption in here?", and so on ...
Very astute observation...
Are you saying the GP is inaccurate, or impolitic, or something else?
The reason we make the case that these countries could have been better if their governance wasn't done for the sake of foreign investors is because we can't find a single counterexample. Not only meaning that we can't find an independent country that wasn't successful, but we can't even find an independent country with anything worth taking that wasn't taken.
Have you ever had someone come into your house and steal your belongings while you were not around? I have.
Have you ever went to the police to report a crime only for them to laugh at your face? I have.
Have you ever tried to sleep with 4 or 5 dogs barking nonstop around you? I have.
I was born in México and I wasn't born in privilege, it took me decades of work to get out of that hellish place. None of the problems I had while I was there had to do with this so called "history or foreign intervention", they all had to do with my immediate surroundings full of imbeciles who could barely function as human beings.
Let me tell you a story about a neighborhood who was throwing their trash to a river next to them (even though they had municipal garbage collection two days a week). That river, which ran through their backyard, was in an absolutely disgusting state all the time. Then when rain season came, all of that trash washed out to another place where it caused flooding because it clogged the wastewater pipes.
Let me tell you a story about a guy who was stealing immunotherapy drugs (who were procured by the government and meant for ailing child, I wish I was making this up) and selling them outside the hospital for a profit, with a complete disregard for the lives of the patients there. You want to know how much he was making out of this? Around 2,000 USD/month. You can EASILY make that money and much more without having to murder kids.
Let me tell you a story about some idiot who tried to get some kids (ages 4-12) from a primary school hooked on drugs so he laced their food with fentanyl and they all went into a coma.
I could write a book with 100s of stories like these that you wouldn't believe were true, I wouldn't believe them myself if not for having witnessed many of them first hand.
The "history and foreign intervention" myth needs to be put to a rest. It's 2022 now, the state of many poor and undeveloped countries is a direct consequence of the people that live there, no one else is to blame for that, nobody.
My son was born 3 months premature 16 years ago. In US hospitals, insertion of vent tubes and other things like this when a baby is first born is handled by specialized technicians. They have a lot of training like nurses do, but they aren't technically nurses. They are called "respiratory technicians". Along with the nurses, they are EXPERTS at doing these procedures on tiny infants. They practice on dummies constantly. I spoke to a few (one of whom saved my son's life) over a period of weeks while my son was in the Neonatal Intensive Care Unit at the hospital in North Carolina he was born in.
Just stating this, because something that I learned from British parents is that NHS hospitals, while excelling in providing affordable care for general issues, are lacking in highly trained specialists who can insert a breathing tube in an infant in literally seconds due to having practiced it obsessively for years. NHS NICUs also lag behind American NICUs in having the latest equipment. The tradeoff of course is that American NICUs are orders of magnitude more expensive, and that is a very important point to emphasize.
The use and training of specialists is only one part of the puzzle that needs to be optimised in so many different ways. And I will point out that one of the key results of this puzzle is infant mortality statistics and the US does not score very well on that metric. I don't understand 1% of the details of why but it's quite a problem. And this is in spite of the money spent on healthcare
I don't really want to be a cheerleader for the NHS or the US system in this comment because both have so many problems involving bureaucracy, money, politics, etc. And it's a pity because ultimately it's the most vulnerable in society who are affected the most.
Obviously not.
If the NHS adopted American standards for NICU, they would save more lives.
But they would have to spend more money. They don't want to spend more money.
Not surgeon specifically, it means 'contractor' effectively - in the UK at least doctors can pick up 'locum shifts' at other hospitals (or otherwise outside their contract, or do this exclusively) for a higher fee (hospital needs to fill a spot it's understaffed for).
From the Latin, as in 'locus parentis' (e.g. a teacher has a parent-like duty of care over their pupils while they're on school grounds) for similar example.
The article doesn't haven't enough info to be sure, of course. But if my wife ever needed a C-section, I'd really like to know it wasn't being performed by a doctor with this track record.
