Saturday, March 11, 2006

 

NHS 'fast track' inefficiences exposed.

Those of us who care about the NHS-not least because it has saved our lives once and may do so again- were dismayed and depressed by Sweeney Investigates,, BBC2 9th March. This looked into the government's much trumpeted success in reducing waiting lists via 'fast track' operations, many involving foreign surgeons for this specific purpose. The programme challenged the company which organises the extra help, revealing muddle and inefficiencies, despite its claim to achieve a 99% success rate. Individual cases were then exposed where the surgery carried out was worse than substandard, in one case leaving crippled a woman who had presented her condition in the hope of being saved from such a fate. Extremely dodgy surgical work- and associated surgeons-were tracked down and interrogated.

Two NHS consultants were interviewed who claimed many of these short-term contract doctors had not been trained up to NHS standards and who could not perform in NHS conditions. Far from a near perfect success rate, they suggested a substantial proportion of the operations had to be re-done, with much suffering for patients along the way. Caroline Flint, the junior health minister, on radio 4 yesterday, blithely reprised the government script of a 'small proportion' of failure- such as one might always expect, but Sweeney's programme raised much more fundamental worries.

I have always been a bit dubious about 'fast track' assaults on the most chronic waiting lists for hip operations and other joint replacements. The reason why such waiting lists have backed up is that these are difficult operations requiring much care and espertise. Throwing hired hands at this problem was fine as long as that help was of the highest calibre but we now see this has by no means been the case. Maybe, taxpayers might ask, a fair slice of the £90bn p.a. due to be spent on health by 2008, is due to be wasted in this way? Maybe the government, with best intention, has bought in substandard workmen to do the job on the cheap and patients are suffering as a result?

The real worry- as deficits for health trusts spiral towards £1bn a year- is that the problem is proving insoluble. A free health service is what we want but this example of Labour's attempts to get it on the cheap is little better than the studied ignoring of such problems adopted as a strategy by the Tories as the service declined into near atrophy during the eighties and nineties. If Labour cannot make it work, with massive cash injections, we cannot expect the Conservatives, whatever Cameron promises, to do any better. Bit of a deepressing situation allround for NHS supporters.

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