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Hospitals in need of more thorough examination
IT would be a cause for concern if University College London Hospital – known universally simply as UCH – wasn’t regarded as one of the best hospitals in the country.
For most of the last century it was always considered by the medical profession and Londoners alike as the best hospital in the capital for nursing and treatment.
Now, according to the Doctor Foster Guide, the UCH is “NHS Trust of the Year”.
How does the Dr Foster grade hospitals? By a minute statistical analysis of their mortality rates and surgical results. Nothing wrong there, it could be said.
But can any organisation be solely judged by cold facts and figures, however important they undoubtedly are?
Recently, an investigation by the NHS Care Quality Commission (CQC), condemned several hospitals in Essex as “failing”. An examination by the Doctor Foster Guide had also found these hospitals wanting. But before the CQC stepped in, these very same hospitals had been awarded good marks – partly based on the use of self-assessment, a method used frequently by hospitals.
But surely, other factors should be put on the scales?
First and foremost there is the human element – not outcomes found in reports but the impact on patients of nursing and medical care, sometimes psychological, and difficult to assess by arm’s-length analysis.
For instance, failure by nurses to properly feed seriously ill, elderly patients – lamentably found in some hospitals – may take ages to spot by statistical analysis alone.
But this would be exposed by good management straight away.
Several years ago hospitals were kept on their toes by Community Health Councils (CHC) with statutory powers to carry out unannounced inspections and the right to take their findings to the very top in the Department of Health.
In Camden, a vigorous CHC wasn’t afraid to stir up debates on the health of our hospitals. It wasn’t perfect. But it kept a reasonable leash on hospital management.
But once the Labour government had abolished CHCs nothing, essentially, replaced them.
Hospitals claim the newly created forums, representing patients and the public, are effective replacements for CHCs.
But all evidence points the other way.
The NHS is an extraordinary institution we should be proud of. But there have been too many meddlesome initiatives introduced by politicians in recent years – with one eye on privatisation and the other on the mood of the tabloids – that help to give the NHS a bad name it doesn’t merit or deserve.
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