Sunday, March 04, 2007

Dumbing Down Healthcare in the UK

NHS Blog Doctor takes a look at the poor state of maternity care in the UK. The top reasons for record numbers of women being harmed or dying in childbirth: lack of resources and the dumbing down of healthcare:

Midwives are doing work for which they are not trained; work that should be done by doctors.

Health care assistants are doing work for which they are not trained; work that should be done my midwives.


Read the whole thing.

41 Comments:

Blogger Wacky Hermit said...

We're having the same sort of crisis here in the U.S. There are cities where you can't find an OB who's taking new patients because of the high cost of malpractice insurance. With my third child in 2004, I very nearly gave birth at home, although I was able to find a GP who would take on a new OB patient. Most GP's don't anymore though, they can't afford the insurance.

Full disclosure: my dad was an OB who was driven out of the profession by spurious malpractice suits. He lives in a town with high demand for maternity care and he still has his license, but he just doesn't want to go back into practice.

9:10 AM, March 04, 2007  
Blogger Helen said...

Wacky Hermit,

The malpractice for OB-GYN's is through the roof and many are closing up shop like your dad. My previous doctor was terrific but one day I got a letter from him saying that he could no longer afford to practice in Knoxville and was moving to Mobile, Alabama where he found a better deal. I don't blame him.

10:10 AM, March 04, 2007  
Anonymous Anonymous said...

The OB who delivered my two oldest children went back to school and became a psychiatrist. The first OB I consulted after I became pregnant with my youngest cautioned me during every single visit about the impossibility to guarantee a perfect outcome, the cost of his liability insurance, and so forth. I wasn't in a particularly elevated risk group beyond being over 30. I couldn't believe how many tests he ran. He had a large practice and came highly recommended, but creeped me out so I changed doctors to one who was more sensible.

You know, when I had my first child in 1982, childbirth wasn't covered by our health care insurance unless there were complications. We paid the doctor about $700 before the end of the seventh month. I stayed two nights in the hospital, and the total bill was about $1200, including nursery. When I had my third in 1989, it was covered by insurance. The costs had skyrocketed, so we had about the same out of pocket expense (deductible and 20% of costs).

11:48 AM, March 04, 2007  
Anonymous Anonymous said...

May be, but the US maternity death rate (17) is higher than the UK (13) maternity death rate (from WHO reports). So even if UK standards are deteriorating the US is still providing worse maternity care than the UK is...

2:29 PM, March 04, 2007  
Anonymous Anonymous said...

Oh! And the US is next to last in newborn survival rates in as survey of 33 developed countries. Of all the countries in the report only Latvia had a higher death rate among newborns... So even if the Uk system is not too good, the US system is still much worse.

2:34 PM, March 04, 2007  
Anonymous JKB said...

How can it be that standards in the UK are dropping? They have the gold standard single payer system, therefore, this can't be happening. Why the Liberals were just saying how America would be a paradise if we would just let our favorite uncle take care of our healthcare.

Life is cheap when the bureaucrats start cost cutting. From what I read, they have to push hard to get new doctors but now they have an 8000 excess. (Just saw it in one of the London papers) How does this happen? By deciding it is cheaper to let the lower trained practitioners take over the physician duties. It reduces cost and gets rid of the pesky long wait list times. So a few women die in birth, what is that compared to socialist efficiency?

2:59 PM, March 04, 2007  
Blogger Purple Avenger said...

So even if UK standards are deteriorating the US is still providing worse maternity care than the UK is...

You don't suppose 12, 15, 20, whatever million or so illegals have anything to do with that?

3:48 PM, March 04, 2007  
Anonymous Anonymous said...

Purple Avenger: If there are "12,15,20, whatever million or so illegals" in the US is just due to the incompetence of US authorities and since US authorities are elected by the American people the American people is responsible for those figures. And FYI all the developed countries have trouble with illegal immigration. Western Europe has huge problems with this.The UK has problems with this. Spain for example has problems as big or worse as those of the US when it comes to illegal immigration... despite this their maternal mortality rate is a meager 5 (WHO data)versus the US 17 so they seem to be doing well illegals and all...

5:04 PM, March 04, 2007  
Blogger Purple Avenger said...

You said a lot annon, but you didn't answer my question.

Try again.

6:21 PM, March 04, 2007  
Anonymous TMink said...

