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End of the Sidewalk: The Right Response to Universal Health Care April 26, 2009

"TB in Harlem"  by Alice Neel

"TB in Harlem" by Alice Neel

There is nothing subtle about my father.
By temperament, he is inclined to strong opinions and prejudices.
He did not attend college like I did.
He has been in jail.
Before my mother passed away, he had not seen her since she was pregnant with me.
Our five year relationship illustrates the best in each of us–one of I approach with a mix of discovery and suspicion.

One night after a nice dinner, decent conversation, and his doing his laundry at my apartment, dad was putting on his jacket to go home. He looked at me and did not want to smile. I knew why. Decades ago he had lost his front teeth in a prison brawl. He is deeply self conscious about it. He coughed a little which reminded me that I forgot to arm him with aluminum foiled left overs from our dinner. Didn’t want him to go home empty-handed. Grabbing a dishtowel, I turned to the stove to grab the roast when he softly asked.

Do you have any antibiotics you can loan me? “

Ironically I was recovering from a cold myself. I had not gone to the doctor for it. Like most of my colds, I treated it with rest, lemon tea and Benedryl. I knew that there were no antibiotics in my house. I paused a long time over his question. I was also a bit distressed that he would think I would share my prescription drugs with him even if I had them. Rather than saving myself the effort, I made a futile trip to my medicine cabinet. It was unsurprising to see that it was devoid of antibiotics. There was Prilosec, Zantac, anxiety medication, Imodium, Pepto, Aspercream, and Motrin for me…Insulin for my diabetic cat accompanied by needles, steroids and glucosimine for my dog that I put down in March (I really need to get rid of that stuff).

Also in the cabinet was an empty old prescription bottle which had my mother’s name on it.

It was for Atenolol. Medication that is prescribed for hypertension, the silent murderer of my mother.

Guilty feelings came back. Afrocity you should have tried harder to get her to see that she had a problem. You should have been there. She died alone, no one knew for days. I closed the cabinet and sarcasm became my escape route as I attempted to recompose myself.

mikelesterliberalblackssplan

“No Dad. No antibiotics. I can’t help you unless you want to shoot up with pig insulin, and get rid of hairballs.” I said dryly. (AWKWARD)

He laughed at my sense of humor but I was not as amused.

At 62 this was no laughing matter for him. How did he let things get this way? My animals have more medicine than he does. He has a nice apartment, a car, but no health insurance. He works but it is only small odd jobs here and there- nothing steady. He receives social security benefits but no medical card.

Mean spirited conservative that I am, I told him that his health was his responsibility. Together we would work on getting him to a doctor if he ever needed one. With his leftovers packed in a Saks Fifth Avenue shopping bag I walked him to the elevator. We rode down together saying nothing. Sundays are not good for me because they remind me of my mother. Seeing that pill bottle was the last thing I needed. At the time of her death it seemed like a nice souvenir. Her name was on it. She had existed once and seeing her name in print proved it. For the same reason, I continue to have her catalog subscription forwarded to me. Sometimes I even buy something to make sure they will remain in my circle of junk mail . Somewhere in Burlington, Vermont my mom is alive in a database. She bought breast firming cream just last week.

The elevator went to the lobby, it was cold and rainy but I still walked down the sidewalk with him to his car. We hugged and then I said something mean and stupid.

“I don’t need to lose another person in my life. I can’t handle it. I don’t need to get another call in the middle of the night from a stranger telling me my parent is dead. I don’t need that.”

He just nodded “I know”.

“She died at 68. That is six years from 62.” I warned as I backed away from the car. Now I was sounding like my parent’s parent AGAIN. Been there done that. Been there FAILED at that. The sidewalk ended time for me to go back inside of myself.

thehistoryofdemocrats1

Honestly I can not tell you how I feel about universal health care. I am undecided. Why can’t I put him on my insurance if I want to? See I want to take care of him. I don’t want the government to do it. There is no tension between the former Democrat I once was and the conservative I am now. I was not in favor of socialized medicine then. See told you I was a DINO.

