With Harry Reid signaling that Congress may be poised to ram some form of government-controlled health care down America's throat through the legislative trick of "reconcilliation," (more here) this is a good time to check in on the latest wonders of government-controlled health care.
In the United Kingdom, where health care has been provided by the government for years (the ultimate "public option"), the system is falling apart under its own bureaucratic weight. The lastest sign of serious distress is that more than 100 sick children at leading hospital had to wash in buckets for nearly four weeks because administrators failed to fix the hot water supply.
More than 100 youngsters, some of them seriously ill, were left without hot running water over a period of nearly four weeks.
Parents were forced to carry hot water in buckets from a single working tap in a sluice room so their children could wash. [A "sluice room" is a place where bedpans, urinals and sick bowls are kept in there and emptied.)
Children were washed from sick bowls at King's College Hospital
Youngsters suffering from brain tumours and cystic fibrosis were among those affected.
Despite complaints from patients and staff, bosses at Kings College Hospital, in South London, failed to fix the broken pump - and left half the children's wards without hot water for weeks.
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Gemma Dadgostar, whose 18-month-old son Aiden was being treated for Cystic Fibrosis at the hospital, said she was 'shocked' that the hospital failed to solve the problem.
'I thought it was absolutely outrageous,' Mrs Dadgostar, 29, said. 'Hot water is an absolutely basic necessity.
'Aiden was just recovering from surgery and the last thing he needed was to be bathing in lukewarm water. We had to carry hot water to his bedside in cardboard sick bowls. Other parents were washing their children in buckets.
'It was bizarre to see. In a hospital of that size it's unbelievable that they couldn't sort it out.'
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King's College is one of 18 hospitals named in a report by the Department of Health this month, for failing to comply with more than 10 orders to prevent people dying from accidents involving drugs, surgery or equipment.
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Earlier this month the same hospital was accused of turning off a grandmother's life support machine before her sons had a chance to say their last goodbyes to save money.
The husband of 58-year-old Lai-Mai Pang-Cheung claims doctors told him the life support machine had to be switched off because of 'tight resources' - even though the couple's two sons were rushing to Britain from Hong Kong to see her.
But the lack of hot water is just the latest omen in Britain's massive health care disaster.
At least half a million patients a year are discharged too early by the National Health Service and consequently end up being re-admitted to the emergency room. The problem has been made worse by a 12% cut in the number of hospital beds.
This isn't due to lack of funding, but rather due to the waste inherent in bureaucracy. Despite massive funding increases, the also NHS kills approximately 40,000 patients a year through errors of various kinds brought on by its bureaucratic culture:
NHS funding has nearly tripled from £39.9billion to £102billion in 11 years but there are concerns the cash has failed to raise standards.
Using new data from U.S. and European research, Policy Exchange says 78,400 NHS patients a year die as a result of 'adverse events' - brought on by accidents or caused by medication or treatment.
More than half of these deaths - 43,000 - could be prevented if hospitals were inspected more rigorously and recommended safety changes were installed.
The figure for deaths is based on ten studies suggesting that 6.6 per cent of hospital admissions each year, around 700,000 patients, suffer adverse events - with 11 per cent of them ending in death.
Policy Exchange used Freedom of Information requests to uncover reports showing that patients became a low priority during a string of organisational reforms.
They were prepared in 2008 as the Department of Health undertook a major restructuring of NHS regulation.
One report, Quality Oversight In England, by the highly-respected Joint Commission International, identified 'the pervasive culture of fear in the NHS and certain elements of the Department of Health'.
Another, by the Institute of Healthcare Improvement, said the 'NHS has developed a widespread culture more of fear and compliance than of learning, innovation and enthusiastic participation in improvement'.
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The revelations follow high-profile failings at health trusts in Tunbridge Wells, Basildon and Mid-Staffordshire, where managers' obsession with targets was blamed for filthy wards and nurse shortages which led to up to 1,200 deaths at Stafford Hospital.
And this doesn't even include patients diagnosed with terminal illnesses who are being sentenced to die prematurely through tactics such as heavy doses of sedation that preclude any possible recovery, in a scandal revealed last year.
Inefficiency is rampant in the NHS for reasons that are intrinsic to government bureaucracy-- to the point where some who have studied the system closely are beginning to propose that the NHS move toward privatization:
Spending has doubled from £51billion in 1999 to £101billion today.
Chief executive David Nicholson has said that the NHS must look to save £20billion by 2014.
But how on earth will it cope with the exploding number of elderly patients and the costly new procedures and treatments coming on to the market?
The answer, says the health think tank the King's Fund, is to increase productivity in the NHS. But over the past decade, it fell by almost 4 per cent.
(Over the same time, it rose by almost 23 per cent in the private sector). So how to push up productivity and get value for the taxpayer?
A possible solution came this week from the Hinchingbrooke Hospital in Cambridgeshire. The hospital has debts of £40million.