Anon wrote: " the American people is responsible for those figures."

I do not like how you said that, I find the point offensive, and I cannot disagree one iota. The buck has to stop with the American voter.

Trey

6:40 PM, March 04, 2007  
Blogger Helen said...

Anonymous 2:34;

You state: "Oh! And the US is next to last in newborn survival rates in as survey"

I am not sure how they count the maternal deaths with the WHO--but I did notice that 321 women died in childbirth in the US in 1997 and NHS doc mentions a number of 391 in three years. We have five times the population of the UK here so it would seem that our numbers are not that bad if you do the math.

The survival rates of newborns are skewed because the US tends to try advanced medical intervention to save premmies that may fail. The US counts this as a death whereas in other countries, they often count this type of a death as a stillborn, so it does not get included in the numbers. It is sometimes hard to compare rates between countries for this reason.

7:02 PM, March 04, 2007  
Anonymous Jack said...

Anonymous is tendentiously misrepresenting fact per usual.

Here's a CBO analysis of the data disparities, which backs-up some of Helens points
http://www.cbo.gov/showdoc.cfm?index=6219&sequence=0

For example, very premature births are more likely to be included in birth and mortality statistics in the United States than in several other industrialized countries that have lower infant mortality rates.
...
Indeed, comparisons with countries for which data are available suggest that low birthweight newborns have better chances of survival in the United States than elsewhere.


Frankly I'll bear the bad publicity if it means that otherwise inviable infants might survive.

12:15 AM, March 05, 2007  
Anonymous Anonymous said...

What do you think that other western european countries do not use advanced techniques for premmies? FYU the most advanced specialist in premmie care I had ever met as a Spaniard who worked for their national health service. They were on the cutting edge in his unit let me tell yout that.

It is funny who some people in this forum seems to be squirming and looking for excuses and claiming that the numbers are skewed by all kinds of specifically american factors. That is simply not true. All numbers in all countries are affected by local factors but the US health numbers are so bad all accross the board when compared with the other developed nations that they are extremely hard to justify. What is it then? if it is not a badly functioning health care system. Are americans genetically deficient? Is the environment specially unhealthy?

Besides the number I have been used are "adjusted" numbers the WHO reports not the numbers the countries themselves report. The WHO adjusts the numbers the countries report to make them fit a common set of criteria precisely to make them comparable.

8:32 AM, March 05, 2007  
Anonymous Anonymous said...

Oh and by the way your CBO report states that even after controlling for the differences in premmie resucitation attempts:

"The international ranking of the United States improves somewhat
when these alternative measures are used but it is still relatively low and
appears to be deteriorating."

Then it goes to speculate that the rates may improve if birth belows 28 weeks of age are included but it concedes there is not enough data to support this.

According to this report the feto infant mortality rate (including stillborns and so not affectedd by standards of premmie care) put the US 19 in the world in 1986-88 and falling rapidly. For the same period the infant mortality ranking was 22 so even if there is a effect there , and I am not sure there is, it would move the US one or two places up in the tables still a lot of explaining and excusing to do.

8:52 AM, March 05, 2007  
Anonymous Anonymous said...

Oh come on, when you cannot even take proper care of your injured and disabled soldiers you have to admit something is deeply wrong with health care in America.

Or is it that Americans do not give a crap about disabled and injured soldiers?

10:06 AM, March 05, 2007  
Anonymous Serge said...

Anon it's a bit sick to wield infant mortality as a cudgle against the US. These figures are very close among developed countries and highly dependent on demographic factors.

If you hate Americans so much, just go to another forum.

11:45 AM, March 05, 2007  
Anonymous Anonymous said...

So it is okey to use the figures to critisice other countries' health care systems but when the same figures are used to critisice the US system it is "a bit sick"?

And please try to get rid of the stupid "any cricism of the US involves hate of the US" mentality. Is there nothing to critisice in the US then?

FYI I do love the US I lived there for almost three year and had a great time. Now that I moved to another country I find that my closest friends here are American expats. That doesn't mean there are not great things and not so great things in the US. The US health care system , and the general standards of health of the US population, are nothing to be proud about. Perhaps if you did not discount any criticism as "hate" You could start doing something about it and helping make America better.

2:44 PM, March 05, 2007  
Anonymous Serge said...

