Fining hospitals

[Dixy]

Fining a hospital for any failure is just bizarre.
http://www.bbc.co.uk/news/uk-england-bristol-43842...
The guberment effectively funds the NHS and collects the fine so they take the money out of one pocket and put it in another.
The trust may be making poor decisions around inadequate budgets or just be incompetent, why do heads never roll or the chief executives get fined personally.

[Voldemort]

Dixy said:

guberment

You is well edgy, bruv.

[TooMany2cvs]

Dixy said:

...so they take the money out of one pocket and put it in another.

You're not an accountant, are you?

The concept of "budgets" is not a particularly unusual one.

[Rovinghawk]

TooMany2cvs said:

You're not an accountant, are you?

The concept of "budgets" is not a particularly unusual one.

I think his point is the lack of personal accountability for those found to be incompetent.

[Derek Smith]

Dixy said:

Fining a hospital for any failure is just bizarre.
http://www.bbc.co.uk/news/uk-england-bristol-43842...
The guberment effectively funds the NHS and collects the fine so they take the money out of one pocket and put it in another.
The trust may be making poor decisions around inadequate budgets or just be incompetent, why do heads never roll or the chief executives get fined personally.

The idea of fining a state institution does seem rather bizarre.

One reason why an individual wasn't targeted might well be because they have excuses. In any underfunded organisation, and that's any, it is probable that the problems have been 'passed upwards'. The guys at the coalface knows that they cannot perform their role effectively so tells their boss. They accept the problem but need more funding to address the problem so passes it upwards. It gets to someone who can make decisions of funding but they know that covering the recently disclosed problem will take funding from another dept.

In a demand led business like the NHS, the obvious answer, one that might be available to most private businesses, of doing less is not an option.

In such situations it can be a case of crisis management so sooner or later something will go wrong.

If the bloke at the top is sacked, the simple answer for the simple, then the person who replaces them will have the same problems but presumably will have less experience. Not only that, if the person does have their contract terminated, they might well have grounds to sue for wrongful, so the trust gets hit from both directions. The person at the top of the trust is often not the person at the top.

Courts have it easy. They see person A has suffered. They see that the trust were aware of the problem, therefore there's a fine, exacerbating the problems the Trust has.

If you underfund a service deliverer that has no way to control the demand then it doesn't take much of a genius to realise that corners must be cut.

[Rovinghawk]

Derek Smith said:

One reason why an individual wasn't targeted might well be because they have excuses.

If they don't have excuses I'm sure that there'll be a legion of apologists able to provide them.

[anonymous-user]

Dixy said:

Fining a hospital for any failure is just bizarre.
http://www.bbc.co.uk/news/uk-england-bristol-43842...
The guberment effectively funds the NHS and collects the fine so they take the money out of one pocket and put it in another.
The trust may be making poor decisions around inadequate budgets or just be incompetent, why do heads never roll or the chief executives get fined personally.

The government funds nothing. The taxpayer funds the NHS.

We just vainly hope that our politicians will spend the money wisely........

[TooMany2cvs]

REALIST123 said:

The government funds nothing. The taxpayer funds the NHS.

We just vainly hope that our politicians will spend the money wisely........

Well, quite.

The taxpayer funds the government.
The government funds the NHS.
The NHS funds the particular trust.
The trust funds the individual department/hospital budget.

In Wales/Scotland/NI...
The taxpayer funds Westminster.
Westminster funds devolved regional assembly.
Devolved regional assembly funds local NHS.
<etc>

[steviegunn]

Dixy said:

Fining a hospital for any failure is just bizarre.
http://www.bbc.co.uk/news/uk-england-bristol-43842...
The guberment effectively funds the NHS and collects the fine so they take the money out of one pocket and put it in another.
The trust may be making poor decisions around inadequate budgets or just be incompetent, why do heads never roll or the chief executives get fined personally.

You could make the same point about income tax and national insurance being levied on public sector employees.

[spaximus]

Too many unknowns in this case to say anything with any certainty.

Was funds available to do anything with the water system? Did anyone think there was an issue that needed urgent attention? Was a specific instruction given to a specific person?

Instead you have one Government funded department, taking another to court and at the end money taken from the funds for patient care to pay a fine. Who did it punish, it was the care of patients.

Sad a man died of that we can be certain.

So many tales like this, NHS used to be able to reclaim VAT, cannot now apparently, so money handed to the NHS is effectively down by 20% in some areas, makes no sense

[WatchfulEye]

spaximus said:

Too many unknowns in this case to say anything with any certainty.

Was funds available to do anything with the water system? Did anyone think there was an issue that needed urgent attention? Was a specific instruction given to a specific person?

