What is the word for a story that reached the level of fiasco some time ago and continued to deteriorate? Fiasco seems inadequate as a decription of the failures of the NHS IT system, several of which have been noted on this site by JG.
Patricia Hewitt, interviewed on News 24 on Saturday morning, explained that she should not take responsibility for the MTAS fiasco because the new system had been widely consulted and widely supported prior to deployment. In other words, doctors liked the look of the system, and if they didn't tell her she'd got it wrong, whose fault was that?
A friend of mine wrote me an email yesterday saying that every time he reads a story on Picking Losers about the NHS it puts him in a bad mood. I promised him I would try and post a positive one as soon as I can. Well, here goes...
From one IT system to another. The MTAS chaos rumbles on and the full reprocussions are going to be felt by the mugs that paid for it in the place - the users and funders of the NHS, you and me. Patricia "only a few weeks left and I'm out of the job" Hewitt has insisted that the system will not be put back up until the DoH is satisfied that all the problems with it have been resolved. And quite rightly, though it doesn't mean that the knock on effects aren't going to create even more trouble. This has led to warnings from consultants that operations could postponed this summer due to a shortage of junior doctors.
Well now we know how Tony Blair would vote in the poll. Yesterday he shot down Brown's hints that the NHS should be taken away from political control. He described it as "a great idea in theory", but warned it would disrupt the reforms and become a device for avoiding tough decisions. Blair also admitted that his programme of reform was slow to start off with and is unpopular with voters and professionals in the NHS.
It is rumoured that Gordon Brown will give the NHS independence from political control in his first 100 days in power. No doubt he is hoping that this will be right up there with his decision to give the Bank of England independence in 1997. Would this be a good move for the NHS or another smoke screen? Please leave your comments below and/or vote in the poll.
JG has been highlighting the MTAS fiasco. Besides the fine illustration it provides of this Government's incompetence and refusal to take responsibility for their mistakes, it also sheds an interesting sidelight on another bad Labour policy. On Thursday's Question Time, Caroline Flint, the Public Health Minister, explained the necessity to scrap the old system in the following words:
"I have heard, for example, from clinicians about how applications used to turn up at hospitals, they'd put them in a pile and literally pull them out at random. So it was all agreed that that system wasn't right."
A bad system is no reason or excuse to introduce something worse. And one of the main criticisms of MTAS is that it made the selection process more, not less random. But equally importantly, does this not describe almost exactly the "lottery" approach to assigning places in schools to students, introduced by egalitarian Labour councils and approved by this Labour government? Why is a random approach wrong for selecting junior doctors but right for selecting students?
But let's be fair and give credit where credit is due if a Minister manages to be sensible (a task made all the more compelling by the fact that Ms Flint is by a long chalk the hottest minister and probably the hottest MP in parliament, and that is not intended to damn with faint praise). Yesterday's Telegraph reports that Ms Flint has taken a robust and rational stance against the call from Alcohol Concern to make it illegal for parents to give their children alcohol. If parents can't teach their children how to drink responsibly, it is hard to know who should have that responsibility. And how would such a law have been enforced? Ms Flint is to be congratulated on resisting blinkered pressure groups, giving short shrift to such a nannyish idea, and choosing masterly inaction over ill-considered action.
Now if she could only teach the rest of her colleagues to apply the same approach, we might have fewer MTAS-style fiascos.
It just gets worse! On NHS Blog Doctor, Dr Crippen is reporting that any applicant can see any correspondent sent by a candidate on the Medical Training Application Service (MTAS) system, just by changing a couple of figures. This NHS recruitment system really is a shambles to say the least!
...read the comments for confirmation. Please take this out of the DoH hands, they are clearly completely incompetent.
The Guardian has revealed that there are 17 trusts that are heavily in debt and finally the NHS and Department of Health has admitted the problem. The debt is to the tune of hundreds of millions of pounds at each of the trusts - 12 of which are not creditworthy enough to be lent money from government funds, according to David Nicholson the NHS chief executive. The DoH must now enter a phase of complete re-organisation to to help them survive.
There is worrying news about the levels of MRSA and other "hospital" superbugs from an independent study done by Dr Foster Research. The study of 167 NHS hospital trusts in England found that infection control was in a state of disarray. Only 10 of the trusts had isolated 90% of individuals with MRSA - a standard that infection control experts regard as fundamental in the battle against hospital-acquired bugs. Trusts are reacting slow and screening patients outside the guideline times in most cases. Even more worryingly, deaths linked to hospital superbugs have increased dramatically.
