Mid Staffordshire deaths:One excess death, if that

[PainRack]

http://skwalker1964.wordpress.com/2013/ ... h-if-that/

Its a very long blog article, but here's the stuff that might interest viewers.

Although I touched on the fact that the wide range of the figures given - 400-1200 – showed how uncertain they were, like everyone else I assumed there must be some truth to them, because they were so widely reported and so seemingly uncontested.
Not only the more lurid newspapers like the Sun, but also the ‘respectable’ press and media have reported the 400-1200 figure as fact – and continue to do so, the relevance of which we’ll see toward the end this article. Only a couple of weeks ago, a politics round-up programme on BBC Radio 4 included these figures as simple fact in their comments on David Cameron’s Commons speech on the Francis Report – and none of their guests there to talk about the issue raised even a murmur of contradiction.
The idea that 400-1200 ‘excess’ deaths took place during a period from 2005-2009 has been repeated so often, with such a complete absence of dispute (unless you knew where to look), that in the public consciousness it has become, to all intents and purposes, a fact.
But it is an idea without any basis in fact.
If you’re a regular reader of this blog, you will know that I believe in research – in drawing together facts and making conclusions based on them. I am no stranger to research and to the effort and time that have to go into an article to be able to make credible statements. But the preparation for this article has taken that investment of time and attention to another level.
My research for my earlier articles on Mid Staffs had led to some even more fundamental questions in my mind that I had to investigate. If you’ve noticed that this blog has been quieter than normal for the past couple of weeks, it has been because almost every spare moment over that period has been spent in researching this post – reading transcripts of witness statements to the Francis Inquiry, investigating the comments and opinions of others on the MSNHS issue specifically or the issues around the use of statistics in general.
What was starting to become apparent to me about the whole Mid Staffs issue was so deeply at odds with the prevailing perception that I had to read more widely and deeply than ever before in order to make sure that I was perceiving correctly.
Because the issues are so complex, and the evidence I could use so abundant (I’ve read well over 1000 pages over the past couple of weeks and will leave out of this article far more than I can put in), that even my best efforts to distill them into conciseness will still leave a post that will take patience and attention for anyone to work through, I’m going to break from the normal ‘good form’ that would mean putting the reasoning and evidence first and saving the conclusion until last.
Instead I’m going to state the conclusion first, and then list the evidence and narrative around it, so that those who wish to and who have the patience to can read through it and satisfy themselves that the conclusion is justifed. So here is that conclusion, along with a very brief justification:
There were no ‘excess’ deaths at Mid Staffordshire NHS during the 2005-2009 period in which the news media and anti-MSNHS campaigners claim there were 400-1200 of them – or, in the words of the independent clinical expert who led the ‘Independent Case-Note Review’ (ICNR) into each individual, contentious death at the Trust:

maybe one
This information has been in the public domain since at least 2010 – but I doubt if you could find a single reference to it in the mainstream media. “One person might have died!” does not sell newspapers, or gain viewers, in the same way that “400-1200 unnecessary deaths!!!” does, I guess.


...............


To identify which cases needed reviewing, the Trust offered all patients who had been treated by the Trust, or their families, the opportunity to ask for a detailed case note review – and ‘detailed’ is the right word: each review would take 5-6 months to complete, so a large number of expert, independent clinicians were needed to complete the process within a reasonable timeframe.
60 such requests were received – which already puts a massive question mark against the figures of 400-1200 ‘excess deaths’. In the course of the review, Dr Laker eventually interviewed 120 families and edited the case notes of 40-50 cases. He was asked by Tom Kark, Counsel to the Francis Inquiry, how many ‘excess deaths’ had occurred among the cases he had reviewed. Mr Kark related Dr Laker’s answer in his ‘final submission‘ to the 2010 inquiry:

Dr Laker was clear that the ICNR process could not identify the 'excess deaths' at the trust during the period 2005-09. During his work, which included editing 40 to 50 reports, he had come across perhaps one such death.

[Simon_Jester]

For those of us ignorant of the mid-Staffordshire deaths, could someone explain what the issue at stake is?

[Zaune]

The gist of it is that a couple of NHS hospitals had an unusually high death-rate, patients and their relatives started telling alarming and dubiously factual tales about the state of patient care there, and it all got unpleasantly political culminating in a public inquiry.

[PainRack]

The Mid Staffordshire hospital is the heart of an NHS scandal, in which shockingly poor care was received by patients. The scandal skyrocketed because despite years of complaints, the hospital passed several reviews until a third audit caught it and highlighted the problems, shocking the government to form an inquiry to determine the bottom of this.


The press and the political party seized on this to bash the NHS, revealing story after story, but the actual cause of the problem was due to inadequate staff numbers, which caused nursing care to be inadequate in three wards and the A&E in the hospital and which generated the hundred odd reports the public gave.


It does reveal the flaw in one NHS hospital, and give calls for alarms because the same factors that caused the problem is easily replicated in other NHS hospitals. However, as the years go by, the solutions is no better, since the call now is to increase privatisation and reduce funding..........


The Mid Staffordshire hospital scandal has also provided ample ammunition for the US "Socialist healthcare is pay" crowd even though none of its flaws were caused by healthcare financing.

[madd0ct0r]

holy shit. a very very long, detailed article. worth reading though.

a perfect statisical shit storm.

[White Haven]

The press and the political party seized on this to bash the NHS, revealing story after story, but the actual cause of the problem was due to inadequate staff numbers, which caused nursing care to be inadequate in three wards and the A&E in the hospital and which generated the hundred odd reports the public gave.

It does reveal the flaw in one NHS hospital, and give calls for alarms because the same factors that caused the problem is easily replicated in other NHS hospitals. However, as the years go by, the solutions is no better, since the call now is to increase privatisation and reduce funding..........

The Mid Staffordshire hospital scandal has also provided ample ammunition for the US "Socialist healthcare is pay" crowd even though none of its flaws were caused by healthcare financing.

I'm not really seeing how the second bolded point flows from the first. Inadequate staffing is either caused by lack of money, period, or money not being properly spent after it's provided. Both of these things are most definitely linked to healthcare financing one way or the other, unless there's a secondary issue of there being a lack of trained nurses available for hire that I'm unaware of. Is there?

[PainRack]

I should clarify.

When I use the terms healthcare financing, I was referring to the difference between a tax funded system like the NHS and the free market system of the US.

Both systems are perfectly capable of the same kind of cost cutting that resulted in the staff dilution policies that caused the problem here. Indeed, we DO see the same kind of problems, usually seen in nursing homes in the states.

[White Haven]

Ah, okay, that makes more sense, thanks for clarifying what you meant.