Instead you have one Government funded department, taking another to court and at the end money taken from the funds for patient care to pay a fine. Who did it punish, it was the care of patients.

Sad a man died of that we can be certain.

In this case, the hospital had a legionella prevention and surveillance programme in place. They did daily water temperature checks on each ward and were having fortnightly samples from each ward laboratory analysed for bacterial contamination.

All the laboratory tests had come back negative, and all recorded temperatures were in spec prior to the illness, but laboratory tests were positive the day before the death (but after the disease had been contracted).

The root cause was found to be that the building plumbing diagrams were out of date and inaccurate. The showers on the cancer ward were supplied from a separate hot water supply, but were not being monitored as the schematics showed them on the same water supply as the ward sinks (which were being checked daily). The re-circulation pump on the shower circuit had failed, and as a result when the showers were not in use, the water in the pipework would stagnate and cool, allowing the bacteria to breed in the pipes. As the pump was not shown on the plumbing diagrams, no surveillance or monitoring of the pump was performed, hence it's failure was not detected and it was not repaired.

The HSE essentially said that the hospital were negligent in basing their surveillance programme on inaccurate building schematics, and that they should have taken additional effort to verify the schematics of "high risk" areas.

This case was highlighted a couple of years ago to hospital management nationwide, and subsequently hospitals have been significantly upgrading their legionella precautions - updating plumbing schematics, installing electronic temperature logging devices on hot water pipes, and bacterial filters on shower heads and taps.

[Ridgemont]

WatchfulEye said:

In this case, the hospital had a legionella prevention and surveillance programme in place. They did daily water temperature checks on each ward and were having fortnightly samples from each ward laboratory analysed for bacterial contamination.

All the laboratory tests had come back negative, and all recorded temperatures were in spec prior to the illness, but laboratory tests were positive the day before the death (but after the disease had been contracted).

The root cause was found to be that the building plumbing diagrams were out of date and inaccurate. The showers on the cancer ward were supplied from a separate hot water supply, but were not being monitored as the schematics showed them on the same water supply as the ward sinks (which were being checked daily). The re-circulation pump on the shower circuit had failed, and as a result when the showers were not in use, the water in the pipework would stagnate and cool, allowing the bacteria to breed in the pipes. As the pump was not shown on the plumbing diagrams, no surveillance or monitoring of the pump was performed, hence it's failure was not detected and it was not repaired.

The HSE essentially said that the hospital were negligent in basing their surveillance programme on inaccurate building schematics, and that they should have taken additional effort to verify the schematics of "high risk" areas.

This case was highlighted a couple of years ago to hospital management nationwide, and subsequently hospitals have been significantly upgrading their legionella precautions - updating plumbing schematics, installing electronic temperature logging devices on hot water pipes, and bacterial filters on shower heads and taps.

Apart from RUH Bath it appears. Who have therefore been penalised.

To the OP: what’s the alternative? Just shrugging and a mild ‘nevermind’? People died because of incompetence. Yes the result is an hospital with a poor record loses money but I don’t see what the alternative is? The financial penalty is to push the hospital to address the issue: stop killing your own patients through stupidity or else you will...

And here we encounter the problem with the NHS; this hospital should be properly exposed to the reality of incompetence: an insurance system as practised in much of Europe would have seen this hospital either marked unfit for purpose or overhauled. Instead of which we have basic water maintenance killing patients as we have had for years. Legionella has been an ongoing issue for decades. And remarkably simple to deal with. And yet.

[iphonedyou]

Voldemort said:

You is well edgy, bruv.

[shopper150]

spaximus said:

So many tales like this, NHS used to be able to reclaim VAT, cannot now apparently, so money handed to the NHS is effectively down by 20% in some areas, makes no sense

A lot of drugs are so expensive as it is, and yet the NHS are unable to reclaim VAT on drugs administered to inpatients. Sorry state of affairs.

[spaximus]

WatchfulEye said:

spaximus said:

Too many unknowns in this case to say anything with any certainty.

Was funds available to do anything with the water system? Did anyone think there was an issue that needed urgent attention? Was a specific instruction given to a specific person?

Instead you have one Government funded department, taking another to court and at the end money taken from the funds for patient care to pay a fine. Who did it punish, it was the care of patients.

Sad a man died of that we can be certain.

In this case, the hospital had a legionella prevention and surveillance programme in place. They did daily water temperature checks on each ward and were having fortnightly samples from each ward laboratory analysed for bacterial contamination.

All the laboratory tests had come back negative, and all recorded temperatures were in spec prior to the illness, but laboratory tests were positive the day before the death (but after the disease had been contracted).

