11 April 2009

Dr Angry speaks out

Dr Grumble found the post reproduced below on dnuk. It refers to a recent Panorama programme, Britain's Homecare Scandal. The author has kindly given permission for it to be reproduced here. None of the views he expresses are in any way unreasonable. Dr Grumble considers them spot on but the author does not want his name to be revealed. Dr Grumble understands only too well why.

As you all know - because the government have told us frequently - the involvement of Private Companies in the NHS is a good thing because it will stimulate competition, put the rest of us on our toes, and raise standards.

Well last night there was a Panorama special which showed just how some private companies at least are working in the home care "industry".

Inadequately trained staff being given too much responsibility, lack of management back up, staff being driven on impossible time targets and being encouraged to falsify the amount of time they spent with each patient and absolutely appalling lack of record keeping plus piles of patient records residing in the boot of someone’s car.

Net result old people left in puddles of excrement not being cleaned, being injured by being hoisted by untrained staff not being fed etc etc. Does any of this sound familiar to any of you docs out there?

A good investment opportunity said the man in the City, downward auctions on price said a Health Board in Scotland, I refuse to answer that said the boss of the Scottish Care commission when asked if she would like her parents looked after by one of these outfits.

Now for the really scary bit: one of the companies shown up as delivering appalling standards was Care UK which delivered record profits last year and is also involved in providing private general practice. In particular they were awarded the contract to run a new practice and walk-in centre in East London.

Now I have no evidence that they are currently delivering anything other than good care in this operation. It would be pretty remarkable if they didn't as they are being paid sums way beyond that which ordinary GPs get for running a practice with hoards of staff looking after a list of less than 3000. But what will happen when the list expands and they have to face the daily reality of trying to deal with high demand and still make a profit?

A couple of years ago a young GP working for a private provider of general practice posted on DNUK about how they and particularly a nurse practitioner were left to run a practice with the nurse being forced to work way beyond her capabilities and lack of management back up.

Of course there are some examples of poor general practices run by GPs but I think the majority of GPs put their heart and soul into providing a good service for their patients mainly I think out of their own sense of professionalism but also reinforced by the thought that if we fall short we will be personally answerable to the GMC and the Health Care Commission to mention just two. And, dare I say, most of us still care about patients as individuals.

Already we have seen in Stafford, and lots of other hospitals not mentioned in the press, what happens when managers and targets take precedence over professionals. How long will it be I wonder before we see a Panorama programme on poor general practice being delivered by a private company.

How much longer will it be before everyone get wise to the fact that this government’s half-baked and non-evidence-based ideas about stimulating competition are not only not working and squandering resources but are just plain wrong? Wrong for the NHS, wrong for professionals but, most of all, wrong for patients.

Dr Angry

The Panorama programme seems to have disappeared from iPlayer curiously early but Dr Angry conveys the essence of the programme so very well that you do not need to watch it.


BenefitScroungingScum said...

My experience of home care taught me that the panorama investigation was the tip of the iceberg. I've posted about my experiences http://benefitscroungingscum.blogspot.com/2009/04/britains-home-care-scandal-panorama.html

I'm young and relatively speaking fit and well (emphasis on relative!)I still cannot bear to imagine how terrible it must be for older, already confused people.

When I lost my care package(and well before) the medical professionals caring for me wrote letters supporting my care needs and my GP had multiple arguments with SS about the situation all to no avail.

A point not made in the panorama investigation is the involvement of social workers in this situation. Obtaining a care package is a lottery, managing to survive your care package has even longer odds.

Bendy Girl

Nutty said...

If children were treated the way far too many old people are treated in care homes and hospital wards, they would be taken into care and there would be scandals in national newspapers.

But granny P will never sell papers the way that baby P does, and whilst people can be found to adopt babies, people can't be found to adopt grannies, so we dump them in homes and try not to think about it.

paul said...

I guess thats the way of the developed world, I hope you've made plans Dr. G, for when you are no longer able to look after yourself. I am trying to think of an insurance plan. I thought stock markets but they crash, then property- too expensive. Now thinking children but perhaps the answer is grandchildren


Julie said...

Never fear Dr Grumble, Panorama is still on iplayer at


Dr Grumble said...

Thanks, Julie.

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