The Health Care Debate Is Centuries Long

The Health Care Debate Is Centuries Long

On Friday Charles Krauthammer warned us to expect health care rationing in this Atlantic Journal-Constitution article:

Expect health care rationing

By Charles Krauthammer

Washington Post Writers Group

Friday, April 24, 2009

In the service of his ultimate mission —- the leveling of social inequalities —- President Obama offers a tripartite social democratic agenda: nationalized health care, federalized education (ultimately guaranteed through college) and a cash-cow carbon tax (or its equivalent) to subsidize the other two.

Problem is, the math doesn’t add up. Not even a carbon tax would pay for Obama’s vastly expanded welfare state. Nor will Midwestern Democrats stand for a tax that would devastate their already crumbling region…

It is estimated that a third to a half of one’s lifetime health costs are consumed in the last six months of life. Accordingly, Britain’s National Health Service can deny treatments it deems not cost-effective —- and if you’re old and infirm, the cost-effectiveness of treating you plummets. In Canada, they ration by queuing. You can wait forever for so-called elective procedures like hip replacements.

Rationing is not as alien to America as we think. We already ration kidneys and hearts for transplant according to survivability criteria as well as by queuing. A nationalized health insurance system would ration everything from MRIs to intensive care by a myriad of similar criteria.

The more acute thinkers on the left can see rationing coming, provoking Slate blogger Mickey Kaus to warn of the political danger. “Isn’t it an epic mistake to try to sell Democratic health care reform on this basis? Possible sales pitch: ‘Our plan will deny you unnecessary treatments!’ “

My preference is for a highly competitive, privatized health insurance system with a government-subsidized transition to portability, breaking the absurd and ruinous link between health insurance and employment. But if you believe that health care is a public good to be guaranteed by the state, then a single-payer system is next best. Unfortunately, it is fiscally unsustainable without rationing.

I agree with many of Krauthammer’s points having always found him to be levelheaded on mostly everything but especially health care reform. I am not looking to save the world. I just want to help my father help himself. Until then I will remember to guilt my doctor into giving me prescriptions for antibiotics and resign myself to being a political orphan on this issue.

Autographed Letter Signed,

AFROCITY

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23 Responses to “End of the Sidewalk: The Right Response to Universal Health Care”

  1. loudmouthjewishbabe Says:

    New here. Got loads of articles from newspapers abroad.

    I also take issue with the fact that those in gvt positions (MP’s of both parties in Britain/Canada/Israel get “fast-tracked” preferential treatment, and also may include treatments which are not deemed “cost effective” for the general public at large.

    And of course, they can always be shipped here to the US at whatever the expense to undergo “special” treatment for cancer, etc.

    So much to say, but not enough time.

    My Stage 3 sister was given Avastin 5 years ago, (not available in Britain- only now and still working on it after many lawsuits) and 4 other chemo drugs with no hesitation. Insurance picked all of it up, according to the plan, didn’t deny anything.

    VERY aggressive treatment.

    She would be dead if she lived in Britain.

  2. Sandra S. Says:

    “In Canada, they ration by queuing. You can wait forever for so-called elective procedures like hip replacements.”

    This is a load of shit. You can criticize the Canadian healthcare system on a lot of fronts, but this one is ridiculous. What happens in Canadian healthcare is triage- people who need care the most get it first.

  3. WMCB Says:

    Healthcare is one area that I (with great fear and trepidation, and allowing that one would have to watch them like a hawk), think govt has a role. We need to either freaking cover everyone, or have the balls to let people die. Because right now, we have laws that FORCE hospitals and doctors to treat those people if they are sick enough, and it is not fair that those in the medical profession have the burden fall on them.

    I’m a nurse. Hubby is a doc. Do you know how many uninsured hospital patients he sees in a week? FOR FUCKING FREE. The American public says “Oh, no, you can’t refuse them, that would be cruel.” Okay, fine. Then everyone pony up and come up with a system where my husband gets paid for treating them, or change the law to say that he can refuse, and if they die on the street, too bad. Otherwise, STFU, you hypocrites – you want them treated, and for it to come out of HIS pocket, but not yours. How is that fair?

