Saturday, 23 November 2013

Tales from the Gulag revisited 001.

A few years ago when doctors in the UK were allowed to write freely the doctors here at ND Central ran a series of pieces describing how well socialized medicine works in the UK and the experience of hospital care of one of their relatives. A recent unfortunate turn of events led to the same relative being admitted as an emergency to one of Northernshire’s finest tractor plants. 

Now the relative was given NHS Choice as to which hospital they were to be confined, banged up in, admitted to and they opted for the one where there was a chance that their care and investigations might be equivalent to those in the first world admittedly the first world as it was in the early 1990s. The local alternative was the Stone Age or Tony Blair’s or Gordon Brown’s Scottish sub third world care. 

So admission was arranged and of course you would expect, if able, to be allowed to go home and collect some basic kit and rations before driving to the local center of excellence. This was not an emergency admission, for all admissions to hospitals and GP appointments in the UK are “emergencies” and all UK patients are “rushed” into hospital or to their GPs surgery to give patients gravitas to justify their ignorance for misusing the health service for trivia and not paying for the privilege of doing so.

So given the huge distances that need to be travelled in Northernshire’s forest and moorland covered hinterland it took a while to drive back to the baronial estate, beat the servants to prepare an overnight bag before being driven to the tractor plant by the aforementioned servants (your average over paid Daily Mail GP). Normal patients just expect an ambulance.

Now this was an admission to get something done and a lot of being in hospital in the UK consists of being banged up and sitting on a bed with nothing to do except wait for your jailers who once used to be nurses now more likely HCAs (Health Care Assistants) to bringing you food and medicines while you wait, and wait, and wait for things to be done.

As a result boredom is endemic in the NHS and a huge part of NHS treatment but never the subject of any NHS managers’ efficiency gains. The great British public being of an athletic ilk spend many hours practicing the active sport of soap watching and above each bed was a personalized TV set with 2 cable attached devices offering you a (private sector) “service”.

We described this in a piece a few years ago so we thought we would play catch up based on boots on the ground not dodgy dossiers.

So how much do you think it would cost to watch TV for 24 hours in a Northernshire gulag today? Well in 2009 it cost £ 7.00 for 3 days of TV watching but today comrade patients it costs a mere £10 a day. Apply that for a year and that equates to £ 3650 a year for the privilege.

So in 4 years the cost of watching TV in hospital for what is truly a captive audience on what we referred to in 2009 as Shaft a Patient Line (SAPL) now called hospedia has gone from £ 2.33 a night to a massive £ 10 a night an increase of 429% against an inflation rate of 3.2% from 2009-12 calculated and averaged from this source.

A clear demonstration of how healthcare inflation greatly exceeds normal inflation and a demonstration as to how the private sector will save the NHS billions. Remember how GP out of hours costs tripled in 3 years using the same system and the service got better too?

Now a 50 inch plasma screen 3D TV from a leading manufacturer (Panasonic TX-P50GTB) costs £ 799.95 (goggles would be extra and other TV brands are available, comrades) and uses 172 watts which if used for a year at 19p per kWh nonstop would come to a massive £ 286.28 of energy per year. Add the cost of a TV license (£ 145.50) to this and to watch a 50 inch 3D plasma TV for a whole year only costs a mere £ 1211.73 or £ 3.32 a day.

And £ 2438.27 left from not purchasing hospedia to spend on takeaways for your whole year of TV watching and clearly hospedia represents a clear NHS patient shaft.

Fellow inmates over a mere 24 hour period were quick to share their experiences of the SAPL now called hospedia notice the subtle inference towards a potential source of knowledge versus crude commercial rip off gain?

One described their experience of a first world university hospital where they were only charged 50 p a day for hospedia and also implied heavily that the care given there was much better there too. Another later in our relative’s stay noted that one of the many nearby district general hospitals charged £ 3.50 a night but at the same time when there was a token sanitization of the screens by staff they pointed out that the screen size was a massive 1 inch (diagonal) difference so £ 10 a night was clearly worth it for the extra inch on a screen possibly no bigger than 14 inches if that.

The NHS market also revealed that just as POWs found ways of eeking out meager rations during World War 2 the NHS patients have learned to scavenge too. We were advised that the trick is to purchase the £ 5.00 package as the 5 so called terrestrial channels were available for free until 18.00 and so pay £ 5.00 to watch evening TV when even less is done for patients rather than £ 10 a massive 50% less than the full price.

But still almost twice as much as buying a 50 inch plasma for yourself and watching it all year (with takeaways as well). 

Praise be to the Party for ensuring that all 3 Parties think private best public not. Perhaps we should ask all MPs to get their own TV from hospedia so that they can see what “value” this “service” is to their constituents? 

This would not work for they would only claim hospedia back on expenses in the same way that those on benefits and low incomes can do when they are admitted to hospital. The MPs would probably be shareholders too and are rarely NHS patients.


Sunday, 17 November 2013

A duty to . . .

The news in the UK has had quite a lot of coverage of a former Director of PublicProsecutions view’s on the need for legislation to make it a criminal offence not to report suspected child abuse. While we are sure he is an expert on matters legal like so many whose views are reported so widely he has not got a clue where the real problems are. He probably has not read any report into any notable cases of child abuse over the past few decades.

If he is proposing an offence it should not be the failure to report abuse. 

It should be the failure to share information and more importantly the failure to act on any information reported. Any GP in Northernshire knows the situation. You suspect something and you want more information.

The Party have taken away our once first port of call the health visitors and shipped them off into central (now privatized) barracks via TCS (technically Transforming but more accurately Transferring Community Services to the private sector) where they are now hidden from us as is the information they hold. 

Instead of you have accountable health visitors whom you knew and saw regularly there are numerous unidentified health visitors allegedly accountable for your patients but only by phone and that is if someone knows which health visitor is responsible for which child in which postcode area and no one is on holiday or off sick. And someone answers the phone.

Phone calls to local social services are of course logged or met with a barrage of excuses to do nothing like “I can’t get in” or “I’ve spoken to the school nurse and there is not a problem” which is pretty good as we can never speak to a school nurse without weeks of trying.

Even if the failure to act is followed up, as our GPs are encouraged to do by the local fly by night senior social service managers, these managers then insist on a GP filling in a 400 page assessment form before they “can do anything” as opposed to someone doing something so once again nothing happens. The forms require not what the suspicion is but important things like the number of plug sockets in the house and their siblings’ shoe sizes all information your average GP has to hand. A form missing a section filled in = a referral rejected.

These senior managers who hide behind layers of bureaucracy believe that technology is the key. They feel that if computers talk to each other that will solve everything.

This is no different to what happens at present. Everyone has information but no one can or will share it. Putting information on to a computer means the information is there and can be tracked, it can be date and time audited which is great for bureaucrats but not for children. You cannot interrogate a computer and computers only share information if instructed to do so by a human being. Most managers cannot program a computer which is no different to those in the UK who write medical software.

Legislation will not improve child protection as the learned lawyer thinks for the law places so many more obstacles to NOT getting information than it allows e.g. Data Protection Act, Human Rights, patient/client confidentiality et al. Any GP out there not had any of these quoted to them by social services in their career?

The law also allows many more reasons for people involved not to do anything and get paid for doing so and so any additional laws will achieve nothing. 

Praise be to the Party and its organs for once again missing the point of the problem. The information is often there but not shared or acted on. So we can report to our heart’s content and history repeats itself again and again . . . regardless of any new law(s).