JAP Volume 7 Issue 1 Comment
Why did the NHS lose its way?
In light of the recent Francis Report on the poor standards of hygiene and healthcare at Stafford Hospital, why has the Mid-Staffordshire NHS trust gone from a body of warmth and healthcare to a soulless corporate machine? Kamelia Kountcheva gives a personal view.
very person in the UK, even the most miraculously healthy person, at one point or another, will come into contact with the National Health Service. Something important – a person’s own health, or that of a loved one – will invariably end up in the hands of the NHS. I’m a huge fan of the NHS. If, heaven forbid, someone I love is struck down by illness, and their life is in danger, I am greatly comforted by the thought that there are qualified doctors that will work what is often nothing short of a miracle to bring them back to health, whether I have money or not. It’s an organisation full of competent doctors, who face chilling illnesses every day, and lovely nurses, who work long shifts and comfort scared patients. The truth is that if someone we love is in danger, we would give
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every last dime and the shirts off our backs and the food from our mouths and anything else we are asked for to have them better and safe, all without a second thought. It has always been humbling and impressive that the NHS is an organisation that does not abuse the fact that a loved one’s health is worth everything we have. The trusted National Health Service, healing the nation. The people’s health service. Unfortunately, all of a sudden, the people’s service has shown
cracks in at least one, now infamous branch, revealing just how low the ‘people’ have dropped on their list of priorities. The damning evidence by the hundreds of voices of the friends and
families of the patients, who were mistreated, and died needlessly at Stafford Hospital between 2005 and 2009, has sadly reflected badly on the whole of the NHS, despite all the good work it does elsewhere, despite all the kindness the vast majority of nurses show patients and despite all the wonderful care that the vast majority of doctors provide. Now, the prospect of being treated by the NHS will be met with stiff apprehension by many, having lost the trust and respect that the patient-doctor relationship requires. Robert Francis QC presented his report on the situation in Stafford hospital on the 6th
of February, and the truth about the healthcare
situation was gut-wrenchingly disappointing. He stressed that the public’s trust in the NHS had been “betrayed”. Every limb of the operation, the hospital staff, the management, the NHS trust monitoring the hospital and all regulatory bodies, had wilted and withered, and lost sight of what should have been instinctively imperative: patient care. The blame trail runs through the veins of the NHS from the doctors and nurses at the tips, right to the bosses at the heart of the operation. At the bottom, many members of staff have been identified as neglectful, culpable and some are under investigation by professional regulators. A couple of weeks prior to the Francis Report being published, a nurse was condemned for taping a dummy on a baby at the very same hospital, which was under the close scrutiny of Mr Francis. The Mid-Staffordshire NHS Foundation Trust responded, saying there is “a zero tolerance approach to poor
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patient care” – a bold statement, considering what Robert Francis was uncovering at the very same time. The report detailed exceptionally poor patient care by the staff, including patients left dehydrated, malnourished, untreated and neglected. Some were reportedly left in agony without painkillers, some without vital oxygen, patients were dropped upon transfer, some were left in their own soiled sheets, and some elderly patients were not given baths or showers for weeks. Families of mistreated patients were distraught at the poor care.
One family member of a mistreated patient, who is a nurse herself, said she is “ashamed of the NHS”. It’s hard to say whether the Mid-Staffordshire trust just like to dole out this “zero tolerance” line when they are under the spotlight, or if they truly believed this to be the case. Given the level of neglect presented in the report, though, the wards should have been a ghost town, if this mantra was truly implemented. It is unfair, however, to tarnish all the staff at the hospital with the same brush. There have been those, who tried to alert management and the NHS bosses to the poor patient care and low standards at the hospital. And to what avail? To be deemed whistle-blowers and fear for the security of their jobs, as Kay Sheldon, a member of the NHS regulator’s board, discovered. Her recollection when trying to highlight problems to the Care Quality Commission (CQC) is that the NHS had a defensive nature. “I’d tried to raise the issues internally and with the Department of Health. But all I got was either denial or a sense that I was the problem.” Her caring was rewarded with only the strong implication that she would not be reappointed on the board, along with attempts to use her past mental health issues to discredit her arguments. The NHS management was not only defensive, but also turned a blind eye, according to Helene Donnelly, a nurse at Stafford Hospital. She had put in over a hundred incident reporting forms, complaining about understaffing and poor equipment. “That was one of the main failings, because it went right to the top that people were just not listening and didn’t want to know, and I think that’s why things got so extreme at Stafford,” said Helene. Evidently, meeting targets and cutting costs, had become
paramount to management, even over providing the best possible care for their patients. Gross understaffing to keep spending down and mismanagement of the available staff, meant inexperienced doctors were put in charge of critically ill patients, nurses were not trained to use vital equipment, and receptionists were left to decide which patients to treat. Understaffing not only exacerbated the careless nature of some of the staff, but also the standards and hygiene, which had been reported as disgraceful. This led to cross-contaminations of patients, some contracting superbugs, including C. dificile,
E.Coli and MRSA. In this long-awaited report, Robert Francis QC stressed that
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