14 Oct 2013

I do not hate the NHS

I have literally just spluttered into my soup (pumpkin, if you must know).  A colleague was recounting a conversation in which she was asked why Channel 4 News hated the NHS so much.

Of course, C4 News does not hate the NHS.  Who does?  But she knew to what he was referring.  Me.  And a film we ran in which I reported on a set a data showing adjusted in-hospital mortality figures (catchy, I know).

Government Pledges Increase In NHS Funding

This data, by the internationally-acclaimed Professor Sir Brian Jarman, compared England’s HSMRs (hospital standardised mortality ratios) with a number of other countries.  In particular, the figures showed that on average, death rates were worse here than in America.

The vitriol and abuse I received was astonishing.  For reasons that have never been quite clear to me, a number of people out there seemed to think that I was saying the American healthcare system was better than the NHS.

I have gone back over my script a number of times but it is not there.  I did not say it.  Indeed, I specifically said that the American system was expensive and that there was no universal access.

US vs UK

Some of my critics said that I had not counted the people who do not have access to healthcare at all. But that was to miss the point of HSMRs.

What the data measures is adjusted in-hospital mortality.  That is, data which looks at what happens to people once they get into hospital and which is then adjusted for key variables including co-morbidities, age, elective/emergency admission.

All countries have different healthcare systems but the mortality rates are a specific value that can be recorded and charted and compared.  It is a peer-reviewed model developed by Professor Jarman, and in the case of America had been adjusted as far as possible to take into account the US insurance issue.

We went to the Mayo Clinic Hospital in Phoenix, Arizona, where we highlighted two very pertinent issues to what is happening here.

The first was that when something went wrong, for instance, a death that was unexpected, they used that as an opportunity to learn from it.  They poured over it in detail.  All staff involved where expected to take part in the analysis.  If systems need changing, they were changed.

Secondly, whistleblowing was actively encouraged because to not listen to a whistleblower meant there was a chance of missing an opportunity to improve safety.

Of course, a lot of this is driven by the fear of being sued, but it also stemmed from that crucial starting point – patients first.

‘Could be fantastic’

Time and again this does not happen in the NHS and we know this from the number of whistleblowers who have been hounded out of the NHS.

We also know this does not happen because there are scandals – Mid Staffs, Winterbourne, Bristol, etc etc.

A recent report from the Health Ombudsman revealed unacceptably high levels of sepsis in the NHS.  This was one of the points raised in the HSMRs film.   There have been several reports, too, in the past month about the poor care of the elderly in hospitals.  Again, this was what we raised in the film.

Is it to hate the NHS to point out these problems?  I think the opposite.  It is because the NHS is capable of being such a fantastic service that it is the responsibility of everyone to point out the bad – and the good – so changes can be made.

When I look down the list of NHS stories I have reported on over the past year, again I am perplexed by the accusation that I hate the NHS.

New cancer treatments, a diagnostic tool for dementia, and how trusts are coping in the increased demand in  accident and emergency units – to name a few.

I did an item recently on the Royal College of Physicians’ report on the need to change the way the NHS works and their examples of good practice.  I highlighted a fantastic service developed by a consultant geriatrician which was helping elderly people stay out of hospital.   How does that turn into me hating the NHS?

Cheap point

But what pains me the most (and it is not the person bending the ear of my colleague the other day or the accusations that I was being played by the people who want to privatise the NHS), it was a response to my Twitter message thanking St Mary’s Hospital and Great Ormond Street for the care my daughter received recently after a head injury.

Someone (I didn’t know them) said that they were surprised I used the NHS.  When I asked why, they referred to the HSMRs film.

I did say that it was pretty reprehensible to make a cheap and inaccurate point out of my daughter’s accident (at that moment we still thought she had a bleed on her brain).

I also said I have reported on the NHS for 25 years, but because of just one story that some disagreed with, and which was misinterpreted as a piece in praise of the American healthcare system (as if), I am suddenly deemed to hate the health service.

It is simply not true.

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