Diana Smith
Recent activity
Comments (3)
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Comment on: Nicholson seeks "legitimacy" amidst a storm of protest
Well done to those people who chose to use their names. Always better when attacking someone who cannot really answer back. I agree with the writers who say that the best course of action is to read the report - thoroughly - maybe several times - before entering into judgement on anyone. Also agree with the writers who suggest that we should be careful what we wish for. Thise who are attacking Sir David are often doing so for completely different reasons, and with a different idea of what they might like to see in his place. The chances of everyone magically being satisfied by a change are slim.
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Comment on: HSJ exclusive: NHS to take responsibility for social care
A lot of this makes perfect sense. The recent Alzheimer's society report which indicated that 25% of people in hospital have dementia, and they tend to be their for longer periods than is good for them or for the service. This ties in with reports like the Alberti Report into acute services in Stafford, which indicates that Hospitals overcrowded with people who would be better off somewhere else cannot work at optimum efficiency. Getting people out of acute beds and into places focused on re-habilitation, or back home can only be done with a transition service that works properly. Whilst you have locally managed social care services with a political interest in minimising their costs it is very difficult to make this happen. Roy Lilley makes the important point that one has to remember that Health service is free at point of use and Social care is means tested. Exactly. We have been here before of course. in the 1990's we saw the closure of many geriatric hospitals and the move to privately owned care homes, with care becoming means tested. What the Conservative government of the time omitted to put in place was an effective option to let people insure themselves against the risk of care costs. The few private schemes that did emerge all collapsed because no one would buy into them. The Green paper to create a social care service does fully address the options for how we can pay for this. if the Comprehensive option is accepted then the financial distinction between health care and social care will cease to be a problem.
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Comment on: Mike O'Brien defends Care Quality Commission
I have been a close observer of events at Stafford. The major problem here is that there is confusing statistical information, have been misinterpreted by the press - led by a vociferous pressure group, led by a handful of people, and that the resulting hullabaloo has brought in lawyers, and politicians all seeking advantage. This is still continuing, and there are clear indications that action is planned to try and influence the outcome of the election. It was at the start of the Stafford experience completely impossible to contest the inaccurate information because of the scale and ferocity of the witch hunt. The press like the personal stories. They do not understand the technical information, and few if any of the journalists had actually read the key reports. I know this because I asked them! One of the things that worries me is that because the statistics are not as clear as they should be, largely because of big variations in the coding of co-morbidity, that there are people who are intent on interpreting this as a failure of "big state" and wish to turn the clock back to where we were before 1997 when there was no attempt to make valid comparative measurement of quality. Part of this is happening because of the involvement of the Patients Association which does have connections with the handful of people who run the Stafford Pressure group. Curring back on the effort to get good compatitive data would be a big mistake. Good data really does help hospitals to analyse their procedures effectively and make positive changes. The Stafford journey actually illustrates this. At the point when the Healthcare commission were investigating, there were adjustments made to correct the way in which the coding was being done. This immediately brought the HSMR figures down from the misleading figure of 127 to the mid 90s. ( where no alarm would have been triggered)After that the Alberti report looked closely at procedures, and did identify real changes that needed to be made. As a result of this work, and the much tighter procedures that now accompany any unexplained death or near miss, the Stafford Figures have continued to fall, until it now shows as one of the 10 best. My belief is that work needs to be done to educate the journalistic profession about the complexity of the exercise of collecting good comparitive data, and they should be actively dissuaded from the knee jerk "who is to blame" reaction. The public need to be told clearly that we are not dealing with simple matters here. I think it is good news that one of the hospitals is actively contesting the Dr Foster results, and I hope that people within the Health service will come to the defence of people who are unjustly accused.
