A friend took a child to St Thomas's with stomach pain earlier this week at about two o'clock in the morning. Although the girl was the only one in Accident and Emergency, it was two hours before she was told she had a bed in....Lewisham. She was then, in the early hours, transferred by ambulance to the Lewisham Hospital NHS Trust.
The ambulance man told the mother that the cost of the transfer was £600. There was also a cost, of course, in terms of the comfort and convenience of the ill child and the parents, who do not live near Lewisham. The ambulance man also told the mother that the hospital in Lewisham had stopped recruiting ambulance men and was seriously under-strength altogether. He actually said '50 per cent' under strength, which must surely be a wild exaggeration. However my friend did indeed get the impression that the NHS at Thomas's and at Lewisham was 'creaking at the seams'.
Although, in theory, her daughter had been admitted to Lewisham by St Thomas's, in fact she had to wait another two hours in Lewisham's Accident and Emergency department. Again, no other patient was there. Doubtless the waiting at the two hospitals will go down on the records as two waiting times of under four hours. A success. In fact, the poor girl had four hours waiting plus the time in the ambulance - an ordeal for someone in her condition, which by now was labelled 'suspected appendicitis'. The girl was at Lewisham Hospital for 48 hours, yet never saw the same doctor twice. Each doctor who saw her asked the same questions. There was no continuity of care. The mother does not think her daughter was at any point seen by a consultant. (Incidentally, the girl was not X-rayed or given any other kind of scan. I don't know whether, according to best international medical practice, she should have received some diagnostic work of that sort.)
The hospital in Lewisham was so short of nurses that they positively wanted the parents there to be present and - effectively - to do some of the nursing. One parent came in with a baby and then left. The baby screamed and screamed. There was no nurse available to comfort it, so the screaming just went on for a couple of hours.
We were told that all that was wrong with the NHS was that it was 'underfunded'. Now it is not underfunded yet it still provides service like this.
St Thomas's was founded at an unknown date, it appears, but certainly before 1212. It was named after Thomas Becket. A little more on its long history is here. And here is a lovely picture of the old operating theatre in 1930, before the hospital was expropriated by the state. It has been a great hospital. It is deeply sad that, under state ownership, it should have reached the stage that it keeps sick children waiting and then sends them away to somewhere else in the middle of the night, allegedly using up £600 in the process.
I would be interested to have any comments from others who may have experience of the situation in Thomas's, Lewisham or, indeed, elsewhere in the NHS.
Posted by James Bartholomew • Indexed in NHS • Waste in public services
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Almost certainly targetism. The government targets are always more important than individual suffering.
It's nothing to do with "state ownership" though ; it's to do with this particular government's approach to ownership ; the object is to produce political propaganda for the Labour party.
Sadly, the ambulanceman's figures may not be that far out (but probably includes some not-actual-vacancies but "what is needed to do the job properly")
Norfolk and Norwich is closing wards and redeploying staff to fill vacancies elsewhere in the hospital ; there is extensive use of bank/agency nurses in the hospital.
Posted by: Paul at July 2, 2005 08:15 AM
So, the NHS needs more money ?
I've posted a couple of messages on a local noticeboard run by the local paper regarding our hospital. One is that the hospital walls are almost entirely blank and plasterboard, the second, that the glossy magazine produced by the NHS Trust is PR puff which could be better spent on nursing.
This has generated email responses, *personally* from the "Head of Communications" at the Hospital, who appears to be monitoring this board. These have been started by the trust ; I have never contacted him, or heard of him, and it wasn't till I saw his name on a news report that I realised who he was.
I have this morning been invited to make a "formal complaint" - my argument was basically that the charitable trusts who pay for the PR magazine would be horrified if they knew what was being done on their behalf.
It fascinates me that the hospital is so desperate to control the message that it feels the need for its departmental head to *personally* correspond with someone who is - well - nobody really, just a voter.
It bothers me the amount of money wasted in this fatuous PR exercise.
It is probably because the hospital has to save money again, 7 million this year, and is doing so by the process of closing wards.
He claims 3.09% of the money is on "management expenses" - I suspect this does not include salaries.
Posted by: Paul at July 4, 2005 10:37 AM
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Bits of it are underfunded. The bureaucracy isn't.
The *only* solution IMO is to make the public sector accountable in the same way that the private sector is. (Screw up, you get sacked)
I think this is the *real* problem with the public sector. There's no intrinsic reason why it should be less well run, but the total lack of personal responsibility at any level encourages people not to "watch the pennies" but to indulge in politicking and expanding their little acre for personal benefit and covering up. Parkinson's Law running riot.
It's simple enough. Many hospitals (for example all the main hospitals in Norfolk and Suffolk) are in a mess financially.
The administrators are given the task to solve ; so they do what they always do, pass it down through the levels of bureaucracy, making no cuts themselves, and pass it on to the tips of the tree - every department passes the demand for savings on, making minimal or no savings themselves, until they reach the people who do the actual work ; Doctors, Nurses, Porters - so they are closing wards to cover the massive deficits. The Five-a-Day coordinators etc. are untouched and sit there producing reams of nonsensical paperwork to justify their own existence, which the poor saps who do the actual work have to waste time filling in.
Same thing happened in the County Council, which is overspent. The people who get the sack are Teachers, Social Workers, Binmen and so on - those who work at the sharp end.
There's a debate in the local press which explains mindsets. The council is claiming that schools are not spending all the money they are given, and are complaining about this (it's likely they are simply trying to make excuses to take it back).
There is no concept, apparently, of prudent financial management ; saving for a rainy day, or a new building, or for extra staff, or to protect against redundancies.
The public sector can, of course, simply get more money by fleecing the taxpayer. The individual school cannot cover up its incompetence in this manner.
Posted by: Paul at July 2, 2005 08:08 AM