(One might say, well, then there will be fewer doctors and they'll be more overworked and things will be worse. To which I would say that I have indeed lost family members to NHS incompetence, and separately I was an NHS-delivered emergency C-section (I survived, obviously, but from my understanding it shouldn't have needed to be an emergency procedure). I no longer live in the UK, and would not subject my kids to the NHS. I know this is a secular British heresy; too bad.)
If you care strictly about efficiency at bargain basement costs, NHS is probably your favorite model.
Unless you are actively dying nobody in the NHS will lift a finger to help you.
But the NHS is not only merely unhelpful when it comes to anything slightly nontrivial, they can be actively negative. I have had severe back pain laughed at and ignored. I have been told that sinuses can't hurt (after describing severe pain in the area of my sinuses which made me want to crawl out of my skull, regardless of whether they can or cannot hurt (the NHS website seems to suggest they can) the right response to "sometimes I have such severe pain that I forget what it's like to live a normal life" is surely not to dismiss it offhand). I have had ibuprofen and paracetamol prescribed simultaneously (by the same person) for severe pain while walking (which turned out to be flat feet, once I got referred to a specialist who produced a pair of tailored inserts in 10 minutes the pain quickly went away). I have had a GP prescribe half a course of antibiotics for suspected lyme disease because she didn't really think there was a chance that the tick that bit me had it (laboratory tests of the tick confirmed it did carry lyme disease). This was after I came back from Poland and had a massive red ring around the point where the tick bit me. Not sure what the logic was there, had to go to a private GP to get the other half prescribed. I think realistically for the average Joe who is mostly healthy until the age of 55 and only ever gets a broken leg, cut, or whatnot the experience of the NHS must be stellar. But for people like me, the experience can leave you in serious pain for large and important portions of your life.
Now I don't really know what the health system in the US is like, whether it's better or not. Doesn't sound better to me. But in the instances where I've paid for healthcare in the UK and in Poland I was at least met with people who didn't offhandedly dismiss my problems or laugh at me.
I don't think the problems which the NHS has are endemic to public healthcare systems, I've certainly met people in the NHS who did try to be helpful, but from all appearances of what I've heard, the NHS is constantly encouraged to be like this. I think the NHS could be a lot better.
Of course the whole system doesn't work if no one ever questions it. It's a shame some grandad had to step in to get things moving.
As someone who would love an NHS for the US, I was somewhat disturbed by the outcome being a fine for the hospital. It seems like they should have fired some administrators and funded more full time OBs??!?!?
From what it sounds like, there was trouble with the vaginal delivery - either mother's birth canal was too small or there was a breech, cord issue, or even placenta previa (unlikely because if mother had been receiving neonatal care, this would have been identified) or abruptio placenta (where the placenta comes free of the uterine wall prematurely).
Either way, the decision was made, more slowly than it should have, to perform a C-section, and a locum (fill-in) was to conduct the procedure (the fill-in part isn't inherently the problem, though it does mean they were likely unfamiliar with the patient). At some point in the process, between the complications of vaginal delivery and the C-section being completed (going off the 'coming out floppy'), the baby was likely starved of oxygen, likely to the point of needing resuscitation. The 'life saving tube' was most likely an ET tube for intubation and ventilation, but even for the most experienced obstetricians, paramedics, etc., intubation of a neonate is absurdly complicated, due to the tiny size of things (a neonate's trachea is about the same diameter as a pinkie finger, at most). If it took 26 minutes of attempting to place this (and who knows what mechanical ventilation was happening in the process, if any), then absolutely, that was a HUGE failure (for reference, in our protocols for working cardiac arrests, pauses to compressions for intubation placement are limited to TEN SECONDS. The average adult has sufficient oxygenation of the blood supply to last several minutes, but obviously the neonate has much less, and probably had near zero blood oxygenation by the time they were delivered and resuscitation efforts started). At the risk of armchair quarterbacking, if I'd had that much of an issue intubating, we would have gone with blow-by oxygen (if there was any spontaneous ventilation), holding a mask close to the face, or continuing manual ventilation with a bag valve mask alone, or attempted something close to an ET, like an I-gel, an invasive but less complex airway management device - if ET is considered the "gold" standard, then an SGA (supraglottic airway) would be a "silver" standard.