13000 Deaths - Keogh

[ellroy]

Ah, yes the NHS.

That paragon of the UK that we are all so proud of, angels and saints to a man, worth very penny of the billions we pour into its ever open maw.

I do find it odd that the stories, both in print and from individuals i know who've had the pleasure, nay privilege, of using it are all so negative.

God forbid we ever grasp the nettle and shut swathes of this benighted behemoth down, I don't know how we'd cope.

[aw51 121565]

Eric Mc said:

I have little faith in "predictive" calculations.

The whole financial system is based on such "maths" - and look what happened there.

I cannot disagree with your comment in any way but sadly the headline under discussion is based on this 'method' of working out the predicted baseline/average/achieveable/whatever figures (hence this thread).

And the unknowing will (once again) be up in arms, taking the thirteen thousand too many deaths figure as gospel .

I read in the DT this morning that some Trusts had (in broad terms, it was only a glance ) "much higher than average death rates"... Who'd've thunk that???

Sums it all up, really!

[PlankWithANailIn]

The team next to mine at work does financial forecasting, often the error inherent in their calculations is larger than the predicted change in our future financial position. Its still a useful tool as it shows the things that are most important to us as a company and highlights the areas of risk.

The result of this is that trusts will now try their hardest to get any estimates that effect them changed prior to them being set as targets (even unofficial targets as these appear to be). I expect there are a couple of places which had less deaths than expected, this may mean they are great trusts, or it could just mean their management understand statistics and how they will be used against them in the futyre.

[Eric Mc]

The latter I bet.

Abuse and misuse of numbers is very much a characteristics of modern times.

[aw51 121565]

And misunderstanding of 'the numbers' and how they are actually extracted from the data - but this is at least one step further ahead of the so-called 'issue' under discussion .

As an example, Bolton Hospital recently had an issue around unexpectedly high death rates under certain circumstances; it transpired that the "cause of death" was being 'coded'* wrongly and the computer 'report(s)' were drawing down data which had been - at least partly - wrongly 'coded'* therefore the data was unknowingly defective. There was no problem at all (not in this particular strand, anyway, but of course figures elsewhere will be affected).

* 'coded': a particular incident or illness, for example, will have a specific 'code' on the computer system in use (in a GP Practice, for example, the 'code' for receipt of a request for medical records for one of our patients from a Solicitor [in connection with an injury claim following an RTA] might be 9er6. If we want to find out how many requests for such medical reports we received in a particular period we would search for the particular 'code' 9er6 and specify the start and end dates).

There will be particular 'codes' for causes of death in a hospital as well as how soon after admission the death occured - these 'codes' are specific and use of the wrong 'codes' for particular incidents can totally muck up the figures. This is what happened in Bolton Hospital early this year .

So potentially it's a case of "garbage in, garbage out", every time , including this "news" in the papers today !

[otolith]

If it's easy to make the statistics look bad by accidentally miscoding, I hope nobody is deliberately miscoding to look better.

[eccles]

Sevo said:

vonuber said:

grumbledoak said:

The headline is there to sell papers. It no more galling than the "Envy of the World" crap we get peddled by the left each time.

Bits of it are very good: A&E is fantastic and should be free at point of use. Much of the rest is poor: how many people would pay a plumber in full up front? And if he was the only plumber in town, what sort of service would you get? Quite. But what the NHS is mostly is 1.7 MILLION bought-and-paid-for Labour voters, and the Unions will fight tooth and nail to prevent any change there.

I don't love the idea of the NHS. I don't generally believe that collectivist ideas are "perfect ideas spoiled by people" - I believe that they are more often rotten ideas promoted by ruthless politicians to gain power for themselves: "Free at point of use" is just "Tragedy of the commons". IMO we should move to free A&E/walk-in, and private for everything else.

Can't say I agree with this. If we had free only a&e I would either be bankrupt or dead.
As for buying votes.. seriously?

Indeed, so what happens when you are admitted to A&E seriously unwell but have no money or health insurance? Turfed out onto the street? Kept in A&E for 2 weeks? "A&E" is not any more fantastic than any other bits of the health service, there's good and bad. It's this kind of ill-informed rubbish that drives me nuts.

And as for voting labour, I think not, the majority of my colleagues strike me as conservative voters, I'm a life long conservative (although currently re-evaluating that).

Ah, yes, but it fits in with that funny lot on here who think anyone connected to the public sector couldn't possibly think for themselves and is some kind of labour drone.

[rich1231]

aw51 121565 said:

And misunderstanding of 'the numbers' and how they are actually extracted from the data - but this is at least one step further ahead of the so-called 'issue' under discussion .