The root cause was found to be that the building plumbing diagrams were out of date and inaccurate. The showers on the cancer ward were supplied from a separate hot water supply, but were not being monitored as the schematics showed them on the same water supply as the ward sinks (which were being checked daily). The re-circulation pump on the shower circuit had failed, and as a result when the showers were not in use, the water in the pipework would stagnate and cool, allowing the bacteria to breed in the pipes. As the pump was not shown on the plumbing diagrams, no surveillance or monitoring of the pump was performed, hence it's failure was not detected and it was not repaired.

The HSE essentially said that the hospital were negligent in basing their surveillance programme on inaccurate building schematics, and that they should have taken additional effort to verify the schematics of "high risk" areas.

This case was highlighted a couple of years ago to hospital management nationwide, and subsequently hospitals have been significantly upgrading their legionella precautions - updating plumbing schematics, installing electronic temperature logging devices on hot water pipes, and bacterial filters on shower heads and taps.

So was one person responsible for this? From what you have written they were doing the right things for 99% of the job, but due to a plan being wrong missed a vital piece of information and a person died. Who was negligent in this case, find that and deal with them not just fine a faceless organisation which in this case the RUH is already massively in a black hole financially.

[Derek Smith]

shopper150 said:

spaximus said:

So many tales like this, NHS used to be able to reclaim VAT, cannot now apparently, so money handed to the NHS is effectively down by 20% in some areas, makes no sense

A lot of drugs are so expensive as it is, and yet the NHS are unable to reclaim VAT on drugs administered to inpatients. Sorry state of affairs.

It's similar in the police. The government say they are giving £x but in reality only a fraction of it gets to the individual forces. (That's not even to mention the £450 million that May said the police were getting when, in fact, most forces got a further reduction.)

There are all sorts of scams the government run, such as obliging the service to eschew the cheapest and sometimes best option and instead go for the system where they provide a poor but expensive option.

[paulrockliffe]

shopper150 said:

spaximus said:

So many tales like this, NHS used to be able to reclaim VAT, cannot now apparently, so money handed to the NHS is effectively down by 20% in some areas, makes no sense

A lot of drugs are so expensive as it is, and yet the NHS are unable to reclaim VAT on drugs administered to inpatients. Sorry state of affairs.

Except that isn't true.

You're probably thinking of Police Scotland where the SNP were told if they constituted the Police the way they have they would not be able to reclaim VAT as a Public Body. They did it anyway, so the Police in Scotland can't reclaim VAT, but in the rest of the country where there aren't as manyidiots in charge this doesn't happen.

[TooMany2cvs]

spaximus said:

So was one person responsible for this? From what you have written they were doing the right things for 99% of the job, but due to a plan being wrong missed a vital piece of information and a person died. Who was negligent in this case, find that and deal with them not just fine a faceless organisation which in this case the RUH is already massively in a black hole financially.

Why were the plans wrong? Had somebody failed to record a change, or had the change been recorded but the update had been filed and the wrong version of the diagram was in use? Was it originally constructed wrongly? It's almost certainly compeltely impossible to point to one person and say "It's their fault!". Even if you could, what if they've changed jobs or retired or died since?

How does that prevent similar errors happening in the future?

[pavarotti1980]

Dixy said:

Fining a hospital for any failure is just bizarre.
http://www.bbc.co.uk/news/uk-england-bristol-43842...
The guberment effectively funds the NHS and collects the fine so they take the money out of one pocket and put it in another.
The trust may be making poor decisions around inadequate budgets or just be incompetent, why do heads never roll or the chief executives get fined personally.

You could also argue that public sector organisations paying VAT is equally as strange when private companies may be exempt. However it means they recoup 20% of the money handed out so it means they arent spending as much

shopper150 said:

A lot of drugs are so expensive as it is, and yet the NHS are unable to reclaim VAT on drugs administered to inpatients. Sorry state of affairs.

But Boots,Lloyds, Well pharmacies can, hence the increase in them providing dispensing services for NHS hospitals. Saves the trust 20% on large parts of drug budget

paulrockliffe said:

Except that isn't true.

You're probably thinking of Police Scotland where the SNP were told if they constituted the Police the way they have they would not be able to reclaim VAT as a Public Body. They did it anyway, so the Police in Scotland can't reclaim VAT, but in the rest of the country where there aren't as manyidiots in charge this doesn't happen.

NHS does pay VAT. They do this on everything apart from the VAT exempt products

Edited by pavarotti1980 on Monday 23 April 10:01

[Rovinghawk]

TooMany2cvs said:

It's almost certainly compeltely impossible to point to one person and say "It's their fault!". Even if you could, what if they've changed jobs or retired or died since?

How does that prevent similar errors happening in the future?

In that case never mind, let's just gloss over it & carry on regardless. We won't even need to say "lessons will be learned".