Nurses for Reform Blog

Last week I had an article published on the IEA blog that was picked up by Conservative Home.  Conservative Home is the UKs leading Conservative blog.

I was again publicising that, using their own statistics, the NHS kills more people annually than drink driving does.

This is a fascinating article written by someone who is not an expert in the healthcare debate, but someone who has experienced the pitfalls of the current US healthcare system and come to the conclusion that there must be a better way of healthcare delivery and funding.

It gives a comprehensive review of the history of US healthcare provision and funding and goes on to draw some interesting conclusions on how future healthcare funding could work for the benefit the consumer.

For those of you able to attend, the author is speaking on this subject at a CATO Institute event in Washington D.C. later this week.

The Taxpayers Alliance (TPA) have published a revealing new report in to the underuse of vital diagnostic and treatment equipment in NHS Trusts.

The key findings of the report are:

Using Freedom of Information requests to every one of the 200 Acute NHS Trusts, the report investigates how many times a year each Trust uses each of five different classes of medical equipment:

•  Linear accelerators (Linacs) play a critical role in cancer care as part of radiotherapy treatment. Each patient receives several treatment sessions, known as “fractions”:

    - The average usage of each Linac machine in 2008 in the NHS was 7,191 fractions per year. That is significantly below the recommendation from the National Radiotherapy Advisory Group of 8,000 fractions per machine per year – a rate which was only achieved by 11 Trusts nationally.

    - There is also considerable variation between trusts, with two Trusts (Hull and East Yorkshire Hospitals Trust and University College London Hospitals Trust) providing fewer than 5,000 fractions per machine.

    - If all trusts below the national average brought their usage rate up to the average, an additional 128,758 fractions could be provided – equivalent to 18 additional Linac machines.
 
• Positron Emission Tomography (PET) scanners are extremely useful in effectively diagnosing cancer and then planning appropriate treatment.

    - The average usage of each PET scanner identified was 956 scans per year. That is significantly below the Department of Health target of 2,000-2,500 scans per year. Only one Trust, University College London Hospitals NHS Trust, achieved that Department of Health target.

    - There was considerable variation between Trusts, and three Trusts produced fewer than 500 scans per machine while one met the Department of Health target.

    - If all trusts below the national average brought their usage rate up to the average, an additional 2,492 scans could be provided – equivalent to three additional PET scanners.
 
• Magnetic Resonance Imaging (MRI) scanners are a safe means of producing detailed internal scans useful in diagnosis and treatment of a wide variety of conditions. 

    - The average use of MRI scanners in 2008 was 4,912 scans per machine.

    - There is considerable variation between trusts; nine trusts used each machine less than 2,000 times while nine trusts used each machine more than 8,000 times in 12 months

    - If all trusts below the national average brought their usage rate up to the average, an additional 273,680 scans could be provided, equivalent to 56 additional scanners running at the average annual usage.
 
• Computerised Tomography (CT) scanners provide a detailed view of different tissue types not available with traditional x-rays.

    - The average usage of CT scanners in 2008 was 7,424 scans per machine.

    - There is considerable variation between trusts, with six Trusts using their CT scanners over 15,000 times, while seven had an average
usage lower than 2,000.

    - If all trusts below the national average brought their usage rate up to the average, an additional 656,647 scans could be provided, equivalent to 88 additional scanners running at the average annual usage.

• Lithotripters use ultrasound shock waves to break up kidney stones.

- The average usage of lithotripters in 2008 was 457 uses per machine.

- There is considerable variation between Trusts, with three Trusts getting more than 1,000 uses per lithotripter and another just 18 uses per lithotripter.

- If all trusts below the national average brought their usage rate up to the average, an additional

8,528 uses could be provided, equivalent to 19 additional lithotripters running at the average annual usage.

As Katherine Andrew of the TPA states:

“These pieces of equipment are not only expensive, they are crucial to the treatment of people who suffer from a wide variety of conditions. It is simply not good enough that so many Trusts are failing to make the best use of their resources, and in doing so letting down patients and taxpayers. If those Trusts that are lagging behind caught up just with the NHS average, it would make hundreds of thousands of extra treatment and diagnosis procedures available.”

I love this posting on Samizdata by my good friend Antoine Clarke:

Do check out the links; particularly the one to the excellent Daily Mail article pointing out that a million Americans took to the streets of DC in opposition to the socialism of Obamacare.

In this excellent article republished on the Centre for Public Medicine Website, Robert M. Goldberg discusses an event that he recently attended where the American public were protesting against President Obama’s healthcare reforms. 

One thing that is notable about the American public is that because they have never has to suffer the NHS nanny state model of socialised medicine, telling them what is good for them and what they can have, the Americans are well informed healthcare consumers.  They know better than most politicians that more government intervention in healthcare will lead to rationing, waiting lists and denial of treatments and care on ground of ‘cost-effectiveness’.

That is why so many of them marched on Washington DC this weekend to protest against the Obamacare health plans.