    Hubby and I have seen the horrors of the ridiculous healthcare system in this country. I have a real aversion to govt doing it, but I have an even worse aversion to letting the private insurance companies do it. I understand the aversion to govt – truly I do. But what I don’t understand among conservatives is this belief that for-profit insurance companies wouldn’t screw it over worse even than the govt would.

    All I can say is that I have worked with many examples of insurance companies – from BCBS to Cigna to UHC, both as a nurse and as hubby’s office manger/billing clerk. I DESPISE them all. Their bureaucracy is WORSE than anything the govt has ever even imagined. I have fought and fought and fought with them to get treatments covered, drugs covered, tests covered. Their paperwork is unbelievable, and they are DELIBERATELY obstructive.

    The only govt-provided insurance I have dealt much with is Medicare. And ya know what? They are not perfect, but they are MUCH better than the private insurances, as far as being responsive, and covering things, and just generally not being assholes.

    So while I have my concerns about a govt-sponsored plan, and how it would work, whether it could be tied to income etc, I do know that in my own experience I would rather deal with Medicare all day long than deal with Cigna or UHC.

    Medicare open to all is what I would be for – maybe start slow by covering children up to 18, then gradually expand to everyone. Make people pay a percentage of income as premium. That is NOT the same thing as socialized healthcare, where the govt OWNS the hospitals and clinics, and the doctors are govt employees. Leave private and supplemental insurance in place for anyone who wants it and can afford it.

    We’ve had a govt-sponsored plan for decades in this country, limited to those 65 and over. It’s called Medicare. And as far as I can see, it works just fine – not perfect, but not horrible, either.

  4. Deathknyte Says:

    Be careful on those anti-biotics. They can mess you up just as bad as what ails you if you mis-use them.

  5. manbearpig68 Says:

    WMCB- What do you think about Dr. Muney in NYC as another option?
    http://www.nypost.com/seven/03042009/news/regionalnews/state_slaps_dr__do_good_157907.htm

    He charges $79 a month and $10 copay and bypasses the insurance company completely..

    • WMCB Says:

      We actually considered that, if hubby had stayed in private practice (he’s at a hospital now.) A lot of docs are, because the paperwork environment has gotten so hostile.

      The companies seem (can’t prove it, but some whistleblowers have said) to just randomly deny a certain percentage of charges. It takes a lot of time and office-staff hours to go back and challenge those, and they bank on the fact that some of them will not be challenged just because they either get missed or it’s just not worth it. They don’t get paid for those hours spent arguing on the phone and filling out forms and faxing records. Not one dime. At some point you spend more money out of your pocket arguing it than just writing it off, and the companies BANK on that fact.

      Look, I’d have no problem with a plan that covered everyone, but utilized private companies instead of govt – IF there were actual rules and controls on the insurance companies.

      But as much as I dislike govt bureacracy and control, those who think that the insurance companies as they exist now would somehow magically be better, just because they are private, is fooling themselves. Power over our health coverage concentrated in their hands is no safer than in the hands of the govt.

  6. This is a very touching story, Afrocity. The personal makes it unique and powerful. Thank you for sharing it.

    On a practical note, the argument against universal health care (which I waver on, too–if Hillary oversees it, I trust her; if it’s someone else, forget it) is that it is a choice. I know times get tight for people, but isn’t there always a smaller apartment to rent, more hours on the job to earn more, and/or ways to reduce the entertainment budget? I know some families without health insurance–they live in mega houses, though: they CHOOSE to put health care near the bottom of the list.

    Insurance is a funny thing–the amount you don’t use you feel you have wasted. That’s why people put it as a low priority–they feel they are wasting money and want other things with that money instead. It’s their choice, though.

    I think a very basic national health care would be fine, but with retaining the private sector so people can ‘upgrade’ to whatever level they choose. Problem is, no one will agree on where to draw the line with the basic care.

