Failing NHS bosses will go

A típica tolerância católica não é aceite nos países protestantes. Vejamos mais um exemplo:

• Health Secretary Jeremy Hunt has warned NHS managers cannot expect to keep their jobs if they preside over failings in care.
• There were hundreds more deaths than expected at the hospital between 2005 and 2009. Some of those deaths were caused by the failings at the hospital.
• A public inquiry has been looking at how the failures in care were allowed to happen by managers and regulators. Ahead of its report, Mr Hunt called for "total openness and transparency when things go wrong", and a change of culture to give greater priority to compassion. 
• "Just as a manager wouldn't expect to keep their job if they lost control of their finances nor should they expect to keep it if they lose control of the care in their organisation either,"
• "And that means above all happy and motivated staff - something that is always a priority in successful NHS organisations or indeed any other organisation as well. "Most of all we need a change of culture.
• "Patients must never be treated as numbers but as human beings, indeed human beings at their frailest and most vulnerable."
• The Patients Association backed Mr Hunt's comments, saying "managers and boards must be held accountable for what goes on within their trusts and the appropriate action must be taken".

Como se percebe, a situação reporta-se à Grã-Bretanha. Em Portugal, who cares!

NHS opens first clinic for 'club drug' users

One of the first NHS clinics dedicated to helping 'club drug' addicts has been opened. Doctors have opened the centre in London because they claim there is a 'higher demand' from people who use drugs such as ketamine, ecstasy and 'legal highs'. At present, existing clinics cater for those addicted to alcohol, heroin and crack cocaine, which means they are unable to deal with the specific needs of 'club drug' users.

NHS: cultural revolution III

Em Portugal, discute-se a insustentabilidade do SNS. Na Grã-Bretanha, discute-se a revolução cultural no NHS:

The backbencher spoke out after Cameron outlined four key changes to the NHS reforms. In a speech to members of the medical profession at the clinical neurological centre at University College London Hospital, the prime minister said:

• The health and social care bill will be amended to make clear that the primary role of Monitor is not to promote competition but to promote the interests of patients. It will "use competition as a means to that end".
• The 2013 deadline for the creation of new GP-led commissioning consortiums, due to take charge of 65% of the NHS budget, will be shelved.
• Clinical commissioning will be opened up, with hospital doctors and nurses involved. Clinical senates will be introduced to allow groups of doctors and healthcare professionals to "take an overview of the integration of care" across a wide area. In a key declaration, Cameron said: "Our changes will now secure clinically led commissioning, not just GP-led commissioning."
• The 18-week limit on waiting times, enshrined in the NHS constitution, will be kept.

Por cá, a "festa" está quase a começar!

SNS: a máscara vai caindo

O artigo 64º da Constituição da República Portuguesa diz que "a saúde é tendencialmente gratuita para todos os portugueses".

Mas, como já temos vindo a escrever sucessivamente, aquele é um artigo um pouquinho mentiroso, que deve ser retirado da Constituição, apenas porque a Lei deve ser consentânea com a sua aplicabilidade, sob pena, se não o fizerem, de se criarem falsas expectativas.

Vejamos porque é que afirmamos sucessivamente que o SNS já só existe na Constituição da República Portuguesa: Cerca de 90 por cento dos milhares de pessoas que precisam de cuidados paliativos em Portugal não os tem, o que se deve ao desconhecimento e à excessiva burocratização do sistema, alertou hoje Isabel Neto, especialista nesta área.

Pois é, afinal a realidade é mais forte do que os ditames jurídicos. Os Homens devem ser idealistas? Evidentemente que sim. Mas, antes de serem idealistas, devem ser sérios. Com eles próprios e com os outros. Somos favoráveis a um sistema de saúde em que só quem tem dinheiro é que pode adquirir a saúde? Evidentemente que não. Se há aspecto da vida humana que é absolutamente democrático, é o seu estado de saúde. Rico ou pobre. Branco ou preto. Homem ou mulher. Velho ou jovem. Todos estão sujeitos a maleitas várias. Porque não inspirar-mo-nos em sistemas de saúde equilibrados, como o francês, o holandês ou o alemão? Até já os britânicos abandonaram o mítico NHS, adaptando-o!

NHS: cultural revolution II

Fonte: aqui.

Andrew Lansley's recent announcement that the government is embarking on a two-month "period of listening" about its NHS reform plans has been seen by some as a U-turn over a deeply flawed policy.

There are, however, some areas where the government is not prepared to listen: the commitment to abolish primary care trusts, to transfer major powers to commission services to GPs, and the ambition to vastly increase the participation of the private and, in theory, voluntary sectors in providing health services. In future, the NHS will continue to be funded from taxation and (for the time being) will be free at the point of delivery, but the government will step back from running the service.

Private sector involvement in the NHS is not new. Dentistry, worth £2.1bn, opticians and pharmacies are already in the private sector. GPs themselves are effectively private contractors, accounting for £8bn, or almost 10% of the entire NHS budget. Under Labour, private involvement was extended via independent sector treatment centres (ISTCs), handling mainly non-emergency elective treatments, as a way to bring down waiting lists.

