Let's Just Keep Bashing England, Test Case for America's Future.
Dept. of Socialized Medicine, This Time.

I'm on a roll. Might as well. (The Telegraph is such a wealth of material.)

I present to you this op-ed on just how wonderful England's National Health Care system is:

My mother was dying, but no one would take charge of her care

By Alasdair Palmer
(Filed: 15/05/2005)

The latest report into the failings of patient care in the NHS has a depressingly familiar ring. An organisation called the National Confidential Enquiry into Patient Outcome and Death found that nearly half of patients needing intensive care were not properly cared for. In a substantial number of cases in which the patient died, the care was so bad that it could have contributed to hastening the patient's death. The report found that the overall quality of medical records was "poor". Ten per cent of patients did not even receive a complete examination, nor was their medical history available to the doctors who were charged with making decisions about their care.

Dr Bill Kirkup, the Deputy Chief Medical Officer, was quick to insist that "there is no evidence to suggest that the failings identified by the report are typical or found throughout the NHS". But of course there is: many people who have experience of NHS care will have their own stories illustrating "less than good practice". Mine relate to my mother, who died of cancer 18 months ago. Initially, she went to her GP with back pain. He gave her some pain killers, and reassured her that nothing was wrong: he did not order any tests of any kind, even though her medical notes stated that two years earlier she had had breast cancer.

The pain killers he prescribed had no effect. She went back to see him, in increasingly severe discomfort, several times. Each time, her GP said the same thing: "Don't worry, it will clear up." My mother's cancer was diagnosed only when she took herself to see a neurologist who had, years before, helped her get over back pain. That neurologist did some tests - and told my mother she would have to be admitted to hospital immediately.

The GP's reluctance to look at my mother's records delayed by six months the diagnosis of the recurrence of her cancer, which turned out to have metastasized into her bones and liver. It was unquestionably a dire example of "less than good practice". But once she was admitted to the Royal Free hospital, in north London, the standard of her care did not improve much. Some of the nurses were inhumanly rough with her, causing her tears of agony when lifting her off the bed to wash her. We complained and tried to get the nurses changed. The complaints had no effect. Then the hospital's supply of pain-killing drugs - essential for my mother - first threatened to run out, then not to be renewed.

There was no continuity of care. Several different teams of doctors were assigned to her. They didn't lose her notes, but they did seem to have difficulty in reading them, for they each asked her the same questions - the answers to which were in her records - each time they saw her. Most of the very limited time the doctors had available for her consultations were thus taken up with these routine questions.

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I remember my father sitting at her bedside as a group of doctors finally came to deliver an assessment. The senior consultant - who was standing in for someone else, who was on holiday - introduced herself and started to repeat the familiar questions whose answers were in the notes. My father interrupted and said: "We do need someone to take charge of this case. Can I take it that you are responsible for my wife's care?" There was a long pause. Then came the answer. "Um… No," the senior consultant said. "I'm not responsible. It is a committee thing."

And there, it seems to me, is the crux of the problem with so much hospital care: no one is responsible for anything. There are endless teams and committees - the palliative care team, the medical emergency team, the patient-at-risk team, and so on - but no one takes responsibility. The whole point of the committees seems to be to ensure that no individual can be held responsible for whatever decisions are taken. "Less than good practice" is the inevitable result.

"No one is responsible for anything." Let me quote Mark Steyn from the piece I pointed to in the last post:

Almost every act of the social democratic state says: don't worry, you're not responsible, leave it to us, we know best. The social democratic state is, in that sense, profoundly anti-social and ultimately anti-democratic.

That goes for everyone from petty criminal to Member of Parliament.

Please, please, PLEASE let us not take that path here.