Friday, May 18, 2012

NHS Waiting Time figures are not worth the paper they're written on.

If one was to take at face value the Coal, Iron and Steel production reports available in the Communist Archives of Soviet Russia from 1932-5 during the 'three great years', they would be tempted to view the second 5 year plan as a mesmerising success. No doubt of course it was the more successful of all the pre-war plans but factory managers falsified the reports so that they could avoid death for lack of productivity. You weren't no one if you were were not a Stakhanovite in 1930s Russia.

Since Cameron has become the Prime Minister of the UK we are witnessing something similar occur here in the UK. As you know, we in the UK rightly obsess over hospital waiting lists. Results are not recorded under the Stalinist threat of death but the success of a government can hinge upon the number of operations, waiting times, and cancelled operations. Cameron's government have responded to this challenge with an orgy of misinformation. Perhaps the most deceitful UK government we have had since WWII, they massage the truth and bend the facts to their liking. Let me outline some of the ways below that hospital waiting times, and cancelled operations are being massaged below to give you a flavour.

1. Doctors are now bribed £30 per patient to cancel their follow up appointments at hospitals and instead conduct them in GP surgeries (here).

2. Patients are offered operation slots in holiday seasons in the hope that they refuse them. When they do the clock is reset on their waiting time so that the 18 week guarantee becomes null and void. If a patient refuses then the hospital is not beholden to keep the limit.

3. As Polly Toynbee recorded (here) nurses are being leant on to actually falsify records. This meant that any patient who had gone over the 18 week limit would not be given an appointment and instead those about to break the 18 week limit would be prioritised. In some cases the failure to provide an appointment within the 18 weeks is simply wiped from the records.

4. Another trick is to provide hospital slots at the last minute without any notice which patients sometimes turn down because they and their family have either a) not psychologically prepared themselves for the operations, or b) family childcare and work arrangements are too late to finalise (here).

5. The whole process has become that distorted and cumbersome that private health care providers such as Spire have reported a boom in profits of 9.2% as people have preferred to go private than suffer the chaos of NHS waiting lists (here). Ironically, this then has the knock on effect of making waiting lists appear more successfully managed.

6. Sometimes waiting list clerks arrange a consultation meeting of just a couple of minutes where the patient is not even examined as I reported of one patient in Wiltshire and that is counted as a proper appointment.

7. In some cases  emergency patients are not even making it into the hospitals. You see as long as they never make it to the hospital they are not subject to the 4 hour A & E target for example. Instead, patients are treated in "A & E" centres or cattle sheds to you and I. Paramedics etc. cater for their medical needs before they are discharged off home again. This has resulted in a "bouncing" of discharges. Guess what, we don't measure "bounces" in the discharge system so this goes completely hidden from the records.

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