    I also think Krauthammer fails to recognize that private health insurance rations end-of-life health care, too. They just don’t phrase it in those terms.

  7. Nancy Says:

    Wow! Very good post Afrocity. I think it’s nice that you keep your mother’s pill bottle. I would do the same thing.

    I’m torn on the issue. I don’t want total gov’t run HC, but it can’t stand the way it is now. I love what Dr. Muney is doing in NY. I saw him on Glen Beck several weeks ago. It’s definitely an idea worth exploring, IMO. Whatever we do, it needs to be somewhere in the middle. I don’t want to end up like Canada.

    Afrocity, I used to have a diabetic cat. She lived to be 11. Very sweet kitty- I miss her. We now have three cats, one of which is a insane kitten.

  8. loudmouthjewishbabe Says:

    Here is an article from the UK Independent. Stuff you don’t see in “Sicko.”

    http://www.independent.co.uk/opinion/leading-articles/leading-article-our-health-service-can-no-longer-dodge-reform-924452.html

    http://www.independent.co.uk/life-style/health-and-wellbeing/health-news/judgement-day-for-cancer-patient-denied-costly-drug-924511.html

    As I said earlier, my sister has single insurance (not group rate) and they had no hesitation with paying for all the docs deemed necessary. Avastin was very costly and a newer drug at the time.

  9. astra14 Says:

    The small company I work for doesn’t offer health insurance because it can’t afford it. When I was younger healthcare benefits were always part of the benefits packages companies gave when they hired you, and you didn’t have to help the company pay for them, but over the years companies then had to have their employees put in to help offset costs, and now a lot of companies are no longer offering healthcare benefits because they aren’t affordable even with employees contributing. To leave to find a company paying what I could live on just to have health care (with money would be taken out of my pay) would be impossible where I live. It’s an either I have enough money to pay my bills and have a roof over my head (I definitely do not live in a mega-house)or not enough money just so I can have healthcare. Private insurance is out of the question, it costs too much. I’m still paying for surgery I had over 5 years ago (no I’m not on charity care and I don’t qualify for public assistance since I’m told I make too much money, which is a laugh).

    The one thing I’ve found: doctors and hospitals will work with you (payment plans) if you don’t have coverage and don’t qualify for assistance. Good healthcare professionals do not want to see people die for lack of care.

    Personally, I don’t want to see government force a universal healthcare program down people’s throats – especially if it’s benefitting the insurance companies that are making out like bandits and denying claims on whims. To force people to choose between Cigna and Aetna or else suffer the consequences doesn’t work for me because insurance companies like Cigna and Aetna want over $500/month on a private policy, I don’t see that changing and people like me would be out on the street. A government run program would be nice, but it still should be a choice because you know they’re going to screw it up or take it away at some point, and economically right now it’s far from feasible since our government is broke.

    From where I’m standing, the only ones who can really save the healthcare industry are the doctors and medical facilities. They need to find a way to make a stand against the insurance companies, who should not be making medical decisions. Once healthcare is firmly back in the hands of medical practitioners and out of the hands of big corporations, I think healthcare would improve in this country.

    • Janis Says:

      The doctors want to take a stand, desperately. You should hear my cardiologist get going on the topic. He HATES them — he has to think three and four and five times on whether to give someone a test he wants them to have because he feels he needs the information to make a good diagnosis — and he can’t order it because he knows the patient will end up getting the shaft. He gets furious over it.

      Doctors are focused on their patients, but fundamentally they are also egotistical bastards who got into medicine because they are convinced they know best. To be second-guessed by some desk pilot who never saw their patient is like a gauntlet to the face for most of them. They do NOT like being told what to do. My own cardiologist is the west coast expert for the issue I have, and he spits nails when someone who can’t even SPELL it tells him what he can and can’t do.

      I only have to worry about my paperwork. He’s got a couple hundred people’s insurance paperwork to sort though. It drives him up a wall. But he probably can’t bitch too loud, either. It’s insane, absolutely insane.

