Tuesday, September 01, 2009

Yet More on Socialized Medicine in the U.K.

From the Daily Mail:
Patients in Health Service hospitals are far more likely to go hungry than criminals in jail, scientists warned yesterday.

They say frail and elderly patients do not get the help they need with meals, and nobody checks whether they get enough to eat.

Despite years of Government promises to tackle poor hospital nutrition, food still arrives cold, and patients often miss out because meal times clash with tests and operations.

Meanwhile, prisoners are enjoying carbohydrate-rich, low-fat foods which in many cases are better than they would have been eating on the outside.

The Daily Mail has been highlighting the scandal of old people not being fed properly in hospital as part of its Dignity for the Elderly campaign.

Hospital meals are often taken away untouched, because they are either unappetising or are placed out of patients’ reach.

The latest figures show 242 patients died of malnutrition in NHS hospitals in 2007 - the highest toll in a decade. More than 8,000 left hospital under-nourished - double the figure when Labour came to power.

The NHS throws away 11million meals every year, and many nurses say they are too busy to help the frail eat.

Earlier this year the Mail revealed that some hospitals spend less on meals than the average prison.

Ten hospitals spent less on breakfast, lunch and an evening meal than the £2.12 a day allocated for food by the prison service. One spent just £1.

Although most hospitals do spend more than £2.12, prisoners end up better nourished than patients, say experts from Bournemouth University. After studying the food offered to inmates and across the NHS, they found patients face more barriers in getting good nutrition.

Professor John Edwards said around 40 per cent of patients were already malnourished when they were admitted to hospital, but their condition did not tend to improve while they were there.

“If you are in prison then the diet you get is extremely good in terms of nutritional content,” he said.

“The food that is provided is actually better than most civilians have.

“There’s a focus on carbohydrates, then there’s the way they prepare the food, it’s very healthy. They don’t add salt and there’s relatively little frying of food - if you have a burger then it goes in the oven. Hospital patients don’t consume enough.

“And from the work we’ve done we know that people who sit round a table eat a lot more, but this doesn’t happen in hospitals.”

His colleague, Dr Heather Hartwell, said fruit and vegetables were given out in hospitals “but this doesn’t mean it’s eaten.”

While patients suffer due to a loss of appetite as a result of their illness, they often go hungry because there is no one to help them eat.

Dr Hartwell said once food was prepared, it generally hangs around waiting for porters to transport it to patients. Then it may be left on wards until it goes cold.

“Ward staff also don’t actually know how much patients are eating because it is domestics who clear the trays away,” she said. “This is an example of fragmentation in hospitals that does not necessarily happen in prisons.”

The research found temperature and texture are among the most important factors in patients’ satisfaction with food.

It concluded lack of appetite due to a medical problem is probably the main reason for under-nutrition, but said hospitals can make improvements.

Liberal Democrat health spokesman Norman Lamb said: “It’s incredible that so many hospitals are failing to serve healthy meals. If prisons can serve good food then so can hospitals.”
Then we have this, from The Telegraph.
Patients with terminal illnesses are being made to die prematurely under an NHS scheme to help end their lives, leading doctors warn today.

In a letter to The Daily Telegraph, a group of experts who care for the terminally ill claim that some patients are being wrongly judged as close to death.

Under NHS guidance introduced across England to help doctors and medical staff deal with dying patients, they can then have fluid and drugs withdrawn and many are put on continuous sedation until they pass away.

But this approach can also mask the signs that their condition is improving, the experts warn.

As a result the scheme is causing a “national crisis” in patient care, the letter states. It has been signed palliative care experts including Professor Peter Millard, Emeritus Professor of Geriatrics, University of London, Dr Peter Hargreaves, a consultant in Palliative Medicine at St Luke’s cancer centre in Guildford, and four others.

“Forecasting death is an inexact science,” they say. Patients are being diagnosed as being close to death “without regard to the fact that the diagnosis could be wrong.

