Monday, May 23, 2011

Queen Square & MP: Mayo Clinic & Integrated Health Care.

In April, Guy Opperman (M.P.,Hexham) developed headache and vomiting and sought medical help from Commons staff, who initially believed it to be nothing more than a bad headache. The door keeper thought it would be best to ask Dr. Daniel Poulter (M.P., Central Suffolk and North Ipswich and a medical doctor) for an opinion.
Dr Poulter :
........ Guy’s symptoms were pain in the back of his head and vomiting. I took those as possible signs of bleeding in the brain. He hadn’t been drinking so it was clear something was happening. He was going to be sent home but I realised it was urgent to get him to hospital.
Dr Poulter told Opperman to go immediately to St Thomas’ Hospital, close to Parliament, where he was sent on to the National Hospital for Neurology and Neurosurgery (Queen Square) in central London, and had surgery.  More>>>>
Perhaps he was lucky as he did not have to cope with the following:
GPs are facing demands to deliver unprecedented reductions in hospital activity over the current financial year, with NHS managers setting targets for cuts in admissions of 15% or more by next April, a Pulse investigation reveals.
NHS North Staffordshire has called in private providers to implement admission avoidance strategies, including Aetna Health Services to provide the Connected Care Programme, BUPA to offer risk stratification tools and Tunstall Healthcare to deliver a telehealth scheme.                                            Pulse
Our MP luckily did not have admission avoidance or telehealth imposed on him.

Queen Square as The Cockroach Catcher still remembers from his early training there, is a world class Neurological Hospital. Whatever the present government might want to do to save some money, some of us, including our MPs might need the services of well trained specialists.

My view is that for the few that are unfortunate enough to need it, the rest of us should support them through our taxes for a National Health Service. That was the best of integrated health care for Opperman and I do hope that our MPs will see the merits of our NHS at its best.

It was medicine at its best.

Earlier when I talked about the Mayo Clinic

“The best interest of the patient is the only interest to be considered.” 

These words not only resonate with anyone who has ever worked, trained or been educated at Mayo Clinic but also with medical professionals around the world who emulate Mayo’s Model of Care.

The Cockroach Catcher surprised even himself that he was still naive about the future of the NHS that he joined over 40 years ago.

The truth is that there is indeed a shortage of specialists world wide:

Private Health Care providers all knew the value of specialists. (These specialists have been known as hospital consultants in England and the rest of the U.K.). Private Health Care providers know that secondary care is where the money is. Primary care has never featured in Health Insurance schemes. It has always been secondary care.

The only reason why they now want to move into GP service is to have control over secondary care. Many Insurers have full control over the consultants and the hospitals they are allowed to operate.

Why are hospitals and the consultants not kicking up a fuss?

Here is a view:

“In the case of the consultants, a show was made of trying to make them accept much closer supervision by hospital managers, and cut back on their private work. But it soon came to seem that the real aim of doing this was to make them feel more disenchanted with working as salaried NHS employees and readier to go into business – to form doctors chambers, on the model of barristers, or other kinds of business, and sell their services to any employer, public or private, that offered them the best terms. A significant number began to plan to do so and some have begun to. And as the cuts begin to bite there will be unemployment among hospital doctors. As you will have read, consultants are among those scheduled to be laid off by St George’s hospital in Tooting, and elsewhere. Working for private providers will become normal again in a way it hasn’t been since 1948.”

                                                                                      The Plot Against the NHS

It is of course likely that after plotters plotted for nearly 20 years to have the money making part of the NHS privatised, they are unlikely to give up quietly.

Democracy is a peculiar business and there is truth that some of us know who the enemies of the people really were.

Some politician may regret too late for not taking the opportunity and grasp the three hairs on the god of opportunity. The Cockroach Catcher did spell it out not many weeks ago.

That many of the plotters in the Labour camp are now unashamedly working for private health care insurer or provider in one form or another that they did not get the votes from the PEOPLE.

Mayo’s Egalitarian Culture
You may have heard that at Mayo, doctors collaborate. But did you know that after their first five years all physicians within a single department are paid the same salary?  During those first years, physicians receive "step raises" each year. After that, they top out ,and "he or she is paid just the same as someone who is internationally known and has been there for thirty years,"  says Patterson. ("Most could earn substantially more in private fee-for-service practice." he adds.) 
“It doesn’t matter how much revenue you bring in,” Patterson explains, “or how many procedures you do. We’re all salaried staff—paid equally.

“Turnover is very low. It’s unusual for people to leave here, and when they do, many like me, wind up coming back.  You would be surprised—we celebrate many 35 and 40 year anniversaries. That fact that people stay so long is important to the success of the organization.”

Patterson does not sound as if he’s boasting. He didn’t found Mayo. He didn’t create the culture. He merely works there—and he is telling me why he likes it. 

Yet I believe that there is much that health care reformers can learn by studying how Mayo operates.

There is, after all, a difference between healthcare and hamburgers.  Healthcare is not a commodity.

“…….Mayo offers proof that when a like-minded group of doctors practice medicine to the very best of their ability—without worrying about the revenues they are bringing in for the hospital, the fees they are accumulating for themselves, or even whether the patient can pay—patients satisfaction is higher, physicians are happier, and the medical bills are lower.”

As Doctor William Mayo explained in 1905: 

“The best interest of the patient is the only interest to be considered, 
and in order that the sick may have the benefit of advancing knowledge, 
union of forces is necessary
…it has become necessary to develop medicine as a cooperative science.

If Mayo can, we can!!!

Dr Jest’s Caseblog: Re-Assura-nce ?

So, how dare a PCT dictate to a consultant when and how a patient should be reviewed? Well the first motivation right now will undoubtedly be financial. Each encounter of a patient with any hospital or “hospital-supplied” service since at least the early 1990s has carried a price tag. So the initial encounter at outpatients generates a bill. There is then a tension between hospital and PCT, both of whom have a primary statutory duty to deliver a balanced budget which overrides any other duty they may have. So more hospital outpatient reviews means more money for the hospital, and a bigger drain on PCT resources.

1 comment:

iolite said...

For curing any specific diseases we require the help of the specialists. Private Health Care providers all knew the value of specialists. In a hospital for the proper care of the person and for that specialist need to be present.