Some readers see me as the Great Satan, because I dare to criticise certain luddite practices and attitudes in the NHS. But my criticisms are as nothing compared to what doctors say about each other. Pulse Magazine recently published a survey on what 500 GPs thought about their local hospitals. It was not a pretty picture.
Only 74% of GPs would use their local hospital for themselves and their families. You could interpret this as a ringing endorsement of the local hospitals; or you could be shocked that 26% of the GPs found their local hospitals sub-standard. I lean to the latter view.
Worse still, only 64% of the GPs whose family members had been in hospital during the past year received a high standard of treatment. Again, 36% didn't. Personally, I would rate the treatment I have received in hospital over the past 10 years to be of high standard. But, I am just a simple patient. I have to defer to the more professional but adverse judgment from GPs.
Some 34% of the GPs considered that the care their patients had received at the local hospital was dangerously sub-standard. 74% said their patients had complained of poor quality care, and 10% claimed that patients had died because of this sub-standard care. These are awful figures. I am a patient and do not want to die. One would expect GPs to support me in taking the battle to the hospitals.
But I find that only 32% of GPs have raised concerns with the hospitals. Why not 100%? Perhaps it is because, in an answer to another question, only 42% "have confidence that the concerns would be fully investigated and acted upon". This is a dreadful admission, that doctors, bound by the hippocratic oath, do not believe it is worth their while to blow the whistle on patient abuse carried out by another part of the medical profession and its managers.
There are too many vested interests stacked up against the poor patient, even those related to GPs, who one might expect to be able to make the hospitals sit up.
To me, these attitudes explain Mid Staffs, and could result in a multiplication of Mid Staffs across the country. The editor of Pulse makes the same point in his editorial about the survey.
The survey is very important. It shows that, in the view of those who should know best – the GPs – that the hospital sector is imperfect, to put it mildly. So, what happens next? Does the hospital sector admit its failings and draw up a plan to improve? I doubt it, because the consultants and managers do not really understand the criticisms.
Do the GPs mobilise to insist on better performance from the hospitals? In my view, there is a chance that they could do that with the Lansley "GP commissioning" model. But they have probably blown that by opposing the bill. I was looking forward to GP commissioners getting tough with hospitals, for instance, refusing to do business with them unless they provided discharge summaries in under two days. According to the Pulse survey, 77% of discharge summaries are sent after two days, which to me as a patient, and to most GPs, is totally inacceptable. But hospital doctors carry on blithely providing their discharge summaries when they see fit, three years after a DoH published a directive that discharge summaries should be sent to GPs within 48 hours.
I am alarmed that GPs may not be prepared to confront the abuses in the hospital sector. I have a nasty feeling that they want to huddle together for warmth with their hospital colleagues, and not rock the boat. I can see them trying to rubbish the survey; it is too small, with only 500 GPs responding; the survey is academically flawed; and, worst of all it was produced by a branch – albeit a tame one - of the media, and therefore not worth serious study.
I disagree. The Pulse survey shows that a quarter of 500 doctors consider that their local hospitals are not fit for purpose. It would be rash to extrapolate that a quarter of the country's hospitals are not fit for purpose, but it sets the alarm bells ringing. (I have to say that I have been in and out of hospitals a lot in the last month, and have never found any of the problems that the GPs are complaining about. Maybe I am just lucky.) How the royal colleges and the BMA react to this survey will show their mettle and their often-expressed commitment to patient-safety. My guess is that some "motherhood statements" will be made about how the "safety of patients is paramount, and it will then be brushed under the carpet with all the other "inconvenient truths" expressed in recent Care Quality Commission, ombudsman and National Audit Office reports. The Guardian Professional
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