The Hospital of Death

Although it didn't make much news in the United States, Britain's National Health Service ("the envy of the world") has been rocked by the discovery that it is killing patients needlessly at a rate of knots. According to the NHS's own bulletins, 40,000 patients needlessly die per year in its hospitals. The Independent put the number at only 1,000 needless patient deaths per month. The Telegraph, citing evidence given in Parliament put the number of patients harmed in treatment at one in ten.

In other words a lot of deaths. Not that management didn't know.  The NHS spent 15 million pounds in taxpayer money to prosecute and gag 600 whistleblowers who thought things had gone too far. The man at the center of the scandal was Sir David Nicholson, the Chief Executive of the NHS.

Nicholson is a man who never held a job in his life outside of government and activism. "Nicholson joined the NHS on graduation, and then the Communist Party of Great Britain".  Nor was he just a casual, student Red. Nicholson, according to the Guardian, was a "tankie", a "term referring to those members of the Communist Party of Great Britain that followed the Kremlin line, agreeing with the crushing of revolts in Hungary and later Czechoslovakia by Soviet tanks; or more broadly, those who followed a traditional pro-Soviet position."  And rung by rung  this compassionate man climbed the ladder of the NHS until he reached its pinnacle.

One of the biggest concentrations of deaths was at an "elite" hospital, the Mid-Staffordshire hospital which triggered an investigation by the "apparently high mortality rates in patients admitted as emergencies". Too many people were turning up dead. A study subsequently showed that up to 1,200 patients may have died due to negligence in the "elite" hospital, which has since become so notorious it may now be placed under new management.

The Independent says that five more hospitals "with persistently high death rates are facing investigation tonight after a damning report into Mid-Staffordshire NHS Foundation Trust raised fears that basic clinical failings could be putting patients at risk across the NHS." So the saga is by no means over.

However, Mid-Staffordshire was where it all started to unravel. The report on that hospital is in a video below.

Even the investigative report makes stomach-churning watching principally because the analysis consists of almost a series of cliches. It  faults a lack of 'care', 'compassion', 'patient centeredness' and a failure in 'transparency' as if it were referring to a breakdown in table manners at a dinner party.

But when report touches on what actually happened to the patients it is the stuff of war-crimes. It is not an exaggeration to say that nothing suggested by the most rabid critics of Guantanamo is half so bad. Baldly put what really happened in the hospital was that thousands of old Britons were left to starve, die of thirst, stew in their waste for extended periods,  lie neglected and unmedicated or cast out of the wards at the slightest opportunity.

Nicholson denied knowing that anything was amiss, despite admitting to avoiding a meeting with irate relatives of dying patients and his record of ignoring whistleblowers.  Despite being under the spotlight Nicholson seemed eager as squirrel anticipating a nut to get back to his life's work, for which believes he is uniquely qualified. As to accountability, he made the argument that since by definition his subordinates are responsible for everything he was technically responsible for nothing. That was the nature of his job as chief. As you can hear below he said "but I'm the only one who doesn't [have any responsibility]".

The saga of the 40,000 deaths may interest Americans since the administration is now moving in the direction expanding government's role in health care delivery. The experience of the NHS may tell a cautionary tale about the dangers of care provided by huge impersonal bureaucracies; human ant-heaps so vast that individuality is annihilated in the very scale of things.

For strange as it may seem, NHS head Sir David Nicholson, of whom nobody may have previously heard, ran the fifth largest organization in the world. The NHS is far bigger than the British Army, larger than the Indian Railways and the Chinese state-owned energy network. Sir David Nicholson's fiefdom is actually exceeded only by McDonald's, Walmart, the US Armed Forces, the Chinese Army and the Chinese railway and may have inflicted more deaths than all of these organizations combined.

The definition of  a faceless bureaucracy is where the individual finds himself at the mercy of a complete non-entity; before a strange man whose only skill was to worm his way up the towers of Byzantium deciding your fate with the Clipboard of Destiny in his hand. But enough of that.  When Obamacare finally gets going it bids fair to become far larger than the NHS and supplant it as the new "envy of the world".

The Three Conjectures at Amazon Kindle for $1.99

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No Way In at Amazon Kindle $8.95, print $9.99

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