As an example, Bolton Hospital recently had an issue around unexpectedly high death rates under certain circumstances; it transpired that the "cause of death" was being 'coded'* wrongly and the computer 'report(s)' were drawing down data which had been - at least partly - wrongly 'coded'* therefore the data was unknowingly defective. There was no problem at all (not in this particular strand, anyway, but of course figures elsewhere will be affected).

* 'coded': a particular incident or illness, for example, will have a specific 'code' on the computer system in use (in a GP Practice, for example, the 'code' for receipt of a request for medical records for one of our patients from a Solicitor [in connection with an injury claim following an RTA] might be 9er6. If we want to find out how many requests for such medical reports we received in a particular period we would search for the particular 'code' 9er6 and specify the start and end dates).

There will be particular 'codes' for causes of death in a hospital as well as how soon after admission the death occured - these 'codes' are specific and use of the wrong 'codes' for particular incidents can totally muck up the figures. This is what happened in Bolton Hospital early this year .

So potentially it's a case of "garbage in, garbage out", every time , including this "news" in the papers today !

Basildon Hospital has an absolutely woeful reputation and has done for years. Patients beg GP's not to be sent there.

[aw51 121565]

So does Bolton; some years ago, a GP I worked with said that he feared for the safety of his patients when he referred them to be in-patients...

I swore that I and my family would NOT be treated at Bolton Hospital, from reading media reports. Unfortunately my wife had a minor surgical procedure (clearing of a blocked tear duct) there under a very established ENT specialist in early December 2012 - against my own better judgement, she went along (our local GP appears not to do "Choose & Book" ) and didn't go with my argument for going somewhere - anywhere - else for the procedure.

It didn't go well (there were complications in what should have been a minor procedure); my wife wasn't the same after the op and two of our GPs did nothing effective to help...

And so it came to pass, 5 weeks later, that my wife was admitted after a 999 call for suspected Stroke (in reality, Meningitis plus a small Stroke, and massive brain damage but her persona is still there thankfully ).

She has been a patient in Bolton Hospital for 27 weeks now (23 weeks in the stroke unit plus 1 week in ICU, 1 week in HDU and 2 weeks in Thoracic Medicine in the early days) and we are extremely happy with her care on the wards she has been on (we are aware of one particularly dubious ward that - if she was less unwell than she is - she would visit as a 'half way house' and isn't very positive at all, but thankfully she will miss that ward out of her journey home as she is paradoxically so disabled ).

We - my wife and I - are victims of our circumstances, The Missus went where she was sent as a blue light case back in January. We were looking at palliative care for her back in March (Bad Days! ) - but everyone (especially the staff) kept the stiff upper lip (opposing the "end of life pathway" ) and she fought through.

Back in January, I wouldn't have chosen to have gone to Bolton Hospital for all the tea in China. Now? I - we - can't complain about her care this year, but it was her alleged 'care' last December at the same place, plus the ineptitude of two of our GPs, that sowed the seeds of where we are now. She's about to be discharged, needing full care (she's totally dependent on others for care) plus a "Smartbox" to empower her and allow her to communicate...

Feelings are mixed, let's say . Would I recommend Bolton Hospital? I'd have to say a guardedyes .

[turbobloke]

eccles said:

Sevo said:

vonuber said:

grumbledoak said:

The headline is there to sell papers. It no more galling than the "Envy of the World" crap we get peddled by the left each time.

Bits of it are very good: A&E is fantastic and should be free at point of use. Much of the rest is poor: how many people would pay a plumber in full up front? And if he was the only plumber in town, what sort of service would you get? Quite. But what the NHS is mostly is 1.7 MILLION bought-and-paid-for Labour voters, and the Unions will fight tooth and nail to prevent any change there.

I don't love the idea of the NHS. I don't generally believe that collectivist ideas are "perfect ideas spoiled by people" - I believe that they are more often rotten ideas promoted by ruthless politicians to gain power for themselves: "Free at point of use" is just "Tragedy of the commons". IMO we should move to free A&E/walk-in, and private for everything else.

Can't say I agree with this. If we had free only a&e I would either be bankrupt or dead.
As for buying votes.. seriously?

Indeed, so what happens when you are admitted to A&E seriously unwell but have no money or health insurance? Turfed out onto the street? Kept in A&E for 2 weeks? "A&E" is not any more fantastic than any other bits of the health service, there's good and bad. It's this kind of ill-informed rubbish that drives me nuts.

