Long Time No Post

Both Mitch and myself have been consumed with the stuff of life, and have been remiss in posting for a while now.  This post is an attempt to at least call attention to a variety of follow-up stories from themes of the past.

First, the NHS continues to struggle with its own unique combination of limited resources and externally mandated 'performance' or 'quality' targets.  This combined with a variant of a civil service mentality, combined to produce this report:

http://news.bbc.co.uk/2/hi/health/8531441.stm

Secondly, the NHS, chronically short of resources and funds, is doing what every other under-funded government run service is doing: reducing service at a time when demand is surging.  This kind of action can only occur when supply is uncoupled from demand, as is the case when the government budgets health care in an annual funding cycle.  The NHS has long wait-lists for almost every kind of service.  Reducing capacity in the face of such demand is.....

http://news.bbc.co.uk/2/hi/health/8610173.stm

http://news.bbc.co.uk/2/hi/health/8590710.stm

The story of the computerized medical record there has become surreal.  Original launch date: 2006.  Most recent launch date: 2015.

http://news.bbc.co.uk/2/hi/health/8543328.stm

As importantly, as the BBC story points out, there is little or no transparency to these decisions by the NHS.

The NHSis increasingly a political football.  Is this a vision of our future?

http://news.bbc.co.uk/2/hi/health/8343340.stm

http://news.bbc.co.uk/2/hi/health/8570822.stm

http://news.bbc.co.uk/2/hi/health/8614684.stm

And for those of you that ponder such things, the ratio of managers to beds continues to climb:

http://news.bbc.co.uk/2/hi/health/8587122.stm

Think about it: an 84% increase in managers over a decade where hospital beds contracted significantly. I guess it is worth noting that the NHS is almost certainly THE largest employer in England, with more than 2% of the population employed directly by the NHS!

Change of subject: Is this really an accident?

http://news.bbc.co.uk/2/hi/uk_news/8613791.stm

20 organs might not seem like a huge number, and there is no doubt that dozens of recipients benefited from this glitch, but make no mistake: if this were not the result of a software failure, the only question would be: who is going to jail?

The electronic health record continues to produce news, but not in the ways that its proponents hope:

http://spectrum.ieee.org/riskfactor/computing/it/more-hurdles-appear-in-us-electronic-health-record-adoption

Finally, as is often the case, authors of fiction see the world more clearly than we do.  I have carved this delightful quote:

In “The Hostile Hospital,” from the Lemony Snicket “Series of Unfortunate Events” books, the three young orphans at the center of the story visit the fictitious Heimlich Hospital, where Babs, the head of human resources, asks them if they know what the most important work done in a hospital is.

“Healing sick people?” one of the children asks innocently.

“You’re wrong,” Babs growls, silencing the children. “The most important thing we do at the hospital,” she continues without flinching, “is paperwork.”

from this story:

http://www.nytimes.com/2010/04/08/health/08chen.html?ref=health

For practitioners, the new era of reducing 'waste, fraud, and abuse' heralds documentation requirements so onerous that they might drive many to leave the practice of medicine.