Too Many Old Boys

I am shocked but not surprised at the reports of the problems at Stafford Hospital A&E. There has been a long history of failure in the NHS due to the unwillingness of clinical and nursing staff to openly criticise colleagues who perform badly. The heart surgery scandal at Bristol went on for many years before action was taken to prevent poor performing surgeons operating way beyond their capabilities. The same lack of willingness to act at Stafford would appear to have resulted in many avoidable tragedies.

In the past the old boys network has been very strong in many parts of the NHS and served to protect individuals who had a reputation for poor outcomes and post operative complications. There are more checks today, but they are no where near as vigorous or extensive as they need to be, particularly considering the devastating impact when things go wrong.

Medicine is not an exact science, doctors will inevitably get things wrong or miss important indicators. But that is no excuse for the dismal way patients get treated. If we were to treat animals this way there would be a public outrage. Some how we seemed to have become a custom to poor service, a very sad indictment of the NHS today.

Here’s Your Pills, Now Sign Up For A Better Life Style

In the days I worked for a living I undertook a study of emergency and elective hospital admissions. The results showed over 60% of hospital patients were admitted because of lifestyle related illnesses. Substance abuse in the form of smoking, drinking and drugs together with poor diet and sedentary lifestyles were the underlying cause of most of the ill health treated by GPs and hospitals. Treating this self abuse costs the NHS a significant proportion of its annual budget.

Its interesting to think the founder of the NHS, Nye Bevin, thought the demands on the NHS would slowly reduce as the service healed the sick and improved the nation’s health. The increase in demand on the NHS from the obese is a continuation of the problem of self inflicted health problems. There seems to be little point in patching up someone who does not attempt to eliminate the very habit that has caused the problem in the first place. It has been suggested in the past that patients should sign a contract to improve their life style in exchange for the care and treatment they need to get back to good health. To a limited extent something like this happens now. Many surgeons will not operate on excessively overweight people simply because it’s unsafe.

The suggestion that those who create their own health problems because of their lifestyle choices should act to help themselves always brings a predictable response from politicians and libertarians. Political chicanery, interference, abuse of freedoms and nanny state are just a few of the comments made by the critics. What they do not criticise is the way so many people abuse the system and there own health. The NHS is not an inexhaustible resource a fact needs to be accepted by everyone. The sooner those who abuse their health are taken to task, the better for the NHS and the nation as a whole.