And as for voting labour, I think not, the majority of my colleagues strike me as conservative voters, I'm a life long conservative (although currently re-evaluating that).

Ah, yes, but it fits in with that funny lot on here who think anyone connected to the public sector couldn't possibly think for themselves and is some kind of labour drone.

That funny imaginary lot sure is funny and imaginary.

Your obvious strawman is real though.

[Sevo]

aw51 121565 said:

So does Bolton; some years ago...

That sounds awful. Glad she's on her way home.

[Sevo]

turbobloke said:

That funny imaginary lot sure is funny and imaginary.

Your obvious strawman is real though.

Unless I've misunderstood you are arguing "anyone connected to the public sector couldn't possibly think for themselves". I know you are one of the resident argumentative wind up merchants but thats just foolish.

Edited by Sevo on Monday 15th July 09:54

[turbobloke]

Sevo said:

turbobloke said:

That funny imaginary lot sure is funny and imaginary.

Your obvious strawman is real though.

Unless I've misunderstood you are arguing "anyone connected to the public sector couldn't possibly think for themselves". I know you are one of the resident argumentative wind up merchants but thats just foolish.

You're mistaken, and your flippant one-liner about winding people up applies more to you after that misguided post.

If you get wound up for no reason then try calming down.

My point is that there are several PHers who point out the poor vfm offered by the public sector, as revealed by ONS, who also point out the folly of recruitment to non-jobs under the previous government's unaffordable expansion of the public sector, and these people also tend to find striking over the higher pay job-for-job - and excellent pensions still on offer - to be misguided. NHS fraud and waste totalling between £10bn and £25bn (depending on source) also gets criticised and rightly so.

These same PHers tend to value the work of armed forces personnel, paramedics, non-striking skilled teachers and so on, and only claim that there is a greater likelhood of public sector workers voting Labour compared to the private sector, which is shown by surveys as published in The Guardian.

Strawman arguments from eccles, like your failed one-liner, make no difference to the valid points of criticism made from time to time on here.

[Eric Mc]

Who is this straw man that TB always seems to throw into so many of his comments?

Is it anything to do with "The Wizard of Oz"?

Or is it Mr Ad Hominem I am thinking of?

[Sevo]

Eric Mc said:

Who is this straw man that TB always seems to throw into so many of his comments?

Is it anything to do with "The Wizard of Oz"?

Or is it Mr Ad Hominem I am thinking of?

I understand Eric, its easy to get confused with all the muddying of waters that go on in his posts

I mean we seem to be suddenly talking about non jobs and striking teachers.

[IroningMan]

I don't think it's likely that Staffs was a statistical manipulation.

I am even less inclined to think that it is unique in the Health Service.

Headline-grabbing numbers are fit for purpose if they serve to open the eyes of those who still cling to the belief that the Health Service is the envy of the World and staffed exclusively by angels.

[turbobloke]

Sevo said:

Eric Mc said:

Who is this straw man that TB always seems to throw into so many of his comments?

Is it anything to do with "The Wizard of Oz"?

Or is it Mr Ad Hominem I am thinking of?

I understand Eric, its easy to get confused with all the muddying of waters that go on in his posts

I mean we seem to be suddenly talking about non jobs and striking teachers.

It's easy to get confused if you're easily confused, and it's hardly sudden when used as illustrations of the use of strawman arguments in this thread and in this context.

Obviously, and spelling it out for the hard of thinking and those engaging in obfuscation, use of 'all' either in terms of all PHers claiming all public sector workers vote Labour (or any other inappropriate use of all) creates a transparent strawman argument.

Setting up a strawman argument allows somebody in a weak position who cannot counter the valid points being made, to fool themselves into thinking they've made a worthy reply when all they're doing is arguing against a point that was never made. Silly and pointless, basically.

It happens from time to time with certain people, eccles being the latest example.

[Eric Mc]

You don't have to deliberately manipulate statistics to make them work for whatever political agenda you wish to peddle.

All you need to do is be selective.

[turbobloke]

Eric Mc said:

You don't have to deliberately manipulate statistics to make them work for whatever political agenda you wish to peddle.

All you need to do is be selective.

If the selection highlights local serious failure it's entirely appropriate.

Selecting Stafford and Basingstoke was necessary.

However in general terms the abuse of statistics by government either via manipulation or selectivity is indeed commonplace and parts of the media seem less than effective in recognising it and challenging it when it happens.

[Eric Mc]

But not unique to government, is it?

If certain hospitals fail the norm (and there is no doubt that some have done so), there must also be many that exceed the norm.

Otherwise, how is the norm established?