LOL - you'll forgive the mistake, is accusing someone of endorsing infanticide considered a compliment where you're from?

2:59 PM, March 05, 2007  
Blogger TMink said...

Ya know anon, the posts were worth reading at first. Then they got more and more snippy and pressured. I think you lost any audience and credability you may have had by the last one.

Trey

5:43 PM, March 05, 2007  
Blogger Purple Avenger said...

I'm still waiting for an answer from annon...

chirp

chirp, chirp

5:55 PM, March 05, 2007  
Anonymous Anonymous said...

serge:

Different anon here. Help me out here. What are you talking about, "accusing someone of endorsing infanticide"?

6:20 PM, March 05, 2007  
Anonymous Anonymous said...

tmink:

Again, different anon here. And no, the above anon hasn't lost an audience as far as I'm concerned. Doesn't seem snippy and pressured. In fact, it is you all who seem snippy and pressured. I mean, this anon's posts are lengthy and somewhat detailed. Where as you all have not really addressed his/her points but just posted basically one-liner insults. So, who's snippy?

I WOULD prefer it if this anon had better spelling and grammar. That certainly has an effect on credibility. But then again, I could say the same about you.

6:24 PM, March 05, 2007  
Anonymous Anonymous said...

I think anon is brilliant and insightful. They are not snippy unless by snippy you mean incisive, which anon is in spades.

BTW: what do Americans do with all of the children that they kill, sell them on eBay?

7:55 PM, March 05, 2007  
Anonymous Anonymous said...

Same anon here. Sorry about the grammar and spelling. I picked English as an adult and it is my third language. Still some work to do here...

And Purple Avenger I did answer your question. All Western European countries have the same problems with illegal immigration and they seem to be doing a better job than the US. So no, illegal immigration is not the issue here. Still let me expand...

I gave you the example of Spain. The US has a population of 298,444,215 Spain around 40,000,000.Spain has just legalized 700.000 illegal immigrants. While there are no good numbers for illegals in the country the legalization is thought to have affected may be 50% of illegals. That gives Spain a illegal to legal ratio of 1 in 29. Your 15,000,000 illegals for the US (your middle estimate) gives a ratio of 1 in 20. given the uncertainties regarding this figures these are comparable ballpark figures. Still Spain maternity ratio is more than three times lower than that of the US. So there is no way illegal immigration is going to account for that difference.

You have a problem with that answer? Rebate it with some arguement instead of repeating "you haven't answered... you haven't answered... " That is cheap, childish and makes you look stupid

And tmink what exactly in my last intervention destroyed my credibility? Do you also suscribe to the "every criticism of the US is just hate" mentality? Or what? what did I say in that last intervention that was so damaging to my credibility?

9:03 PM, March 05, 2007  
Anonymous Anonymous said...

Good grief, could all you anons just give yourselves a code name and sign it at the bottom so we can keep you straight?

Amy K.

9:09 PM, March 06, 2007  
Blogger br549 said...

annonymous 7:55 PM certainly struck a point with me, if that was a jab at abortion.

How many millions? The entire population of Spain at least. For the love of God, shame on this nation.

I think this blog needs a technology boost. It needs to become a talking blog. To hear what someone is saying with voice registers and inflections, would certainly go a long way in preventing urination contests, and other types of misunderstandings.

Some genius somewhere is already working on it, I'm sure.

Back from the brink, fully in the pink!

Bob

6:48 AM, March 07, 2007  
Anonymous TMink said...

Hey other anon:

I certainly do have poor spelling, damn dyslexia. Or lysdexia, I forget which. The grammer is intentional though!

Trey

10:54 AM, March 08, 2007  
Anonymous TMink said...

Anon thinks that Anon's posts are first rate. Is this where you color me surprised?

As for my saying that anon was getting snippy, here is what I was referring to. "Oh come on, when you cannot even take proper care of your injured and disabled soldiers you have to admit something is deeply wrong with health care in America.

Or is it that Americans do not give a crap about disabled and injured soldiers?"

It is off topic and inflamatory. Maybe snippy was an understatement! So while I was initially impressed with the anon posts, that one capped it for me. And that is my opinion. In your opinion, I am the snipmeister. I appreciate your succinct post, to me, your post was not at all snippy. Cool.

Trey

10:58 AM, March 08, 2007  
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