Britons were horrified by a report released on Tuesday that documented "truly dreadful" care at an English hospital, from patients left moaning in their own waste to family members forced to bring in food.
British Prime Minister David Cameron said he would press for a culture change in his country's treasured National Health Service to give patients a bigger say in their care-- and he’ll get American help to do it.
The report says patients were ignored as they pleaded for clean sheets and even water, and it says certainly thousands died from the neglect. Britons, who take huge pride in their health service, were shocked by the findings of the report.
"Many will find it difficult to believe that all this could occur in an NHS hospital," Cameron said Tuesday.
While it was just one hospital – in the central English town of Staffordshire – Cameron said he couldn’t believe the problems were restricted to a single facility.
“What happened at The Mid-Staffordshire NHS Foundation Trust between 2005 and 2009 was not just wrong, it was truly dreadful. Hundreds of people suffered from the most appalling neglect and mistreatment,” Cameron said.
“Calls for help to use the bathroom were ignored and patients were left lying in soiled sheeting and sitting on commodes for hours, often feeling ashamed and afraid,” reads the report, written by lawyer Robert Francis.
“Patients were left unwashed, at times for up to a month. Food and drinks were left out of the reach of patients and many were forced to rely on family members for help with feeding,” added Francis, who was appointed to investigate the hospital in 2009 after it showed a higher-than-usual rate of deaths.
Francis said it would not be possible to say just how many patients died from the neglect and poor conditions. Many British newspapers ran lurid accounts of conditions at the hospital, but Francis said he couldn't document some of them, such as reports about thirsty patients drinking from flower vases.
“The inquiry found that a chronic shortage of staff, particularly nursing staff, was largely responsible for the substandard care,” he added. “Staff who spoke out felt ignored and there is strong evidence that many were deterred from doing so through fear and bullying.”
Cameron said he would get help from an American – Dr. Donald Berwick, who was appointed President Barack Obama’s administrator of the Center for Medicare and Medicaid Services, but who finally stepped down after Republicans in Congress refused to confirm his appointment. Many Republicans were infuriated by Berwick’s praise of Britain’s NHS.
Berwick, an expert in healthcare quality, is now at the left-leaning Center for American Progress. He has recommended changes in quality after a series of reports have shown that anywhere between 100,000 and 200,000 Americans die every year from mistakes and neglect in the U.S. healthcare system.
Britain’s National Health Service is such a source of pride that it featured prominently in opening ceremonies for last year’s Olympics. U.S. supporters of healthcare reforms have pointed to its lower costs and to reports that show Britons are healthier than Americans. Critics of Obama’s approach have expressed doubts that Britain’s system works better than the U.S. system.
“I love our NHS, I think it is a fantastic institution, a great organization, it says a great deal about our country and who we are,” Cameron said Tuesday.
The report blamed cost-cutting for many of the problems at the Staffordshire hospital. Britain’s hospitals are run by trusts, which are a type of public corporation, with outside boards.
“Problems at the Trust were exacerbated at the end of 2006/07 when it was required to make a 10 million pound ($16 million) saving,” the report reads. “The Board decided this saving could only be achieved through cutting staffing levels, which were already insufficient.”
Cameron said boards need to be held more responsible for the hospitals they oversee, and patients need a chance to speak up when something goes wrong. But he also blamed Britain’s Department of Health, nursing organizations and doctors for failing to act.
He said there were three problems in the NHS as a whole. “First, a focus on finance and figures at the expense of patient care,” he said. “Second, there was an attitude that patient care was always someone else’s problem….Third, defensiveness and complacency.”
Health experts have identified similar problems at U.S. hospitals. The 2010 Affordable Care Act will gradually change the way hospitals are paid by Medicare and other government health insurance plans, to take patient satisfaction into account. Hospitals will also be penalized if patients get sick again too quickly after they are discharged or if they acquire infections while in the hospital.
John Newland in London contributed to this story