Posts Tagged ‘Bernard Mandeville’

From 2012: Poor Care at Private London Hospital

January 28, 2015

Apothecary's Prayer

Thomas Rowlandson: The Apothecary’s Prayer!! An 18th century apothecary prays for an outbreak of a host of diseases so that he and the undertaker can make money.

Physicians valued fame and wealth
Above the drooping patient’s health.

-Bernard Mandeville, 18th century doctor, on his profession’s medical ethics.

You tell your doctor, that y’are ill
and what does he, but write a bill.

– Matthew Prior, 18th century.

I’ve blogged several times about the poor standards of care in private hospitals, including the recent withdrawal of Circle Health from managing their NHS hospitals and the extremely poor care given to patients there. Private Eye in their issue for 19th October – 1st November 2012 printed this story about one woman’s experience of her appalling treatment at a private hospital in London.

Private Hospitals
Bloody Disgrace

Don’t expect too much joy complaining about sub-standard care at the major private hospitals run in the UK by US healthcare giant HCA International (and performing increasing amounts of NHS work). One Eye reader’s stay at the company’s London Bridge Hospital exposed her to appalling care followed by a total failure deal with the mistakes.

Soon after a hysterectomy the patient, herself a former nurse, suffered serious bleeding which, she believes, was caused by rough handling by HCA nurses.

While an expert brought in by the industry-funded Independent Sector Complaints Adjudication Service (ISCAS) concluded that this was unlikely, he did find that, while in severe distress, her nurse left her “without a call buzzer or oxygen and no means of summoning assistance”. HCA “had been unable to identify this nurse and suggested she was from an agency”. This was “a most unsatisfactory response and means that the hospital cannot take steps to ensure that other patients do not experience similar problems”.

Worse was to come, however, as the patient’s safety and dignity were repeatedly compromised. Her “vital signs” were not recorded despite her serious condition, the expert concluding that it was “certainly unwise to have totally discontinued any monitoring at this time”. Dressing procedures were then performed while an engineer was working (and removing ceiling tiles) in the patient’s room. “The sister”, found the ISCAS, “refused requests from nurses for you to move rooms.” There was also “a lack of professionalism amongst the nursing staff in the way assumptions were made about your condition (believing you had cancer) and communicated with you, causing you further anxiety.”

The aftermath, alas, is just as alarming. The patient first complained about her nursing care the day after her discharge, giving HCA every chance to act; but the issues were not investigated at all. “This is a serious allegation that has not been addressed by the London Bridge Hospital or HCA International,” concluded the adjudicator. The patient’s subsequent formal complaint was then hampered by obfuscation on HCA’s part, the adjudicator agreeing that medical records including the consultant’s notes had been withheld, while many others mysteriously, er, went missing. Despite the many failing the ISCAS eventually identified, HCA’s grandly-titled Group Director of Clinical Performance & Governance, Rosemary Hittinger, “responded that she could not find ‘[that the standard of nursing care fell beneath the reasonable standard expected of the nursing profession’.”

In short, HCA – currently under investigation by US authorities for performing unnecessary operations (see Eye 1321) – first couldn’t be trusted to care for its patient and then wouldn’t accept that it had failed to do so, or seek to learn from the episode.

Little good did the ISCAS findings do for the patient, however. The toothless body was limited to recommending a payment of “£1,000 from HCA International, as a gesture of goodwill.” This is hardly likely to force the company behind 23 British hospitals and medical centres, including the Wellington and the Portland, and in receipt of UK taxpayers’ money, to mend its ways.

This is important, not just as a case of extremely poor care in itself, but because it demonstrates what could occur elsewhere as more work is given to private hospitals. The government is pursuing a policy of the piecemeal privatisation of the NHS under the pretext that private enterprise automatically leads to higher standards and better quality. This is untrue. There are people, who have had surgery privately. Their operation was conducted so poorly that it required correction by NHS staff. Private enterprise, which puts profit before care, is a real threat to this nation’s health.

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The Tories as the Party of Gordon Gekko: Part 94 – The Boris Johnson Years

November 30, 2013

I’ve commented several times before that the Conservative Party has all the morals of Gordon Gekko. Remember him? He was the monstrous incarnation of ruthless corporate greed played by Michael Douglas in Oliver Stone’s 1980s film, Wall Street. This had the now notorious scene in which Gekko makes a speech in front of his fellow financiers praising greed. ‘Greed is right’, he intones, ‘Greed is good. Greed … works’. The film ends with Gecko himself ruthlessly betrayed and discarded by a younger protégé, a man Gekko has been raising up through the corporate ladder according to his own set of amoral principles. Here’s the speech:

Unfortunately, it didn’t quite work out like this in real life. The global banking system nearly collapsed due to the colossal greed of leading bankers and financiers through a system of toxic debt and a web of complex fraud. This brought down Lehmann Brothers and a whole host of other firms in Britain and America. The system itself has been saved by a massive bail-out by Gordon Brown, amongst others, with the result that Cameron’s coalition has seized on this excuse to curt welfare services even further under the pretext of ending the massive national debt this incurred.

And the bankers and Tory politicians have learned absolutely nothing. Indeed, they have become every more like Gekko. On Have I Got News For You last night they reported a speech made by London’s mayor, Boris Johnson, this week, in which he expressed pretty much the same appreciation for greed as Stone’s fictional anti-hero. Greed, according to Johnson, was a good thing, as it could, in certain circumstances, lead to economic growth. Now greed as the motor of economic growth and material benefits, with private vices becoming public virtues, was first proposed in the late seventeenth and early eighteenth century by Bernard Mandeville in his Fable of the Bees. This was so shocking to the Christian culture of the time that he was bitterly attacked for his immorality, and denounced as ‘Man-Devil’. The idea was gradually taken up by other economists, including Adam Smith in his Wealth of Nations. Nearly three hundred years later, the idea is now so widely accepted that Johnson thought he could make it without adverse comment to his audience in the City. This is despite the banking collapse, and the recession and rioting, which then followed. One is reminded of the comment about the restored Bourbon monarchy in France after the Revolution: They have forgotten nothing. They have learned nothing.
And they are determined to act more and more like Gordon Gekko with no trace of self-consciousness or irony.

As an aside from this, one of the very few good things to be inspired by Yuppie greed in the 1980s is, in my view, Queen’s I Want It All. The song’s title and chorus seems to me to have been taken from the Yuppie culture of avarice. Unlike Yuppie culture, the song is genuinely bright, optimistic and fun. So to cheer everyone up after this post, and remind us just how great Freddy Mercury was, here it is: