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Tuesday, February 05, 2013

40,000 NHS Deaths - Move Along, Nothing to See

  News of the British NHS experience juxtaposed with a Pournelle comment on his own country's health system.

40,000 die every year after hospital blunders, MPs are told

Hospital blunders are involved in the deaths of up to 40,000 patients a year, MPs have been told.

One in 10 people admitted to hospital suffers some kind of "harm" because of the treatment they receive, members of the House of Commons Health Committee heard.

The figures were given to members of the House of Commons Health Committee as part of its inquiry into the safety of patients.

NHS managers have already drawn up a list of serious mistakes which doctors and nurses are required to report in order to build a more accurate picture of the numbers who die as a result of mistakes by hospitals.

The blunders include carrying out the wrong operation on patients, administering the wrong drugs, leaving instruments inside patients after operations and failing to put up bars to stop patients falling out of bed.

Professor Richard Thomson, from Newcastle University's institute of health and society, said the most reliable evidence showed around 10 per cent of patients admitted to hospital suffered "harm" because of treatment.

He told the committee that the number of overall deaths caused by medical care going wrong was far from clear but that some estimates put it at up to 40,000 a year.

"A definitive study is needed to address the size of this problem and to identify priorities for action," he said.

Official figures from the National Patient Safety Agency (NPSA) suggest that around 2,000 NHS patients die each year as a direct result of errors in treatment - half of which could have been avoided. An estimated 5,000 die from superbug infections.

  He said:

The CDC estimates that there about 99,000 annual deaths from hospital acquired diseases, and the number is growing. By contrast, deaths from traffic accidents peaked at about 50,000 a year a few decades ago, and have been dropping ever since. We’re down to under 35,000 a year now. Of course much of that decrease is due to modern medicine and modern emergency hospitals.

It’s just one more thing to worry about.

For a short period of time when I was in high school I was employed as a junior blood technician at a downtown Memphis clinic. Standards in those days were much lower than they are now, of course, but one thing we were taught was meticulous if somewhat drastic sanitation. One of the practices we used was periodic sterilization of darned near everything with carbolic acid, which, I admit, was pretty drastic. It used to be that every biology lab had a bottle of carbolic acid for sterilization, and you could ever get soap with carbolic acid in it – I know, because we were required to use it to wash our hands before and after taking a blood sample. I don’t suppose they do that now. I do wonder how a bug could develop a resistance to phenol, and I doubt any have done so. Maybe we need to go back to something like that? I mean, how much do we spend on trying to prevent traffic deaths, which seem to account for about half the number that you get from hospital infections, and we’re only discussing deaths now, not infections from which people recover.

   Note the wide difference between Professor Thomson's figure "up to 40,000 a year" and the NHS saying 2,000 + 5,000. Either he is way out wrong or the NHS are criminally complacent. I can only guess which but echo his call for a "definitive study".

   The US has a population 5 times ours so extrapolating from their figure we should expect about 20,000 hospital infection deaths so we are either doing much better or worse than them.

  Road deaths however, at 1901 in 2012 are far lower than in the US and, by either estimate, far lower than hospital deaths (27% or 4.7%)

  But still far more newsworthy. Now why is that?

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It is my understanding that hospital managers, unless clinically qualified and experienced should not be able to overrule decisions on clinical care taken by qualified staff. Since all those qualified staff taking decisions are professionals and members of a professional body, such as the BMA or the royal College of Nursing, they must presumed to be well aware of their professional obligations. It seems that once again, self regulation has not been enough to maintain standards
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