UK Health Care System In Need of Repair
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By Brian M. Carty, MD, MSPH
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January 26, 2008
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Inadequate facilities, poor quality medical and nursing care in several British
hospitals cause deaths from intestinal infections.
Imagine that you are seriously, even
critically ill. You are in a dirty, rundown, understaffed hospital.
The nurses, doctors, and other employees are rude, inattentive, and
incompetent, and you can't get out. What could be more terrifying?
Such, apparently, was the nightmarish
predicament of a number of patients with serious intestinal
infections in a group of British hospitals between 2004 and 2006. An
October 2007 report by the government's Commission for Healthcare
Audit and Inspection has exposed a number of deficiencies in the UK’s
rickety government-run health care system, the National Health
Service (NHS). The report showed that outbreaks of Clostridium
difficile (C. diff.) intestinal infections in several NHS hospitals:
Kent Hospital, Sussex Hospital, and Maidstone Hospital, directly
caused at least 90 deaths between 2004 and 2006 and contributed to
many more. C. diff. is a type of bacterium which can cause serious
intestinal infections, often after the administration of antibiotics.
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The report documented poor quality
medical and nursing care and inadequate infection control measures. Doctors made mistakes in antibiotic prescribing, fluid and nutrition
management, and in many other aspects of care.
Nurses frequently did not wash their
hands, wear gloves and gowns, clean mattresses, empty and clean
commodes, feed patients, or give patients their medications. Patients who asked for help in going to the toilet were often told to
"go in the bed," then left to lie in their own urine and stool
for long periods. Patients and family members described the care as
"despicable," "sickening," and "appalling,"
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A sink in the "clean" utility room.
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The NHS hospitals involved were old,
dirty, and rundown. Although patients with C. diff. infection should
be put in single rooms to prevent transmission of the infection to
other patients, this was usually impossible. Only 10% of the
hospitals’ beds were in single rooms. Patients were usually put
in beds jammed together in long rows in large rooms. One hospital
had only one sink for every 6 beds, and the other two hospitals had
one sink for every 12 beds.
Empty apologies, empty promises.
The public release of the report was
followed by the usual cynical apologies and promises of reform and
"zero tolerance." In addition to the C. diff. outbreaks at Kent,
Sussex, and Maidstone hospitals, a similar outbreak at another NHS
hospital, Stoke Mandeville Hospital, caused 33 deaths between 2003
and 2005.
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UK health care system needs a makeover.
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Patients were usually put in beds
jammed together in long rows
in large rooms.
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How did the UK end up with such a
dysfunctional health care system? The English are prosperous,
intelligent, even brilliant people. One of my medical school
professors, originally from the UK, published the first account of a
carotid endarterectomy, the operation to clean out the arteries in
the neck to prevent strokes. He was famous as a surgeon, professor,
and writer and operated on Winston Churchill and the King of Kuwait.
Inadequate funding, poor management.
Although government mismanagement is
without question part of the problem, the UK spends much less on
health care than the US. Still, the British government nationalized
the health care system in 1948 and has had over fifty years to work
the kinks out of the system.
The British people deserve better.
© Copyright 2008 All Rights Reserved.
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