This is a great article from Grace-Marie Turner of the Galen Institute commenting on President Obama’s key note speech on his healthcare reform made earlier this week to both houses of congress in the US.

A Speech Not A Plan

President Obama’s speech last night soared with oratory but fell flat in delivering on his promise to present details or any substantive new policy initiatives for his health reform plan. He may get a few days of lift from the passion and cheers in the House chambers, but the hard realities of policy will continue to chill prospects for getting sweeping reform legislation enacted. A few examples:

Paying for reform. The president said “the plan I’m proposing will cost around $900 billion over 10 years” and that “we’ve estimated that most of this plan can be paid for by finding savings within the existing health care system, a system that is currently full of waste and abuse.” 

He dropped talk of higher taxes on the rich to pay for the reform plan, perhaps after realizing that much of the burden would fall on small businesses. So that means that, apart from some new taxes on health insurance (which will just be passed along to consumers), the massive coverage expansions will be paid for by curtailing Medicare and Medicaid waste and abuse and making them more efficient. 

That doesn’t pass the laugh test. I testified before the House Energy and Commerce Committee in 2008 about seven rules that the Bush administration had written to curtail documented fraud and abuse in the Medicaid program. The fraud was documented by the Government Accountability Office and the Inspector General at the Department of Health and Human Services — things such as using Medicaid money to take people shopping for party dresses and to Bingo games. 

But Congress has done everything it can to stop implementation of the Bush rules to stop documented fraud. What do you think the chances are that they will be able to pay for their $900 billion reform plan mostly with savings from Medicare and Medicaid?

Rising health costs. Gone is the campaign promise that every family will save $2,500 a year on health costs when the Obama plan is implemented. It has been replaced with new language that says reform “will slow the growth of health care costs for our families, our businesses, and our government.” 

Slowing the growth of health costs is a much different agenda. But even with that, he offered little or nothing of substance to explain how he would achieve that goal.

Keeping the coverage you have now. The president has changed his rhetoric about no one losing the coverage or doctors they have now. Now he says “nothing in this plan will require you or your employer to change the coverage or the doctor you have.” The operable word is “require.” 

But the employer mandate is still in place, and the president still wants the new public plan. So there would be every incentive for employers to drop coverage, pay the new tax, and send their employees packing to the public plan, many involuntarily. The Lewin Group says between 88 million and 120 million Americans would find themselves in the new government-run health program. But they wouldn’t be required to join. 

Do you find that reassuring?

So what we heard last night was a campaign speech which was, by the way, alarming in his threats to those who oppose him. Promises made are not promises kept. Michael Tanner of Cato has a good new paper out that details the very difficult challenges of getting from promise to policy. The president began his speech by saying: “We know we must reform this system. The question is how.” We’re still waiting for answers.

Following a recent upgrade of of NFR’s online outreach programmes, I am pleased to announced that the organisations content is now available via twitter.

You can follow it here;

Yet more evidence is coming to light that the NHS is not a service that is there to care for its customers – yes the NHS does have customers they are called tax payers!

A report in the daily mail today shows that NICE is not only rationing medicines for NHS patients by not approving them, it is stopping patients having from medicines that improve quality of life by not even assessing them for three years.

So much for the promise at the inception of the NHS that all medicines and care would be given from ‘cradle to grave’.  As far as I can see the NHS and other government agencies such as NICE seem now to be there for the sole purpose of making sure that very little is available and that the journey to the grave is very uncomfortable and much quicker than necessary.

Please do click on the link to the Daily Mail article and spend a little extra time reading the comments from people who have suffered at the hands of the NHS.  It makes for very uncomfortable reading and really makes you question how any civilised, developed country can continue with this system of healthcare.

The reports today that the NHS must cut 10% of its workforce over the next 5 years in an attempt to save over £20bn are laughable.

The people who draw up these reports have no understanding of economics, of the government or of the NHS.  First, economically, the NHS is a system that cannot work, it is failing faster than ever before and must be fundamentally changed.

Second, even if the government were to accept and implement these proposals they would do so incompetently.  Third, the NHS would still want to meet other targets set by its political paymasters so, while reducing staff numbers on paper, it would then spend vast amounts of money employing consultants and agency staff to do the jobs of those that have been made redundant.

As I have been saying for a long time.  The NHS has to change, it is not viable in its current state.  All of the NHS estate must be removed from state ownership.  When this has happened the new owners of the hospitals can decided how many staff they will need to undertake the treatment caseload that the NHS has purchased from them.  After over sixty years of NHS failure, it is time that the government learned that central planning does not work.

Any American thinking that Obamacare and more government intervention in healthcare is a good thing must read these articles carefully.  Over the past few days a plethora of stories have emerged demonstrating how the NHS is self destructing.

Evidence of  appalling care form nurses have been reported time and time again with little or no comment or apology from the government.  However, with NHS patients dying due to neglect and many more lives being put at risk by sub-standard care, the powers that be in the NHS seem to have other priorities. A leaflet on how nurses can prevent climate change!