The Book of the Dead is the name of the current Egyptian exhibition at the British museum it would have made a good alternative title for Dr Foster’s hospital guide. Nineteen hospitals are identified as having high death rates. The report names those hospitals where unexpectedly high numbers of patients have died after developing complications following routine operations suggesting poor quality care.
Poor quality care was also highlighted in the Mid Staffordshire Hospital Trust enquiry which concluded that a preoccupation with cost cutting led to appalling standards of care. The message is clear if you cut ward staff to save money the result is poor quality care and higher death rates. Just to be clear we are not talking about indifferent or callus ward staff we are talking about too few staff on duty for the number and needs of the patients. Other reports have identified dehydrated and malnourished elderly patients. Two thirds of patients on acute hospital wards are over 65.It’s no good saying to someone who has dementia “make sure you drink plenty of fluids”. It’s no good simply saying to a frail elderly person “you must eat to keep up your strength” and it no good saying “you need to tell someone in plenty of time if you need to go to the toilet”. You need staffing levels that take into account that these patients need help and encouragement to drink, eat and go to the toilet.
Back to the Book of Death the average life expectancy in ancient Egypt was 28. When life was so short it is hardly surprising that the Egyptians were preoccupied with the afterlife. Average life expectancy in England today is 83, we give less thought to what happens after death but we are rightly concerned that average life expectancy disguises that some section of the community can expect to die a lot younger. For example life expectancy amongst homeless people is in the low 40’s. So I was very pleased to read that the coalition government wanted to do something about health inequality particularly amongst the most disadvantaged groups. I was less pleased when I heard the Governments spokes person’s rational.
“Improvements would save money because such groups cost the NHS disproportionate amounts of money. Homeless people spend eight times more time in hospital and make five times more visits to A&E departments than other groups.”
It would appear the Government still hasn’t leant the lesson about being preoccupied with costs when it comes to health.
Blair McPherson is author of Equipping Managers for an Uncertain Future www.russellhouse.co.uk