Thursday, 12 September 2013

At least we have a piano

There's no question the NHS needs to improve. Its recovery rates from too many cancers are woeful. Yes, they've improved, but they remain woeful. Agency nurses, who may be good individually but lack local loyalty and accountability, are too widespread. GPs have contracts which pay for responsibility without accountability, while A&E avoid working weekends and leave it to junior doctors to tackle the chaos of Saturday night.

The system makes mistakes. I have a family member whose broken back was missed by an X-Ray; my grandmother died at Wexham Park Hospital, much to the apparent irritation of a senior nurse and a close family member lost a baby when she shouldn't have done. These were not good experiences.
But, and it is a big but, the Channel Four news programme last night comparing the death rates of the NHS with the United States health system left me little short of livid with frankly shoddy use of statistics.

Ostensibly they have a good story. Sir Bruce Keogh, the NHS medical director, is to investigate after being shown statistics which reveal the death rate in the NHS was 58 per cent higher than the United States back in 2004, 45 per cent in 2012.

Channel 4 claimed to have access to exclusive data but the viewer only heard comparisons between the United Kingdom and the United States; other countries' figures were kept secret for reasons of 'confidentiality' which is a shame.

But no mention is made of the methodology. Professor Brian Jarman has been credited with highlighting the unusual death rate at the Stafford Trust and he deserves credit. But, his 'HSMR' system is no longer used by the NHS. It doesn't, for example, include deaths within 30 days of discharge.

No comparison between hospital deaths and home deaths in either country was made.
In US, 29 per cent of people died in hospital in 2010. In this country, it's roughly about 58%. Moreover, the cost of treatment in a US hospital was not mentioned, let alone end-of-life bills.

The programme had several moving, disturbing stories from family member whose loved ones died, having apparently suffered unnecessarily, while in hospital. All undoubtedly tragic. Yet, no further investigation is done. No causal link between the deaths and the NHS is made. They just died in hospital.

No comparison is made between health spending per capita. In 2011, in the United States it was $8,608, while the UK spend $3,609. Quite a contrast.

Life expectancy isn't noted either. For all the US spend per head on health care - and let's ignore the multitude who get no health provision at all, as the US government does - it lags behind Britain. For men in the UK it is 79, in the US 76. Meanwhile for women, in the UK you can expect to reach 82, in the US 81.
And for the record, US GDP per capita in 2012, according to the World Bank, was $49,922, the UK's $36,941.

But, I repeat, this is not to say genuine issues were not raised and investigations should be held into aspects of NHS care and death rates. But casual statistical use undermined an otherwise good story. And this is not what Channel 4 News normally does.

And perhaps most riling of all, the Channel 4 journalist was terribly impressed to find piano music echoing from the hospital she visited in the United States. Mayo hospital was 'impressive, with piano music paying in the lobby and sunshine streaming into the rooms' her blog read. Not sure there's much British hospitals can do about sunshine, especially in comparison with a centre in Phoenix, Arizona.

But, I was even more impressed to find a pianist playing a grand piano in the atrium at Guys and St Thomas' during my frequent visits there a few years ago. Better than piped muzak in dull, hotel-style ersatz, this was a patient having fun.

No comments:

Post a Comment

The comments expressed do not necessarily represent the views of the blog.