“As a result a national wave of discontent is building up, as family and friends witness the denial of fluids and food to patients.”

The warning comes just a week after a report by the Patients Association estimated that up to one million patients had received poor or cruel care on the NHS.

The scheme, called the Liverpool Care Pathway (LCP), was designed to reduce patient suffering in their final hours.

Developed by Marie Curie, the cancer charity, in a Liverpool hospice it was initially developed for cancer patients but now includes other life threatening conditions.

It was recommended as a model by the National Institute for Health and Clinical Excellence (Nice), the Government’s health scrutiny body, in 2004.

It has been gradually adopted nationwide and more than 300 hospitals, 130 hospices and 560 care homes in England currently use the system.

Under the guidelines the decision to diagnose that a patient is close to death is made by the entire medical team treating them, including a senior doctor.

They look for signs that a patient is approaching their final hours, which can include if patients have lost consciousness or whether they are having difficulty swallowing medication.

However, doctors warn that these signs can point to other medical problems.

Patients can become semi-conscious and confused as a side effect of pain-killing drugs such as morphine if they are also dehydrated, for instance.

When a decision has been made to place a patient on the pathway doctors are then recommended to consider removing medication or invasive procedures, such as intravenous drips, which are no longer of benefit.

If a patient is judged to still be able to eat or drink food and water will still be offered to them, as this is considered nursing care rather than medical intervention.

Dr Hargreaves said that this depended, however, on constant assessment of a patient’s condition.

He added that some patients were being “wrongly” put on the pathway, which created a “self-fulfilling prophecy” that they would die.

He said: “I have been practising palliative medicine for more than 20 years and I am getting more concerned about this “death pathway” that is coming in.

“It is supposed to let people die with dignity but it can become a self-fulfilling prophecy.

“Patients who are allowed to become dehydrated and then become confused can be wrongly put on this pathway.”

He added: “What they are trying to do is stop people being overtreated as they are dying.

“It is a very laudable idea. But the concern is that it is tick box medicine that stops people thinking.”

He said that he had personally taken patients off the pathway who went on to live for “significant” amounts of time and warned that many doctors were not checking the progress of patients enough to notice improvement in their condition.

Prof Millard said that it was “worrying” that patients were being “terminally” sedated, using syringe drivers, which continually empty their contents into a patient over the course of 24 hours.

In 2007-08 16.5 per cent of deaths in Britain came about after continuous deep sedation, according to researchers at the Barts and the London School of Medicine and Dentistry, twice as many as in Belgium and the Netherlands.

“If they are sedated it is much harder to see that a patient is getting better,” Prof Millard said.

The letter has also been signed by Dr Anthony Cole, the chairman of the Medical Ethics Alliance, Dr David Hill, an anaesthetist, Dowager Lady Salisbury, chairman of the Choose Life campaign and Dr Elizabeth Negus a lecturer in English at Barking University.
Of course, supporters of ObamaCare insist that nothing like this can ever happen in the U.S. And all the while Obama promises to cut a half trillion dollars from Medicare.

And all the while Obama and liberals work to vest in unelected bureaucrats the power to deny certain treatments to people deemed somehow unworthy.

And they keep insisting that the U.S. spends “too much” on health care, and should be spending an amount more like that of Canada and the U.K.

And of course, liberals reject policies that might actually make the system more efficient, like malpractice reform and allowing interstate competition among insurers.

Are the ignorant of the foreseeable consequences of what they promote, or are they simply dishonest?

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1 Comments:

Blogger Billiam said...

I think it's a little of both. I'm also relatively sure that British citizens were likely told the same thing that we are being fed now. "That won't happen here!" Since our Government, and the left, refuse to learn from history, or even the world around them what doesn't work, we are all doomed to suffer the repeated mistakes and consequences of a lesson ignored. There's always someone who thinks they can do the failed and unthinkable better.

9:47 AM  

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