Meeting targets at all costs

On Thursday the weather was foul; schools shut and hospital transport was stopped. The forecast for Friday did not look any better.

One of my colleagues had a day case operating list for the Friday morning and noticed that three of the patients were very elderly; perhaps it would be safest for them to be cancelled and rebooked. A manager was consulted. "NO" the answer came, because if they were cancelled they would be breaching the waiting list target.

So, it's better for an 85 year old to risk falling on the ice and breaking a limb than imperil the government's entirely arbitrary waiting list targets. Have they no shame?

How to fudge a waiting list : method one

GPs in Bedford have been told by the local Primary Care Trust not to refer any cases to the orthopoedic department at Bedford Hospital (or anywhere else) until the new financial year. As one GP said to me yesterday, I just have to tell patients to come back in April and I'll try again. Of course these patients have not yet got on to a waiting list, so the government can perpetuate the lie that they have reduced waiting. These patients are now queueing to get on a waiting list.

Keep logging on and I will reveal some of the other tricks being used.

Improving patient choice

This week the Department of Health has surpassed their own extraordinary standards for mad pronouncements.

They have rolled out their master plan for improving maternal choice in childbirth; this is to be achieved by reducing the number of centres where mothers can go for maternity care!

No wonder no one believes anything they say; indeed I sometimes wonder whether they believe this nonsense themselves.

Getting ready

The Save Bedford Hospital party continues its preparations. A general election may come sooner than expected. I am in consultation with two other doctors who are planning similar local campaigns in other parts of the country.

Offers of help are always welcome, but in the meanwhile, do tell people about this website.

Choose and Book

Choose and Book is an essential feature of the government's much vaunted but massively overspent NHS IT programme Connecting for Health.

Choose and Book is already over budget and behind schedule. It is a hopelessly designed system which is almost universally unpopular with doctors and patients. To date, only 13% of GP referrals to hospital are being made on the system, against a target figure of 80%, and this despite the GPs being given financial inducements to use it. Some 30% of patients who the GPs think they are referring never manage to complete the complicated booking process and are just lost in cyberspace.

Most remarkable of all is the extraordinary cost of he scheme; at present prices, over the 10 year lifetime of the IT contracts it will cost a remarkable £125 to make every patient appointment. That's not the cost of the treatment, that's just the cost of making the appointment.

Going private

Bedford Hospital NHS Trust is millions of pounds in the red. In a desperate attempt to balance the books four wards are shut and retiring consultants have not been replaced. Surgeons are instructed not to treat patients unless they have waited the maximum allowable waiting time. In short, the place is barely functioning as an acute district hospital.

So what do the managers do now? Amazingly, they are planning to open a private wing (allegedly to "subsidize NHS activity").

Would it not be better for them to learn to run a proper NHS service first?

Normal Service is Resumed

Sorry for the absence of postings, but I have been in Washington DC; I hope that some political skills have rubbed off.

While I was away I read a most amazing book "Plundering the Public Sector" by David Craig; it describes how the Labour government are squandering millions of pounds of public money on largely useless IT projects such as Connecting for Health.

I'll give you a little taster from the introduction:

The results so far have been disastrous - billions taken out of front-line services to be wasted on worthless consulting and failed IT systems. Already we have seen administrative chaos, massive increase in management costs... The government is paying around £30billion for a new NHS IT system that is already showing all the symptoms of becoming a catastrophic failure. This will cripple patient care for years to come.

Please read this book...but be warned, it will make you very angry