Wednesday, 1 April 2009

Unenthusiastic about interesting times

‘May you live in interesting times’: we all know it’s a Chinese curse. Funnily enough, there’s actually no evidence that it’s Chinese at all, but then you don’t need much evidence for things we all know to be true. In any case, Chinese or Western it conveys an important truth: it isn’t always in our interest for things to be interesting.

It’s also not reassuring to be told there’s nothing to worry about. It’s probably marginally worse, though, to be told we ought to be worrying hard. Tonight we got a letter from our Member of Parliament, here in Stafford, telling us just how bad he feels about the way things have been in our local hospital and urging us to urge him to do something about it.

His message isn’t reassuring, but though he may be jumping on a bandwagon that’s already gone past, he’s not wrong. Stafford Hospital has been through some interesting times recently, in the sense of the curse. Standardised mortality rates sound pretty dull things, but they hide far too interesting an underlying truth: for Stafford Hospital, that truth is that between 400 and 1200 more people have died after emergency treatment there over the last three or four years than should have , given how ill they were. 400 to 1200 people – that’s a reasonable size village.

Now there’s something you’d have to call interesting.

Obviously, I’ve never been that keen on having an accident or falling severely sick. But until things get sorted at my local hospital, I’m keener than ever to avoid either fate.

The management team has changed. I’m certain that whatever else happens there in the next few months, making sure that care quality improves is going to be way up there on their agenda. I don’t think the new management can be in any doubt that anything less would be severely career-limiting.

How did things go wrong in the first place? Well, there was a major move to control costs and make the place more financially secure. They were making nurses redundant even though they were already below established numbers. They cut too deep and quality went.

As it happens, I spend a lot of time working on hospital costs. Every day I work with some clever people on complex problems: how do you calculate hospital costs sensibly, how do you work out just how much it’s costing to treat a particular patient for a particular condition, just how do you avoid errors that will make things look cost effective that simply aren’t?

It’s an exciting challenge. And it’s worth it. As a rheumatologist from one of our client hospitals recently told a conference I attended, if you don’t know where you’re wasting money, then when the cuts start – and in today’s climate, there’s no doubt they’re going to start sometime soon – you’ll not be cutting waste. You’ll be cutting care.

That’s what they did at Stafford Hospital. And a village died.

So I’m delighted we’re working on getting the problem of hospital costing right. Because if we do that we might be able to avoid other hospitals getting quite as interesting as Stafford has been in recent years.

And healthcare is an area where being boring is just fine with me.

1 comment:

Mark Reynolds said...

Saw a bit on this story in the papers when I was killing time in Stansted - I was hoping you were going to write about it.