A few queries/comments:
1. Do we know what proportion of NHS hospital episodes are experienced
as appalling - what would we consider to be 'often'? I have had
considerable experience of the NHS hospital care over the past 22 years
for myself and other members of my family for both minor and very
serious problems and for the management of chronic and both outpatient
and inpatient care and I can honestly say that less than 1% of these
multiple episodes (at least 10 a year on average) were appalling, the
vast majority were excellent (really) and where it was less than good
and particularly when it was appalling it was the medical care/attitudes
not the nursing care/attitudes that were at faulty;
2. Do we have any 'evidence' on the performance of nursing during the
short period when they were allowed to be organised in community trusts
i.e. separate from and free of medical control? I was a non-exec on one
of these and although a sceptic initially I was convinced by the time
they were abolished and merged with PCG/Ts that this organisational form
had potential to release considerable positive capacity amongst those
professions disparagingly but sadly accurately referred to as 'allied to
medicine';
3. Hidden away in the inspection reports from the Commission for Health
Improvement (the regulator prior to the Health Care Commission which was
prior to the Care Quality Commission) which I served on as a
commissioner for a short time, alongside Julian Le Grand, there is a
body of evidence that points to the dysfunctional behaviour of doctors
in team as a factor in poor organisational performance in all
professional groups. Perhaps surprisingly the CHI did not look
systematically across Trust reports to identify just how common a factor
this was but to this qualitative social scientist it seemed to appear
suspiciously frequently. Is it politically easier to criticise nurses
than it is doctors?
Jennie
-----Original Message-----
From: The Health Equity Network (HEN)
[mailto:[log in to unmask]] On Behalf Of Martin
Rathfelder
Sent: 31 May 2011 18:08
To: [log in to unmask]
Subject: Re: This and that
I think successive reorganisations have devalued and disorganised
nursing in many places. I'm not sure that micro-management is the
answer, but Adam is right to raise it as an issue. One which will
certainly not be fixed by choice and competition, because those most in
need of nursing are least able to exercise any choice. Nor is it
obvious that giving more power to doctors will help.
On 31/05/11 18:01, Adam Oliver wrote:
> Alex has been sending a lot of messages to the list, challenging the
> reforms that the current government is proposing/has proposed for the
> NHS. I sympathise with Alex's view on this: I don't think promoting a
> market mechanism via GP fundholding had huge positive effects in the
> past, and there are not strong grounds to expect anything different
now
> or in the future.
>
> But NHS delivery is often appalling. So when one opposes reforms (and
I
> do think that most of those who promote the market in the NHS are not
> trying to privatise the NHS - they think the market will lead to
better
> delivery), I think there is an onus on us now to think about how the
NHS
> could be improved. One view, from me, is that there needs to be much
> more micro-management of nurses on hospital wards. Another is that the
> district nurse service ought to be analysed and reviewed. I'm a little
> bit tired of the NHS being used as an ideological football, when
> thousands (maybe hundreds of thousands) of people each year in England
> are not receiving a quality of service that is as good as it should
be.
>
> I'd be interested in any suggestions.
>
> Best,
> Adam
>
> Please access the attached hyperlink for an important electronic
communications disclaimer: http://lse.ac.uk/emailDisclaimer
>
--
Martin Rathfelder
Director
Socialist Health Association
22 Blair Road
Manchester
M16 8NS
0161 286 1926
www.sochealth.co.uk
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