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"The Killing Wards"

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Sunday Times Magazine feature by Tim Rayment

It is a given that there will always be shortages within the NHS. Advances in medicine, new procedures, increased longevity will all combine to ensure that no budget is enough to meet everyone’s expectations. Consequently, decisions will have to be made about priorities for spending.

Managing the vast expenditure on the NHS is a difficult task as is measuring performance. It does seem to make sense that those measures should be of outcomes rather than of process. This is certainly the conclusion of Tim Rayment in his feature ‘The Killing Wards’ (Sunday Times Magazine 25th June 2011) which follows the continuing enquiry into the treatment of patients at Stafford Hospital and its exceptional death rates. A bitter sweet note in the article highlights the absurdity that the trust was awarded foundation status by one body whilst another body was investigating the abnormally high death rate.

Trusts are assessed on their written procedures rather than on whether those processes are being followed through to successful outcomes. Sadly, the enquiry is hearing evidence of widespread neglect, ill-treatment and missed diagnosis. There is also evidence of suppression of the truth and pressure on complainants and potential whistleblowers.

Individual medical and nursing staff are often struggling to cope in very demanding conditions but, like the patients they serve, they are let down by the system and there are many outstanding examples of excellent care. Sadly there are also too many examples of poor care and unnecessary deaths. Patients find that they need to be good advocates for their own care, or they need to have someone to be their advocate.

Claims for clinical negligence are too common. They do not alter outcomes. In some instances patients have little choice other than to sue for damages to compensate them for significant financial loss as well as for unnecessary pain and suffering. In other cases, patients (or their relatives) are really looking for no more than the truth, an apology and above all some indication that lessons will be learned and that others will not have to suffer in the same way.

The proposed reforms following the Jackson Review will save public bodies (and others) a great deal of cost in defending claims. They will limit the legal costs recoverable by the claimant. That, in turn, will make it harder to pursue claims through the courts.

The Stafford enquiry continues. In the meantime the government is trying to press ahead with reforms.

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