But the current proposals are much more bold. Plans are under way to further outsource central services, such as workforce development (total budget £5bn) and procurement management. Even NHS Direct (worth £146m) is in the firing line.

But what about core and non-core clinical services provided by NHS trusts and community health organisations? These could be harder to outsource. This is especially true of the most complex, unplanned hospital admissions that are costly and inherently difficult to plan for. The Department of Health's (DH) own statistics show these account for approximately £12.5bn of a total budget for "hospital and community services" of £51.5bn. But that still leaves £39bn that could potentially be subject to private sector competition.

NHS: cultural revolution

Enquanto aqui se debate se o SNS sobrevive à custa do contribuinte e não à custa dos seus promotores, na Grã-Bretanha, pretende-se acabar com o tradicional NHS, que subsiste desde 1946. Nem Margareth Tatcher conseguiu ir tão longe, como David Cameron e o Ministro da Saúde britânico, Andrew Lansley, querem ir:

• Andrew Lansley will this week publish the biggest single bill in the history of the National Health Service – one far larger than the 1946 act that set the service up.
• It will, in effect, turn the NHS from what is still, broadly, a directly managed system of healthcare into something much more like a regulated industry of competing providers – and one over which the secretary of state will no longer have day-to-day control.
• “By 2014, the NHS will no longer be a system which still contains many of the characteristics of an organisation. For example, it still has a chief executive and a management chain that stretches out from the Department of Health. Instead it will be a regulated industry in which that management chain no longer exists.”
• “The secretary of state will no longer have the power to intervene in NHS organisations which will stand or fail on their own.
• “There will be a failure regime for hospitals and other providers. But there will be no power for the secretary of state to prop them up, or intervene if something goes badly wrong.
• And unless a service is designated as protected, it will also be possible for a hospital or other healthcare provider simply to stop providing a service or operating a site from which it can no longer make money.
• Mr Lansley is committed to allowing “any willing provider” to enter the NHS market. “But with a budget that is not growing, new organisations can only enter by displacing an existing provider,” Mr Edwards says. “So there will be pressure for exit.”
• The regulator will have a duty to promote competition. How vigorously or subtly it does so, and how far it allows hospitals, for example, to integrate community and GP services providing a complete chain of provision, will depend not just on what the bill says, but on the decisions taken by a chairman, chief executive and regulatory board that has yet to be appointed. The changes are, however, profound.

Mudança. Concorrência. Revolução? Veremos. Não se pode continuar como em Portugal, em que tudo é feito contra quem paga o serviço, que é o contribuinte. E tudo é feito para defender os interesses dos prestadores (médicos do SNS, Indústria farmacêutica, administradores hospitalares, burocratas do Ministério da Saúde, outros técnicos de saúde e vários Acordos com fornecedores).

Obesity: again

A man who once weighed nearly 70 stone is to launch legal action against the NHS, claiming they failed to help him as his size soared. Former postman Paul Mason received life-saving gastric surgery last year binge-eating his way to gargantuan size. But the 50-year-old, who now weighs in at a comparatively small 37 stone, said he should have been helped years ago. Mr Mason, who was eating 20,000 calories a day at his heaviest, claims he sought help from his GP after ballooning to 30 stone. Instead of receiving a treatment programme to manage his weight, he has complained he was told in 1996: 'Ride your bike more.'

NHS: service by numbers

Hospital bosses are advertising for an adviser to help decide which jobs to axe to save money - and will pay £1,000 a day for their services. The so-called 'turnaround' director will earn twice as much as the Prime Minister to oversee 'efficiency and cost-saving measures'. Details of the lucrative salary came as the NHS is being forced to make spending cutbacks, with frontline staff at risk.

Heart screening

Heart screening tests to be offered to millions of adults across England could be a waste of resources, a study warns.

Everyone between 40 to 74 is to be invited for screening for the early signs of heart disease and other problems by their GP. However, Cambridge University researchers say targeting only "higher-risk" people would save just as many lives, and potentially cost less. Their research was published in the British Medical Journal.

The researchers said universal screening, while effective, might be "unrealistic to implement" at a time when the NHS was likely to be increasingly short of resources. "Policy makers have to decide on the balance between the number of people needed to screen or treat and the number of cases that can be prevented in the population," they said. "Given that universal screening will take years to implement, it makes sense to prioritise people who are most likely to benefit," he added. "There are untreated patients at high risk of cardiovascular disease, most of whom can be identified from their electronic primary care records. We should act on this information."

NHS (UK): rolling

Hospitals will have up to 10 per cent of their income based on patient satisfaction, the Health Secretary has announced. Andy Burnham set out his vision of the NHS until 2015 and said some payments would be withdrawn if unsafe care was found. Under his plans, hospitals could face tough financial conditions in the next few years, with the amount they are paid to treat patients frozen until 2015.