A former Minister who has responsibility for NHS reform, Lord Warner, has launched an extra-ordinary attack on all those who work in the NHS. He cites "productivity" issues and resistance to change within the NHS as the major causes for the failure of Labour's investment programme and programme of reform.
It wouldn't feel right if there wasn't an NHS story on Picking Losers, so here goes. Surely the Department of Health must be the worst financially managed "business" in the UK? The National Audit Office seems to think so, and I agree. It turns out that those hard working doctors who received on average a 27% pay rise have seen their work load decrease. That's right - we are now paying even more for less. Edward Leigh, the chairman of the Commons public accounts committee, which oversees the work of the NAO, is pretty damning in his assessment of this department - "The bottom line is that the Department of Health has increased consultants' salaries without demonstrating any extra productivity in return... This is one more example of weak financial management by the Department of Health. It drove through the new pay deal with scant regard for proper evidence and solid financial forecasting."
I haven't mentioned the NHS for a while, but it was always going to come back. So here goes - the National Health Service's £12.4 billion national computer system. It's not a particularly new story, but confirmation of what we all feared has come out yesterday from the Commons public accounts committee. If there was a "Loser of the Year" award for the worst conceived policy or project, the NHS IT system would win hands down.
It is reported today, in the Telegraph, that the Government spends as much as 85p in every £1 spent on health in Labour Constituencies. It is not the first time that we have learnt the Government has been using financial incentives to win votes and I'm sure it won't be the last. There have been the classic Gordon Brown tax freezes and handouts in election years to curry favour with the voters over the past few years. Now details from a Parliamentary question show that of the 46 multi-million-pound hospitals built in England since Tony Blair came to power, 33 are in Labour areas. That amounts to £3.5 billion out of a total spend of £4.1 billion.
Has there been a government better at "charging for old rope" than this current one. As I understand, our taxes go, in large parts, to the funding of all things NHS - including their car parks. However, our money that went to towards building these car parks and maintaining them was only taken from us on the premise that we wouldn't actually use them, it transpires. If we actually want to use these car parks, paid for by us, then the NHS is going to make us pay more. Lots more. What better why to make a quick buck than to charge us twice for the same thing?
NHS shocker: "Reorganisation of NHS services for patients needing medical attention outside normal working hours was shambolic and ran hugely over budget." This is according to a cross-party committee report on one of the government's key health reforms. That headline could be shortened to describe the NHS really - "NHS shambolic and ran hugely over budget." The NHS had been getting off quite lightly from me this week given the focus on the environment, but true to form not a week goes by without some ridiculous tale of waste and poor performance comes out.
Rather like yesterday's post about Gordon Brown and the Treasury, the attacks I am giving the NHS at the moment aren't borne out of partisan views or a fundamental opposition to the idea of free health. I believe it is very important that access for all to an efficient and effective health system is one of the most important aspects of a civilised and modern society. However, the days when the public purse can pay for the NHS alone and we can trust the Government (be it Labour or Tory) to manage and run the service efficiently and effectively are clearly over. The damage being done by refusing to enter real debate and worrying about a complete overhaul is far worse than the alternatives. And it's not just me or a few that think this, it is a view backed up by those who really know - those doctors and nurses who have to put up with a substandard environment every day.
And back to an old favourite. The NHS and IT systems.
The NHS crisis is growing by the day - problems with IT systems, funding issues and misuses of funds, ineffective use of nurse and doctor resources, the list is seemingly endless. A story today has managed to combine all the worse parts of the NHS and highlights the desperate need for comprehensive reform of our health system.
The Office of Fair Trading is expected to expose the extents to which the NHS will go to waste money. Incredibly, the Department of Health has been cosying up to the big pharmaceutical companies and paying well over the odds for drugs with our money! Why is this not plastered all over the front pages??
The scam basically revolves around the PPRS (pharmaceutical price regulation scheme) that prevents drug companies from making excessive profits from the NHS, by effectively capping them. However, within that profit margin, any new drugs can be charged out at as much as they want. This has been quoted in the Guardian as high as £40k per patient per year for some new drugs. So what does a company do if it’s going to make a load of cash from a new drug? It passes its rights to older drugs to other companies who haven’t reached their cap yet. This is costing us millions each year. Yet another reason why the NHS is in serious need of reform.