  10. Janis Says:

    I’m also ambivalent about the whole healthcare issue. People don’t realize that we are all essentially uninsured. I have a good job with a very good health insurance plan — supposedly.

    Unless you need it, upon which point you will be denied coverage FOR NO REASON. AT ALL. On paper, I have coverage for the things I need. In the real world, the deny me out of the gate. That means that, as a good hard-working, employed person who has “taken responsibility” for my own health, I am still up shit’s crick for $1800 when the insurance company spontaneously REFUSES to cover an MRI that my doctor ordered for me, and that I absolutely needed.

    WE ARE ALL UNINSURED, and only someone who hasn’t ever had to USE the insurance they think they have could possibly think otherwise.

    I don’t trust this country to do it right, but I don’t trust this country to do anything right anymore.

    • afrocity Says:

      Amen Janis. As someone who grew up on welfare and received health insurance that way.We called it a “GREEN CARD” because it was green at the time during the 1970’s but it was a medical card. There is a big difference between the types of insurance. I could not get braces, I remember that.

      • Janis Says:

        I haven’t had the echo I need for several years for that reason. My cardio wants me to have an echo once a year. I know I’ll get dinged for that money because the insurance company is worthless, and I want to be able to fly home to see my damned 75 year old mom, so I don’t get the effing echo. So it’s not just a matter of taking responsibility or getting educated and getting a good job, even. The whole issue has just got us all between a rock and a hard place.

        It’s not just a matter of choice. I’m one of those people with a (relatively) stable, white-collar job that I got through education and hard work. I’m supposed to be one of those people that the conservatives love, who got someplace by dint of my own hard work. And yet, if you aren’t a millionare with family wealth behind you, you’re just another slob. And the Dems are no better on it. Candidates for president are all sockpuppets anymore, and the same oligarchs have their hands up their asses. *sigh*

      • afrocity Says:

        Do you have HMO or PPO?

      • Janis Says:

        PPO. I need it, since my cardiologist is out of network.

  11. Daveman Says:

    While I do see that improvements and changes are necessary. I am sorry about you mother.I dont think Universal health care is the answer. I just dont trust govt to ration fairly (from my POV). When my wife and I had our son, we ended up paying almost 8k. long story, we had a hi deductible private plan with an HSA. At least the hospital offered affordable payment plans to pay off the debt.

    There has to be a way to get patients more involved with doctors to eliminate the middle man of insurance and govt? There has to be a way…..I know my state has such high regulations that it makes the insurance cost more….
    .

    Check out some good info on our current health care. the links at the bottom are worth the read and watch.
    http://smartgirlpolitics.ning.com/profiles/blogs/three-health-care-myths

