Political Freedom for the NHS? Er…. No

Andrew Lansley’s promise that his health bill would depoliticise the NHS is proving as fruitless as trying to depoliticise the economy. The theory is that ‘clinical leaders’ will now run the NHS on behalf of patients while politicians calmly retreat from the fray and let them get on with it. But at PMQs on April 24^th, Ed Milliband revisited the Thatcher taunt that the NHS was ‘not safe in Cameron’s hands’. And Cameron responded by rubbishing the NHS in Labour-controlled Wales, before signing off with “that is what you get under Labour: cuts to our NHS, longer waiting lists and all the problems we saw at the Stafford Hospital would be repeated all over again”.

Although Labour should accept accountability for Mid Staffs, as should the NHS senior managers who have glided unopposed into the top NHS jobs under the Tories, it’s absurd not to recognize the extra funding and improvements to the NHS under Labour. It’s also absurd, and very dangerous, to suggest another Mid Staffs would only happen under Labour. In doing so, Cameron is creating the same culture of denial that lead to Mid Staffs.

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Medicine Balls: Lessons from Leeds

First the good news. Data just released shows that survival rates for child heart surgery in the UK are as good as anywhere in the world, if not better. What’s more, no unit in the UK has a significantly higher death rate that the others. So why is the NHS in England considering cutting the number of units from ten to seven? Why all the fuss about Leeds? And why are we not praising and celebrating child heart surgery teams for the incredibly difficult work they do under enormous pressure and scrutiny?

The answers are all related. The most recent data is all the more miraculous in that some of the smaller units have only 2 or 3 permanent surgeons who work ridiculous hours and are heavily reliant on locums, mostly overseas, to cover leave and sickness. The low death rates are as much to do with the pre and postoperative care as the surgery itself. This requires adequate numbers of skilled staff such as cardiologists, anaesthetists and specialist nurses, and highly sophisticated imaging equipment. At present, many units operate with a bare minimum of staff and suboptimal equipment, and sometimes operations are

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Here’s the report Sir Someone leaked to the BBC. It actually shows all units are performing within safe limits, with outcomes as good as anywhere in the world and better than most. So huge congratulations all round. Let’s start praising our child heart surgery teams for the incredibly difficult work they do under huge stress, rather than abusing them. But we still need to reorganize. Why? Read next week’s Private Eye, out on Tuesday

CHILD HEART SURGERY MORTALITY REPORT

Unaccountable accountants

More bad news is on its way for NHS chief David ‘no accountability’ Nicholson.  The report of the joint health overview and scrutiny committee (JHOSC) for six south west London councils into financial mismanagement at Croydon Primary Care Trust is imminent.  It will show how the buck is passed when financial disasters happen, and question what ‘grip’ Nicholson really has on the money.

When is an accountant not an accountant?  When he is not qualified.  This fact escaped Croydon’s director of finance Stephen O’Brien and chief executive Caroline Taylor (Eyes Passim) when they appointed former nightclub owner Mark Phillips as interim deputy finance director.  Under lax supervision and failure of both Deloitte and the Audit Commission, Phillips was able to report a £5 million surplus in the 2010/11 accounts when there was at least a £22m deficit.  Ernst and Young were called in by NHS London when Croydon insiders, including director of public health Dr Peter Brambleby, and managers from surrounding PCTs, raised concerns.

Ernst and Young’s inquiry cost the NHS £1m and went into considerable detail.  A summary with recommendations was published by NHS London and discussed at its board, but when JHOSC asked for authorship and

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Unaccountable accountants

More bad news is on its way for NHS chief David ‘no accountability’ Nicholson.  The report of the joint health overview and scrutiny committee (JHOSC) for six south west London councils into financial mismanagement at Croydon Primary Care Trust is imminent.  It will show how the buck is passed when financial disasters happen, and question what ‘grip’ Nicholson really has on the money.

When is an accountant not an accountant?  When he is not qualified.  This fact escaped Croydon’s director of finance Stephen O’Brien and chief executive Caroline Taylor (Eyes Passim) when they appointed former nightclub owner Mark Phillips as interim deputy finance director.  Under lax supervision and failure of both Deloitte and the Audit Commission, Phillips was able to report a £5 million surplus in the 2010/11 accounts when there was at least a £22m deficit.  Ernst and Young were called in by NHS London when Croydon insiders, including director of public health Dr Peter Brambleby, and managers from surrounding PCTs, raised concerns.

Ernst and Young’s inquiry cost the NHS £1m and went into considerable detail.  A summary with recommendations was published by NHS London and discussed at its board, but when JHOSC asked for authorship and

[…..] Read More