Mr Burnham denied this would result in hospital closures but said they would have to find ways of working more efficiently. He wants to see more patients treated in the community, which is cheaper than providing hospital care, as the NHS strives to save billions in the next few years. As a result, patients with long-term conditions, including cancer, could be given dedicated one-on-one carers to help oversee their health. Also today, Mr Burnham suggested NHS staff could be given a guarantee of employment in return for flexibility at work and accepting a pay cap. He stressed patients should be at the forefront of what the NHS does.

Not very NICE

This (NICE) execrable organisation - run by self-appointed demi-gods who get to say who lives and who dies - are the same idiots who days before - decided liver cancer patients should be denied drugs that could extend their lives by six months or more.

And who just a few months before that decided kidney cancer patients wouldn't be given drugs that could save them either. Their pathetic excuse for robbing people of hope is always that there's not enough money in the NHS pot to save everyone (by "everyone" they obviously mean people with cancer who cost a lot of money to keep alive).

Uma cirurgia no supermercado mais próximo

Fonte: aqui.

Dr Mohammed Jiva stands by his surgery inside Sainsbury's in Heaton Park, Manchester. Another 200 could be opened after its success. Anyone would be able to walk in for treatment, with doctors accessing their records via the NHS computer system.

NHS: nurse

Fonte: aqui.

An NHS nurse has broken the £100,000 pay barrier for the first time as the drive to cut waiting lists brings lucrative rewards for senior staff. The nurse consultant, who is based in Rotherham, earns double the basic salary of around £50,000 by working overtime under a generous Health Service initiative.

Os computadores substituem os técnicos de saúde

As mulheres devem fazer prevenção quanto á possibilidade de virem a ter cancro da mama. Por isso, devem realizar uma mamografia com uma periodicidade anual.

Na Grã-Bretanha realizou-se um estudo em que se verifica que os técnicos de saúde que analisam as mamografias podem vir a ser substituídos por um computador:

• Computer-aided detection found 198 out of 227 cancers, compared with 199 from double-reading, in the Cancer Research UK study involving 28,000 women.
• NHS breast screening could be made more efficient, say the scientists in the New England Journal of Medicine.
• The national programme screens over 1.7 million each year. The NHS would like to see even more women offered screening by extending eligibility to include the ages 47 to 73. Scanning these extra 200,000 women would increase workload by 30%.
• Professor Stephen Duffy said: "We can now say for certain that this system is as good at detecting breast cancer as the one used as standard practice."

Será que a mais-valia da tecnologia vai afastar também técnicos de saúde, como aconteceu em outros sectores de actividade?

Listas de espera

Fonte: aqui.

Hospital Central

Fonte: aqui.

A busca do impossível

Quem trabalha na saúde, sabe que o grau de exigência dos doentes é cada vez maior. Ninguém aceita ter dores. Ninguém aceita sofrer. Toda a gente quer ser bem servida.

Do outro lado, há inevitavelmente, a gestão do possível. Ou dito de outra forma, tem que se saber gerir recursos, sob pena de virmos a gastar quase tudo em saúde e não termos recursos para comer.

O equilibrio é o ideal, mas é difícil de atingir.

Toda a gente percebe, que o SNS tenta copiar, para o bem e para o mal, o NHS Britânico. Desde a sua criação. Veja-se onde já vai o NHS, para perceber quais serão as próximas medidas de Correia de Campos ou do seu sucessor.

A contenção do NHS vem agora da gestão da frota de ambulâncias. Sim, é verdade, vejamos aqui:

• The government is putting lives at risk by encouraging the use of one-person ambulance cars to meet crude targets.
• From next April, ambulance trusts must ensure that 75% of serious emergencies are reached by paramedics within eight minutes.
• The target has forced trusts to increase the number of so-called "solo responders" at the expense of traditional ambulances crewed by two paramedics.

Vejamos o que diz este blogger, condutor de ambulâncias: Tom Reynolds, a London ambulance driver who blogs about his experiences, said of the new target: "I can turn up after eight minutes and save someone's life and the job will be counted as a failure. If I turn up before eight minutes and someone dies, it's a success."

É preciso ter bom senso, antes de se realizarem racionalizações. É evidente que a saúde não pode existir a todo o custo, até porque todos acabaremos por morrer, mais cedo ou mais tarde. Mas, precisa-se de bom senso!

Falta de recursos

Fonte: aqui.

A saúde sem fundos

Fonte: aqui.

A indumentária do Pessoal da Saúde na Grã - Bretanha

O novo Ministro da Saúde Britânico, Alan Johnson, impõe novas regras quanto às roupas que o pessoal da saúde deve usar: Long-sleeved white coats, favoured by physicians for decades, are set to be banned under an NHS shake-up aimed at tackling hospital superbugs.

Mais, toda aquela série de parafernália que o comum dos mortais usa, tem que ser banida, tais como: relógios, brincos, jóias e até unhas grandes....

É que as infecções nos hospitais britânicos só tem paralelo em alguns hospitais do leste da Europa: The moves come after a report found British hospitals were among the worst in Europe for superbugs, behind countries such as Slovakia, Hungary, Poland and the Czech Republic.

E parece que a higiene é tão problemática na Grã-Bretanha, como em Portugal: Experts have said that up to two-thirds of doctors do not wash their hands properly.