January 25, 2006
The Dickensian NHS
My grandmother has fallen and broken her pelvis. She is 100. She is in hospital in London, the Chelsea and Westminster in the Fulham Road.
Yesterday she was not bathed or her teeth brushed. After her admission she was not fed until she asked for a sandwich at 4pm. Yesterday morning breakfast arrived at 9.15am (Like most of the hopspital she had been up since six). She was taken to a scanner and left on a trolley for hours because someone made a mistake with her name. She has cystitis and when she asked about getting an antibiotics course the nurse referred her to a drug she is prescribed for her blood pressure, either not understanding, or affecting not to understand the question.
"You have to ask the doctor," the nurse said.
The doctor comes every day - during the day.
My sister visited her yesterday and commented grimly that she should get out of there as quickly as she could.
How have we let things get to this?
Acute care may be fine in the health service but the routine care is Dickensian - gaggles of staff who seem to be totally unmanaged gather by the desk in the ward - prescriptions are lost, forgotten, meals are not delivered, baths are not administered.
I would assume that this is an isolated case, but when our baby was born by Caesarean section recently, we had the same experience at St. Thomas's - a day when the nurses forgot to administer pain killers, a day when the doctor failed to visit, a prescription that was asked for five times from separate nurses and still failed to appear. During the night my wife needed to call a nurse to have the baby lifted so that she could feed him. The nurse tutted, asked why she couldn't do it herself.
"I've just had a caesarean," my wife pointed out.
Or again: my father-in-law has motor neurone disease. His disease means that he cannot move without assistance and cannot speak. He was abandoned by nurses for a day at Kings College Hospital, not helped to eat, not washed, a urine infection left agonisingly untreated.
The fabric of the health service is breaking down, and it is breaking down at the point where care is delivered - the nursing and routine care. And the failure is one of management. There are oodles of people working, but no one is training or managing them.
***
The thing I find weird is that there is no pressure for change. There is a rising tide of lawsuits for neglect and malpractice, but no one is suggesting that the system (which reminds me of the BBC in the mid-eighties doldrums before Birt arrived) needs reform. How my heart sank when David Cameron pledged not to touch the health service. Without pressure from private providers there will be no improvement.
And until that happens big city hospitals more and more resemble some kind of eighteenth century, where unless your family came in to look after you, you starved, caught an infection and died.
Posted by Mark at 6:02 AM | Comments (0)
January 24, 2006
Google bears
All the bear-ish points you could make about Google in one article by Alice LaPlante. She cites: "excessive reliance on search advertising, lawsuits, eroding public trust, lack of focus and the competitive threat from Microsoft".
Hmm. This probably not the time to buy Google stock, which is way high, but this is a far from convincing case against. Search advertising is what web commerce does best. La Plante argues that there should be more display. Well, sure. But only in relevant contexts. Google's search market position - button one - gives it a head start (and a revenue advantage) over any rivals.
The main threat to Google's market dominance is in the area of possible regulatory threats, and on its own lack of focus on the key next stages of the web, which involve indexing rich media in a way that continues to attract customers. I like Blinkx, but I am not betting against Google. Buy on weakness.
Posted by Mark at 2:04 PM | Comments (0)
January 21, 2006
Dallas Michael Fletcher Rogers
Born 3.50am 13th December 2005, St. Thomas's hospital London.
Posted by Mark at 10:15 AM | Comments (0) | TrackBack