Monday, March 19, 2007

The envy of the world

Starting the day with a reminder that even massive, vast, eye-watering spending levels can't cure the problems of industrial, soviet-style state healthcare. Dr Crippen wrote this a couple of weeks ago, quoting The Independent on Sunday:

  • 391 women have died in childbirth in the last three years, a 21% increase on the previous comparable period.

  • The UK now has one of the highest maternal mortality rates in Europe, with 13 deaths per 100,000.

  • 17676 women have suffered physical harm on labour wards in the last three years – harm such as perforated bowels, necessitation temporary colostomies.

  • Maternity medical negligence claims are costing the NHS £1 billion a year

It is all due to lack of resources and, as Dr Crippen never tires of saying, dumbing down.
  • Midwives are doing work for which they are not trained; work that should be done by doctors.

  • Health care assistants are doing work for which they are not trained; work that should be done my midwives.

How is the government dealing with this?

The Independent quotes the Department of Health as saying:
“Giving birth is safer than it has ever been.”
That's a cut-out-and-keep Labour lie. But what is Crippen talking about when he mentions a "lack of resources"? In 2000, a piece in the BMJ called for a health budget increase of more than £36 billion - roughly equivalent to a rise of 10p in income tax. That's exactly what they got. The statistics in the quote above are the consequence of a government's policy that has included increasing spending from general taxation to the level that was asked for by the profession. But the overall effect of government policy, including spending increases, has been a worsening of the service, its effectiveness and the morale of its staff.

Crippen likes the noises Cameron is making:
But back to David Cameron. He talks of trusting the professionals, of treating doctors like human beings again.

It is a long time since anyone in government said anything like that.
Nice words for a doctor to hear and a good thing were it to happen, but no solution to the problem. The NHS isn't incompetently managed. The problems it is facing are actually intrinsic to any large, monopolistic government-run enterprise. Until Crippen and doctors like him are willing to advocate the only genuine solution - privatisation, customer choice - the problems will remain.

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