Comment - The PM and patient care
Tue, 10 Jan 2012 13:48:00 GMT
View from the North
"Calm down, dear, and think again"
Comment – Former nurse and Professor of Health Care Peter Bradshaw considers the Prime Minister’s recent remedy of measures for the English NHS to tackle what the PM sees as a “real problem” with patient care.
So David Cameron is interested in the Nursing profession.
His speech last Friday in Salford had all the sentiments of Florence Nightingale, the iconic ‘Lady with the Lamp’. He acknowledged laudably, that there are shortcomings in nursing standards in parts of the country and that some hospitals are inhospitable places.
Yet his diagnosis of this condition was ill informed. It concluded that, ‘form filling and bureaucracy’ are the root causes, distracting nurses from spending more time with patients. His prescription; nurses should ‘walk around the ward every hour’ to see that their charges are ‘happy’. So happy indeed, that they would recommend the hospital to their friends!
Mr Cameron (pictured below) added to his gimmickry by offering cash bonuses to hospitals that:
- Achieve patient satisfaction
- Avoid falls in elderly people
- Prevent the occurrence of deep vein thrombosis
- Reduce hospital-acquired infections
For completion, he proposed a Nursing Quality Forum to identify good practice through a patient inspection regime to monitor cleanliness, food and privacy.
This rhetoric all shows naivety of the daily reality of bed-side care. It demonstrates negligible insights into the reasons behind these deficiencies.
But where has the Government been in tackling this in the light of the weight of evidence before it?
Recent critical reports on nursing care have been stinging. Their sources are copious and authoritative. The Care Quality Commission, the Government’s own NHS watch-dog has been toothless, serving only to describe care and the maintenance of patient dignity as ‘alarming’ but proposing no solutions.
The Health Ombudsman has similarly raised gross concerns based on complaints filed by patients and relatives.
The Patients Association has added weight, focusing especially on elderly patients whose care it described as, ‘shameful’. It cited denial of pain relief, being compelled to lie in their own faeces and denial of food and drink as examples of its claims.
But Secretary of State Andrew Lansley has remained comatose in the face of these allegations. So wherein lay the answers that are failing to come from Government?
Firstly, it would seem logical to listen to nurses’ concerns. These repeatedly emphasise the poor skill-mix prevailing in a derelict, cash-strapped NHS. The goodwill of ‘affordable’ Health Care Assistants is invaluable. But to try and run busy acute wards with insufficient, properly qualified nurse/patient ratios is asking for trouble. Running them off their feet with poor staffing levels compounds the difficulty. Inquiries into hospital failings repeatedly reinforce this explanation. The Royal College of Nursing predicts that to save £15 billion by 2015 will mean 40,000 qualified nursing posts will be axed. Hardly an optimistic prognosis, is it?
Secondly, the quest to privatise swathes of the NHS is another impediment. £3.5 billion is being spent on this colossal, untested, ideologically-driven Tory whim that is crippling skill-mix. So the Health and Social Care Bill will predictably worsen matters. The brave new world of the private market will turn patients into ‘commodities’ not people. It will replace an historic system of NHS altruism with one based on the acquisition of profit. Good news for shareholders; bad news for patients!
Florence Nightingale (pictured) said that, ‘the hospital should do the patient no harm’. Her latter day mimic Mr Cameron might think he has secured a tasty sound bite. She would tell him to, ‘Calm down, dear, and think again’.
His gratuitous, populist comments should not disguise the truth. He is presiding over a system dependent on amateur nurses. Might he now create one with amateur doctors?
He should have been better advised on his clinical management of this case before demonstrating that he cannot distinguish his ulna from his elbow!
Professor Peter Bradshaw
