I'm one of the authors of the Nuffield report which confirms the
findings of a number of other studies about the transfomration in
performance on waiting times in Enngland that has not been matched in
the other UK countries.

This is a systeic change but there are still issues over quality of care
in the many organisations that make up the NHS in England. 
Gwyn

-----Original Message-----
From: Anglo-American Health Policy Network [mailto:[log in to unmask]]
On Behalf Of May T. Cheng
Sent: 21 January 2010 20:40
To: [log in to unmask]
Subject: Re: Comparing NHS performance in the UK

Hi, Alan,

Good to hear this from you. One additional data point: Yesterday we had
lunch with Alan Ryan, immediate former warden of the New College at
Oxford, who pretty much said the same thing re waiting times. One of the
employees at the New College had an MI during Christmas holidays and
received timely and appropriate care with good outcome--the ambulance
arrived while the co-worker was on the phone with the dispatcher, and
upon admission the patient was given anti-MI medication and observed
overnight at the hospital, and fitted with a stent next morning and
discharged same day. No complications or readmission. 

May

-----Original Message-----
From: [log in to unmask] [mailto:[log in to unmask]]
Sent: Thursday, January 21, 2010 3:13 PM
To: May T. Cheng
Cc: [log in to unmask]
Subject: Re: Comparing NHS performance in the UK

Hi! Today the Public Expenditure 2009 report was published and senior
folk at the Department of Health were quizzed by the Parliamentary
Select Committee on Health about many issue including waiting times. The
median

waiting time for electives in England is now reported as just over 8
weeks in 2009 and all hospitals usually do all case within 18 weeks.
Errors do

however sometimes occur in some hospitals Steve. In York we have
problems with orthopaedics and opthalmology in some quarters but year on
year have done all electives within 18 weeks for some years Best wishes
Alan



On Jan 21 2010, May T. Cheng wrote:

>Dear Steve,
>
> 
>
>I, too, am truly sorry to hear what happened to your mother. Please 
>accept my sincere condolences.
>
> 
>
>I would offer three points: First, Ali touches on a serious issue in US

>health care, namely, the excessive use of interventional technology, 
>some of which can be dangerous in itself. Stents are an illustration.
>There is evidence that they are excessively used in US health care. 
>
> 
>
>Second, it seem to me that the real cause of your mother's death is not

>the queue per se, but poor diagnosis. Evidently the doctors who allowed

>her to stay on the waiting list did not realize how ill she was and how

>dangerous a delay could be. Do you believe they would nevertheless have

>allowed her to stay on a 20-week waiting list had they been aware of
her
>critical condition? What is truly tragic is what caused your mother's 
>death was septicemia from an infection resulting from a stent that had 
>outlived its usefulness and should have been replaced, and not AMI or 
>heart failure, the 'normal' causes of deaths for patients with CHD. In 
>that sense your mother's death could be considered a preventable death 
>in which case the system is to blame.
>
> 
>
>Third, one could, of course, eliminate the queues with still higher 
>health spending. In the rest of rich European countries, e.g.
>Switzerland, Germany, France, etc., I am not aware that long waiting 
>lines is a problem.
>
> 
>
>Best,
>
>Tsung-Mei Cheng (May)
>
> 
>
>From: Anglo-American Health Policy Network
[mailto:[log in to unmask]]
>On Behalf Of A. Tawfik-Shukor
>Sent: Wednesday, January 20, 2010 9:49 AM
>To: [log in to unmask]
>Subject: Re: Comparing NHS performance in the UK
>
> 
>
>Dear Steve,
>
> 
>
>I'm really sorry to hear about you mother, my condolences.
>Unfortunately, this is more common than is reported or talked about.
>Except in a minority of severely ill patients, CABG, angioplasties and 
>stents (drug-eluting or not) have not been convincingly shown to
prolong
>life or prevent future macrovascular complications on a population 
>level. Much of the $100 billion US heart surgery industry is, 
>unbelievably, nothing short of a sham. The huge cost of iatrogenesis is

>forgotten. At least that's what the evidence is telling us. Hard to 
>believe, as most people who have received such surgeries believe they 
>are alive due to, and not despite, these surgeries. Between that, and 
>the poor governance characteristics you accurately describe below, 
>patients, their families and taxpayers pay the ultimate price.
>
> 
>
>Kind regards,
>
>Ali
>
> 
>
>On Wed, Jan 20, 2010 at 3:35 PM, Birch, Stephen <[log in to unmask]>
>wrote:
>
>I haven't had chance to read the full report but the BBC website piece 
>says
>
> 
>
>"Hospitals in England now see all patients within 18 weeks".  
>
> 
>
>Last June my own mother was placed on a NHS waiting list in England to 
>have a stent removed.  20 weeks later she was admitted to emergency
with
>an infection caused by the blocked stent.  She passed away 4 days later

>from multiple organ failure caused by septicaemia.  I have no reason to

>believe that this is an isolated case. With the benefit of hindsight
she
>could have had the stent removed privately and still been living.
>
> 
>
>Like most things reported by the British Bullshit Corporation (BBC) 
>these days, one should take what they say with a pinch of salt.
>
> 
>
>I hope that the Nuffield Report does not make such irresponsible, 
>inaccurate and politically motivated statements in this election year.
>
> 
>
>Notwithstanding the inaccuracy of the BBC statement - those of us who 
>have sat on health authority boards (and many of those who haven't)
will
>be fully aware of how waiting time data can be manipulated to make it 
>say whatever you want.
>
> 
>
>On a previous occasion my mother received a letter from a health 
>authority explaining that they were to 'update' their waiting lists and

>unless she replied to them within a specified period confirming that
she
>still wished to have the procedure for which she had been waiting for 
>many months she would have her name removed from the list.  Now imagine

>how the average 80 year old disabled widow responds to that!
>
> 
>
>Steve Birch
>
> 
>
>From: Anglo-American Health Policy Network
[mailto:[log in to unmask]]
>On Behalf Of David McDaid
>Sent: January-20-10 9:08 AM
>To: [log in to unmask]
>Subject: Comparing NHS performance in the UK
>
> 
>
>FYI - new report published by Nuffield Trust
>
> 
>
>Our unique analysis of the performance of the NHS across the four 
>countries of the UK before and after devolution has found striking 
>differences in performance with some countries spending more on health 
>care and employing greater numbers of health staff but performing worse

>when it comes to a range of indicators, such as waiting times and crude

>productivity of staff. Our report compares NHS performance across the
10
>English regions with the health services of the devolved countries -
the
>first time such an analysis has been conducted.
>
> 
>
>http://www.nuffieldtrust.org.uk/publications/detail.aspx?id=145&prID=67
5
>
> 
>
>See also BBC News piece
>
> 
>
>http://news.bbc.co.uk/1/hi/health/8467655.stm
>
> 
>
>BW
>
> 
>
> 
>
>David McDaid
>
>LSE Health and Social Care and European Observatory on Health Systems 
>and Policies,
>
>London School of Economics and Political Science
>
> 
>
>
>Please access the attached hyperlink for an important electronic 
>communications disclaimer:
>http://www.lse.ac.uk/collections/planningAndCorporatePolicy/legalandCom
p
>lianceTeam/legal/disclaimer.htm
>
> 
>
>

Please access the attached hyperlink for an important electronic communications disclaimer: http://www.lse.ac.uk/collections/planningAndCorporatePolicy/legalandComplianceTeam/legal/disclaimer.htm