  12. HippieRepublican Says:

    Warning: Getting on high horse….You know, I have an issue with people bitching about having to pay for something their CHOSEN insurance policy did not cover. I am a doctor and occasionally I am a patient. I am a chiropractor….so if you want to talk about the insurance companies denying payment to a provider, ask me, especially Medicare. If you CHOSE your insurance policy/coverage, and YOU did, you have no right to complain about what got covered and what didn’t. I am not talking about the random denial of procedures that are covered. The ins. co.’s are occasionally going to deny, so does Medicare. No one said you wouldn’t have to fight with the ins. co. on occasion. At least once or twice a year, I have to call AT&T, the elec. co., the cell phone co., the cable co., regarding correction of a bill or some extraneous charges. Why would BCBS be any different?
    I have never had health ins. through an employer, but I have been given the option. After reading through the offered policy and what it would cover and how much it would cost, I refused it. I got my own health insurance and it was cheaper and better than what was offered through my employer. Guess what, they were both BCBS policies. I educated myself and CHOSE what worked for me. In my experience, most people have no idea what their health ins. policy covers. They got insurance through their employer and by Godess it better cover everything….or they will bitch. That griping sure showed them, huh?! In Georgia, all regular BCBS policies cover chiropractic, but no one ever knows this. The insurance company should not have to tell you when you can read for yourself. These policies are written in easy enough language to understand, you can also call them and ask them to explain. YOU should know how many primary care visits are covered yearly. YOU should know that just because your MD ordered a test, doesn’t mean it is covered. YOU should know your ER visit cost, YOU should know your co-pay, deductible, yearly out of pocket, etc… YOU should know other insurance options as well. I just don’t see where the government has any place in health care. Catholics think abortion is wrong, Jehovah’s Witness’ think blood transfusions are wrong, many people think it is dangerous to vaccinate their children. Should government make their health decisions? Make your own educated choices about your health care. Investigate and change your policy if you need. The government is never the answer. Think for yourself, especially regarding your health care. Read your policy. Otherwise, please no bitching.
    Don’t go into health care because you want to make a lot of money….because you will have to treat people for free or turn them away. You do have a choice as a provider and if you choose to work for someone else, such as an ER, it is none of your business about the cost of the patient’s care. You are paid to work on people, not paperwork. Do your job and treat the patient and take the worry about the COST out of your head. I do not want to be the patient of someone who is worried about the bill I may end up with, I want to be treated regardless of what it may cost me. I will deal with the cost after I am well. If I am in this dilemma as a chiropractor, if I choose to treat the patient that doesn’t have insurance or money, I assume the cost, if necessary. Otherwise, I am committing malpractice if I choose to only half-ass treat someone due to their inability to pay. I would rather have done everything by the book, than to be paid. I’m serious. Now getting off high horse….

    • I don’t mind your high horse. I think it is a quite appropriate rant. The truth is that people pay much more attention to their vehicle insurance purchase than to their health insurance purchase, because they and no one else, pays for it.

      The crisis of health care we have in our country is not one of access (everyone has access to the health care system) nor even of insurance really (most people have insurance and many who don’t opt not to have it), but it is an issue of cost. The high cost of health care is a function of it’s being both 1) super highly regulated by various state and federal laws and 2) health care providers not really needing to compete effectively in an open market due to the fact that most people just assume “insurance will pay for it.”

      It is interesting to me that eye doctors are among the cheapest and most widely available health care service. You can get your eyes checked at WalMart for crying out loud!! Many insurance plans don’t cover optometry, though they will cover care for eye diseases, etc. The reason eye care is so much cheaper is that optometrists have to compete on price and location for your business, which drives the cost down.

      On a side note, I find it ironic that people who are strongly pro-choice (I know you are pro-choice afrocity) often have no issue with having the government dictate much more intrusively into your personal medical care. It seems a contradiction to me.

  13. Just a little off topic but:

    I was taken aback to see your blog. The picture of the painting “T.B. in Harlem” you have used as the title is well known to me.

    I have seen it in person as the man in the painting by Alice Neel is my late Grandfather Carlos Negron, after he had had a lung removed from Tuberculosis in the late 30’s-1940 was the year Alice did the painting. This one and “Puerto Rican Family” are among our family favorites if I remember correctly.

    I must admit I was a little shaken and just a smidge riled when first I saw it. After reading your blog, I see we are connected in many ways not the least of which is expressive “from the heart” writing styles. Lots of lucid, free thinking posts here.
    I don’t know what else to say but that I felt the need to reach out. I really liked you right away, and I think I dig your politics as well. Ok, I read back, noticing I have gone as corny here as I have in a very long time!

    On a serious note, reading through the posts here is very encouraging. Many more “mainstream” exchanges have little or no respect or tolerancefor opposing views, little in the way of lucid processing of the problems or suggestions for solving them. Many people are so willing to hand over their futures to bigger, inept and mediocrity riddled government it is concerning (ok scary). Thanks for considering my post.

