Three cheers for Nurses For Reform
David T Breaker | Tuesday, March 9th, 2010 | No Comments »
The NHS seems to be getting a lot of column inches today in the news, and as usual none of it is good. It seems the national “envy of the world” religion which none must question isn’t all it’s cracked up to be – at least that is if you need it and have managed to compare it with the health systems of our neighbouring countries. For liberal dinner party chat among Guardian columnists I imagine it’s great, but it’s somewhat lacking if you’re a patient.
Patients are routinely being treated in areas of hospitals not designed for care, a Nursing Times survey has revealed. Nurses are being asked to treat patients in store rooms, mop cupboards, wards that are already full and, in one case, a kitchen area.
In a Nursing Times survey responded to by more than 900 nurses, nearly two thirds said patients at their hospital were being treated in areas not designed for clinical care.
They highlighted threats to safety including patients having no access to call bells, water and suction facilities, missing emergency equipment, risk of infection and fire exits being blocked.
Patients’ privacy and dignity is often compromised and nurses say the situation makes it harder to provide good care. Of those nurses who had seen the practice, nearly 60 per cent said it happened more than once a week. Two thirds said patients were left in the areas for more than 12 hours – for some the areas are used for days at a time. A majority said it had happened at their trust for at least a year.
One nurse said patients had started describing an area normally used to store linen and equipment, where beds were being put, as an “overspill car park”.
One said: “There is little room around the three beds and it would be difficult to get a crash trolley into any of the beds. There is no privacy, no oxygen and no call bell.”
Just 3 per cent said nurses were asked whether they agreed with the area being used. Eighty-three per cent said they had raised it with senior nurses or managers but, of those, only 4 per cent said it had then been stopped.
They were commonly told that all other space was full, accident and emergency was under pressure, the move was authorised by senior managers, or the A&E waiting time target was at risk. They were told there was “a temporary capacity issue”, “the hospital does not close its doors” and “unfortunately the hospital is full”.
A small number said complaining had resulted in bullying, being accused of “not being a team player” or told the issue was “none of your business”.
One nurse said: “I carried out a risk assessment on my ward which showed this was a very dangerous and high risk practice, but it still continues as I am told there are just no other beds available and the instruction has come from the chief executive.”
Another commented: “I was advised to find a more appropriate patient for the extra bed, as the bed was needed, and if I couldn’t find a patient then they would.”
NHS South Central chief nurse Katherine Fenton told Nursing Times: “Directors of nursing should be visiting areas and forbidding this kind of practice. This type of practice is always unacceptable.
“You have to make sure that your processes through the hospital are lean and that you are getting patients out at the other end, as you are bringing the right ones in through the front door.
“If you haven’t got good senior management, and this is not just about nursing, you don’t get those fundamental processes sorted out.”
The Department of Health said: “It is for local healthcare commissioners and providers to assess the services needed locally to meet the demands of their population.
“However, every nurse must comply with the standards, performance and ethics outlined in the NMC code. In particular, any nurse who is concerned about any risk to their patients should report their concerns to their manager, in writing if necessary.”
Nursing Times: ‘Full’ hospitals treating patients in non-clinical areas
Meanwhile, elsewhere in the “eighth wonder of the world”…
A man of 22 died in agony of dehydration after three days in a leading teaching hospital. Kane Gorny was so desperate for a drink that he rang police to beg for their help. They arrived on the ward only to be told by doctors that everything was under control.
The next day his mother Rita Cronin found him delirious and he died within hours. She said nurses had failed to give him vital drugs which controlled fluid levels in his body. ‘He was totally dependent on the nurses to help him and they totally betrayed him.’
Daily Mail: Neglected by ‘lazy’ nurses, man, 22, dying of thirst rang the police to beg for water
But of course none of this seems to bother management, who as you’d imagine are more bothered about their own salary and paying Labout’s higher National Insurance Contributions*…
Primary Care Trusts (PCTs) in England are to receive an average 5.5 per cent increase in their budgets this year. But the prices hospitals will get for their work – their income – has been frozen at zero increase, to try and reduce costs.
With medicines getting more expensive, previously agreed pay increases for nurses, plus bigger national insurance costs*for all staff, hospitals face real terms budget cuts. Gloucestershire Hospitals NHS Foundation Trust is closing 200 beds and two wards to cut a £30m deficit.
There is however an answer to all of this, and it’s in today’s Telegraph from Nurses For Reform, a brilliant group who have both the intellegence to think rationally tocompare other systems and the courage to take on a national institution that so many view through rose tinted glasses.
All health provision in the UK, such as hospitals, clinics and care homes, should be placed in the independent sector, be it for-profit, co-operative, or not-for-profit forms of ownership. What matters here is genuine diversity and openness.
Following the logic of planned Conservative Party changes to education and schools, local planning laws must be reformed in order to enable a much greater diversity of – and non-government investment in – health facilities. In a truly post-bureaucratic age, the Secretary of State for Health should no longer have any say over when or where hospitals are built, opened or closed, and nor should local politicians.
The laws surrounding health censorship should be repealed so that patients can be empowered with much greater information. In this context, hospitals, GP practices and pharmaceutical enterprises should all be free to advertise and build trusted brands. Only by allowing reputations to be freely built will people be able to realise the advantages of competitive standards and judge for themselves who they can trust in a health-care market.
National collective pay-bargaining for health professionals should be ended, monopoly bodies such as the General Medical Council and the Nursing and Midwifery Council should be opened up to genuine private alternatives, and all health-related training should be paid for by independent providers – thereby boosting the diversity and opportunities available in a more vibrant labour market.
Finally, tax-funded “public health” should regain the trust of people by only concerning itself with those areas that specifically overlap with, and are akin to, warfare: for example, natural disasters and pandemics. Beyond these limits, any further health initiatives aimed at informing or nannying people should only be undertaken by independent-sector organisations, be they for-profit or not-for-profit, and providing they do not use any taxpayers’ money in their execution. All initiatives should be created and funded without any involvement from any aspect of the public sector, again including local government.
The Telegraph: Health care needs to be depoliticised and patient led
