In a disturbing article, The Daily Mail reports that NHS hospitals now put children on the Liverpool Care Pathway, withholding food and fluids from young patients and severely disabled newborns. Critics say that it is impossible to say when a patient will die. Using the Liverpool Care Pathway makes death become a self-fulfilling prophecy.
David Friedman weighs in:
I recently came across a news story about a British legislator who proposed that patients suffering from life style illnesses, medical problems mainly due to behavioral choices such as being overweight, ought to have to pay for their own medicines rather than having them provided for free by the National Health Service. It is a proposal that I expect will provoke strong responses both against and for…
[I]t is not clear just how the logic of endogenous disability can be dealt with in a governmental system such as the National Health Service. There is a serious problem of lack of bright lines. Many sufferers from type 2 diabetes, an example mentioned in the news story, may have it because they choose to be greatly overweight, but presumably not all. Similarly in other cases.
Okay, commenters. What do you think?
This is from the Daily Telegraph, courtesy of David Henderson:
A 29-year-old woman will die without a new drug that the NHS is refusing to provide despite the manufacturer offering it to her for free, it emerged today.
Caroline Cassin, 29, who suffers from Cystic Fibrosis (CF) has been offered a new drug free of charge for a limited period by the makers but her NHS hospital is refusing.
Her family says she will die soon without it, yet managers at Heartlands Hospital in Birmingham say it would be unethical to provide the drug under the deal, only for it to be withdrawn later.
The drug, Kalydeco also known as ivacaftor, costs £182,000 per patient per year, and works for five per cent of people with CF who have a certain defective gene, around 270 people in England.
More on the British National health service in The Economist.
NHS doctors are prematurely ending the lives of thousands of elderly hospital patients because they are difficult to manage or to free up beds, a senior consultant claimed yesterday…
Professor Patrick Pullicino said doctors had turned the use of a controversial “death pathway” into the equivalent of euthanasia of the elderly. [T]he Liverpool Care Pathway [LCP], a method of looking after terminally ill patients that is used in hospitals across the country…can include withdrawal of treatment — including the provision of water and nourishment by tube — and on average brings a patient to death in 33 hours…There are around 450,000 deaths in Britain each year of people who are in hospital or under NHS care. Around 29 percent — 130,000 — are of patients who were on the LCP…
Professor Pullicino claimed that far too often elderly patients who could live longer are placed on the LCP and it had now become an “assisted death pathway rather than a care pathway.”
Source: Daily Mail.Thanks to Linda Gorman for the pointer.
The National Programme for IT in the National Health Service was launched in 2002 with a 2010 goal of providing every NHS patient with his very own electronic medical record. Yet in its most recent report, the British National Audit Office states that the Department of Health there has been a:
steady reduction in value delivered not matched by a reduction in costs. On this basis we conclude that the £2.7 billion spent on care records systems so far does not represent value for money, and we do not find grounds for confidence that the remaining planned spend of £4.3 billion will be different.
As in the U.S., the system was sold with claims that it would improve services and the quality of care. In fact, many of the proposed applications, like internet appointment scheduling, electronic prescribing, computerized order entry in hospitals, and a secure organizational broadband communications network are already in use, without government subsidy, in the U.S.
In February, the Financial Times reported that, Britain’s Royal Surrey Hospital made £300,000 in profits last year by buying £4,600,000 of prescription drugs at prices arranged by the British government [gated, but registration is free] and then exporting them to foreign buyers. European Union laws make this practice perfectly legal, and the recent weakness of the pound against the Euro means that a drug sold at negotiated prices in England can fetch much more in Germany.
One in 10 UK pharmacies is arbitraging drugs and by May an estimated £40 million in drugs destined for the NHS were being diverted every month. Because manufacturers allocate supplies according to the price paid, shortages have developed in the treatment of cancer, high blood pressure, epilepsy, asthma, osteoporosis, and high cholesterol — despite official promises that “patients must come before profits.”
Paying for private consultation has cost Jenny Whitehead her place on the National Health Service (NHS) surgical waiting list. A NHS spokesman said that “Anyone who chooses to pay for a private outpatient consultation cannot receive NHS treatment unless they are then referred on to an NHS pathway by their consultant.”
In 2008, the NHS tried to deny all care to cancer patients who paid for drugs not offered by the health service. The government said that it had ordered the NHS to stop withdrawing care from people who paid privately for unobtainable drugs or treatments.
The National Health Service (NHS) considers the traditional, pint-sized beer mugs favored by English pubs, a health hazard. The NHS identified about 87,000 violent incidents each year, where drunken patrons smash a glass mug against another patron’s head or break a beer glass to use the jagged edges as a weapon in a pub brawl. The NHS’s cost to treat bar-related beer glass injuries: $4.3 billion per year. The NHS’s solution: safety glass beer mugs made with glass similar to how auto safety glass is made for windshields.
If you think American administrative costs are high, consider this. NHS Blog Doctor has an informative post on the kinds of jobs that proliferate in the British National Health Service (NHS). There are Equality & Diversity Managers, Patient Experience Managers, and Spiritual & Pastoral Care Managers, all of whom earn “higher salaries than, for example, junior hospital doctors and experienced ward nurses.”
The job description for a Patient Experience Manager? “Work with the Head of Patient Services to embed patient experience metrics as an integral part of performance management across the Trust.”
The same job ad asks “Are you passionate about improving the experience of all our patients and carers? The Trust must put the patient and their [sic] carers at the centre of all we do.”
Does the NHS exist for the benefit of those that they are supposed to serve or the benefit of those that they employ? Judging from this job ad, at least one NHS hospital cannot make up its mind on that point.
Site Visitors