    Warmest Regards and God Bless
    “Thomas” Scott Negron

    • afrocity Says:

      Dear Mr. Negron,

      First let me offer my sincerest apology for my use of the painting. I certainly meant no harm to the memory of your grandfather. Alice Neel is one of my favorite, favorite, artists. I discovered her work while I was working at an art museum in New York City. Her paintings have always moved me and when I thought of the subject of health care, the painting of your grandfather immediately came to mind . I wanted my readers to see the human side of the subject. That painting of your grandfather is one of my favorites, as well as Neel’s “Two Girls, Spanish Harlem” . I have a poster of that one which is about as close as I will ever get to owning an actual Alice Neel painting. I was just thinking last night that I want to own a real piece of art someday to hang in my home -only for my eyes. However then I thought I would give it to a museum for all to see.

      I am honored that you shared your story with me and you do not at all sound ‘corny’. I am overwhelmed.

      The name of this blog is “Autographed Letter Signed” which is a term used in my profession as an archivist,curator. My primary mission is to use my blog as place to discuss politics, collective memory and history while serving a potentially dualistic role as a vehicle to promote art awareness and archival advocacy. I have received quite a few emails asking about the paintings, political cartoons and archival material I have used so I hope it is working.

      I pray for your continued participation in my blog.

      Sincerely,

      Autographed letter Signed,

      Afrocity

  14. kimberly Says:

    universal healthcare is such a wishy washy subject and i see that you agree.

    I have come to the conclution that the Medical Insurance companies need to make it a little easier for us. Their rates are way to high…

    I think this is a very important issue and just like every “important” issue I want the Government out of it.

  15. loudmouthjewishbabe Says:

    More news of that great “utopia” of national health care from Britain.

    http://www.independent.co.uk/life-style/health-and-wellbeing/health-news/death-rates-and-complaint-levels-at-every-hospital-to-be-published-1677114.html

    NHS trusts will be required to report levels of complaints from patients, and health authorities will hold regular “clinical risk summits” to assess threats to patient safety.

    The moves, signalling a new level of transparency in the NHS, were announced by the Health Secretary Alan Johnson yesterday in response to the publication of two reports into the scandal at Stafford Hospital in the West Midlands, where an investigation uncovered “appalling” standards of emergency care that may have led to hundreds of deaths but which went undetected for years.

    Families described “Third World” conditions at the trust, with some patients drinking water from vases because they were so thirsty and others screaming in pain. The scandal was exposed by the Healthcare Commission in March after monitoring of mortality rates showed the hospital had between 400 and 1,200 more deaths than the national average, during the three years up to 2007-08.

    The investigation revealed the hospital was so short of staff that receptionists were assessing patients in the A&E department. Nurses were so poorly trained they did not know how to operate heart monitors. Sir Ian Kennedy, chairman of the commission, described the standards of care as “appalling and chaotic” and said they were the worst he had seen.

    Two separate reviews into treatment at the trust, ordered in the wake of the Healthcare Commission investigation and published yesterday, found a key reason why the poor level of care persisted for so long was that patient complaints were ignored.

    Dr David Colin-Thome, national clinical director for primary care and the author of one of the reports said: “What has particularly shocked and disappointed me is that no NHS organisations, staff or representatives of the public reported any serious concerns about emergency services in the hospital. Yet patient complaints and patient surveys all pointed to poor care.”

    Managers, staff and doctors shared responsibility for the scandal which occurred because of an over-reliance on financial and treatment targets rather than on “providing quality services for patients”.

    The second review by Professor Sir George Alberti, national clinical director for emergency care found that “significant” improvements had been made at the hospital since the investigation and services in Accident and Emergency were now safe. But there were still shortages of nurses, bed occupancy was too high and there was a lack of equipment.

    Responding to the reviews, Mr Johnson said agency nurses were being drafted in until permanent staff could be appointed.

    From yesterday, death rates for all hospitals will be placed on the NHS Choices website which are “a clinical warning sign that should be investigated properly”, the Government said in its response to the reviews.

    Death rates had previously been available on the Dr Foster website, a commercial data collection organisation, but in a “not very accessible or user friendly form”. Sir Bruce Keogh, the NHS’s medical director, is working on more sophisticated measures of safety and effectiveness.

    Patient groups and the Tories have called for a full public inquiry.

    © 2009 Independent News and Media. Permission granted for


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