So from next year it will be run not by the NHS, but by one of five private sector organisations. This is the closest the NHS has come to the privatisation of a leading hospital.
It is a radical departure 'born of necessity,' says Stephen Dunn, director of strategy for the East of England Health Authority. 'We need the best provider and this is the only way forward.'
Only a private company, he says, will get 'real innovation and efficiency' into the process.
It's a bold and controversial step - but I believe he is right. After a year visiting behind the scenes at hospitals, I have seen at first hand how the biggest problem confronting the NHS is its monolithic bureaucracy.
It is not for lack of ideas that our health service has been allowed to stagnate. During my research, I came across plenty of staff - porters, junior doctors, nurses and matrons - with exciting plans for more efficiency and better patient care. (It was surprising how often the two went together). But no one is listening to them.
Instead, initiatives cascade down from the Department of Health (DoH). And there lies the greatest problem in reforming the finances of the NHS.
I had not realised how costly the actual structure of the NHS is until I sat in on a hospital board meeting. Making sure the hospital complied with the latest government initiatives dominated the agenda.
We didn't discuss patients, improving care, saving money or any issue relating to the hospital. The focus was on the bureaucratic process.
The initiatives did not come cheap. The board has to prove to the DoH it is complying.
So, for nearly every new initiative, the hospital appoints a manager, often on £50,000 to £80,000 a year - not to mention a secretary - to collect the all-important data that must then be submitted to the Department of Health.
The hospital is not given any additional money for this. It has to find the funds out of its annual budget, often at the expense of front-line services.
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The effect of this is clear. One consultant calculated the proportion of managers, administrators and support staff to nurses in the NHS is 41/2 times greater than in private hospitals, which are not subject to the government initiatives.
In the year I spent visiting hospitals, I met only one person who was doing what a good manager in the NHS should be doing - questioning activity and redesigning processes to get the best care and the most efficient use of taxpayers' money.
Even finance directors didn't see that as their role. I asked one what he was doing to save money and increase efficiency. He looked at me as if I were mad. He had no time for that. His time was spent reacting to the 'hell of a lot of indicators' pouring out of Whitehall.
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Almost all of the 1.6 million NHS staff have their pay increased automatically every year, at a cost of £420million.
Pay is not linked to performance, as it is in the private sector, let alone to creative ideas.
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I spoke to one non-executive director who has a career in trouble-shooting ailing companies and who was astounded by the attitude of his local hospital.
With only a cursory look at the books, he announced he could save £200,000 just by good accounting. The response he got? 'It was as if I was speaking Ancient Greek.'
His ideas were dismissed as not applicable in a service funded by the Government.
Worse, the hospital's chief executive feared that an investigation might expose failings and leave him vulnerable to political interference.
'They put up a facade composed of ignorance and fear,' said the non-executive director.
Nonetheless, he had a go at the equipment budget, which was 21/2 times over budget in the last financial year. He started from the basics, costing everything from the bottom up.
He was startled to discover that this had never been done before. Cascades of money from the top had left managers indifferent to the basic routine of accounting.
Did the trust know what it owned? Was there an inventory? It appeared not. So no one knew how much equipment had simply disappeared.
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This financial vagueness was in every area he examined. For example, there was no system or control on what vehicles the trust owned or what they spent on transport.
The local energy company had done a free audit of the hospital's heating system and reported that £32,000 a year could be saved by adjusting the boiler controls.
But nothing had happened. Instead, managers were spending a fortune attending conferences to learn about the implications of the latest government initiative.
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Yet for all his experience, my source had not grasped the essential feature of NHS accounting. It is not to provide the hospital with the information on how to run itself more efficiently; it is a tool to secure yet more money from central funding.
I discovered this while I was shadowing a modern matron. A male nurse in charge of the ward's finances stopped her. He was very upset.
Last month, after a lot of juggling, he had managed to reduce spending on agency nurses. It was his best monthly figure ever.
So why was he despondent? Surely the least he had got was a pat on the back from the finance department?
On the contrary. They had ticked him off for spending double the amount. I was confused by this.
The nurse and the matron looked at me pityingly. In the surreal world of NHS finances, reality had nothing to do with it.
What had happened was that the finance department had fiddled the figure to make it look as if he had spent twice the amount - and then had the brass neck to berate the nurse for spending so much.
Why had they massaged the figure upwards? Because they wanted to extract more money from the Department of Health.
'They've told me not to do it again,' the nurse said.
The problems with NHS finances are bound up with the problems of the institution itself. It was designed to be state- owned, centrally planned, financed and run.
Does Harry Reid wish this British-style health care hell on Americans, or is he just ignorant? Either way, his ideas are mortally dangerous, without exaggeration. Patients are suffering and dying needlessly in Britain, despite billions upon billions being poured into the system. Government-controlled health care must be stopped.
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