Thursday, February 25, 2010

I need a photo opportunity, I need a shot at redemption

As we prepare for today's latest exercise in Obamacare Kabuki, just a gentle reminder from the Times of London of why so many Americans aren't especially interested in the President's ministrations:

Patients were routinely neglected or left “sobbing and humiliated” by staff at an NHS trust where at least 400 deaths have been linked to appalling care.

An independent inquiry found that managers at Mid Staffordshire NHS Foundation Trust stopped providing safe care because they were preoccupied with government targets and cutting costs.

How so?

Staff shortages at Stafford Hospital meant that patients went unwashed for weeks, were left without food or drink and were even unable to get to the lavatory. Some lay in soiled sheets that relatives had to take home to wash, others developed infections or had falls, occasionally fatal. Many staff did their best but the attitude of some nurses “left a lot to be desired”.

Which is what happens to people's attitudes when they don't really have to care to keep their jobs. It's what makes a visit to the DMV so much fun. But don't worry, the great minds at the NHS have figured it out:

Mr Burnham said it was a “longstanding anomaly” that the NHS did not have a robust way of regulating managers or banning them from working, as it does with doctors or nurses. “We must end the situation where a senior NHS manager who has failed in one job can simply move to another elsewhere,” he added. “This is not acceptable to the public and not conducive to promoting accountability and high professional standards.”

I suppose not. But is this a bug, or a feature?

But the families of those who died or suffered poor care branded the inquiry a “whitewash” and repeated calls for a full public investigation. The Conservatives accused ministers of trying to blame managers rather than taking responsibility for problems with national targets.
And the Tories are correct. Even in an irrational system, people generally behave rationally. And if you are judged on the results of the balance sheet, you will work to make your number or "national target" and not worry so much about those pesky patients. It's the sort of thing that insurance companies get bashed for all the time, but it's ludicrous to believe that government bureaucrats, protected by civil service, would behave any differently than the worthies profiled here.

And all this could be yours, if the price is right.


Anonymous said...

Could be ours and the price will be incalculable.

my name is Amanda said...

It's what makes a visit to the DMV so much fun.

What makes the DMV such hell are the varieties of people and requests the workers there must deal with all day long, in addition to changing laws and requirements, with which they must comply, but for which they are harassed about by citizens. Plus, there's usually a ton of people there who need help, so by the time anyone makes it to the desk, they're angry at the DMV for no good reason.

Sometimes the St. Paul Midway DMV visits me in my nightmares.

Go to the DMV off of Co Rd C, on Lexington in Roseville. Sunshine and unicorns there, all the time. Seriously!

If I may offer a dissenting opinion about the topic at hand, however: One example of poor mgmt in Britain says nothing about health care reform in the US. I disagree that patients were mistreated because the staff didn't care about keeping their jobs; the article says it was a shortage issue. Perhaps the nurses' attitudes were affected by the stress of having to care for so many people with little resources.

Mr. D said...

I disagree that patients were mistreated because the staff didn't care about keeping their jobs; the article says it was a shortage issue.

Actually, it's both. They don't have to care very much because there are no consequences, and because the government controls everything there are shortages, because the primary driver is cost control, not trying to expand the range of services. And because the staff is on the business end of the shortages, they take the brunt of it and, eventually, they stop caring. It's human nature.

And I've been to the DMV at C and Lexington. They must have been in a better mood the day you were there. :)

Night Writer said...

I don't want to end up a cartoon in a cartoon graveyard. Or in a filthy hospital being "cared" for by trolls.

I will testify, however, that the last time I had dealings with the downtown Minneapolis DMV (about 2 years ago) it was a mind-bendingly positive experience. They had plenty of customer service windows, an updated and comfortable waiting area, a customer service "conceirge" who identified what it was I needed and directed me to the proper area and...they had cookies! I was almost too suspicious to eat one, thinking it might be laced with some drug to get me hooked on governmentium. Almost.