The lead piece in today’s Telegraph is an interrogation by Robert Winnett (above) of the statistics relating to emergency readmissions to hospital following NHS treatment. It’s a disturbing article, suggestive as so often of the braindead nature of New Labour’s target culture being applied to NHS outcomes…the interpretation being that patients have been rushed home too early (a) to make beds free and (b) to make the timeline statistics look better in the Blairite culture.
Having clashed with NHS bureuacracy and discovered its innate dishonesty, nothing in the piece surprises me. But from the outset, there was something about this article that had The Slog’s bollocks-detectors twitching. Let me try and explain why I’m now certain those instincts were right.
First of all, the interpretation made is somewhat cavalier. Winnett refers to the figures ‘sparking allegations that patients are being “hurried through the system” so the NHS can meet waiting-list targets’. This may well be true in some cases, but the only person sparking allegations right now is Winnett himself; and there are other even more disturbing possibilities – for instance, the treatment had been incompetent, and thus required a readmission. Only ten days ago, a study showed that 3,000 NHS doctors are believed to be incompetent. But the Torygraph didn’t seem interested in that part.
Second, the statistics focus on raw numbers. That makes them sound big, but doesn’t put them into any kind of context. Thus, while the investigation Telegraph analysis is fair in sticking strictly to emergency readmissions, it does simplify the picture, and thereby mislead the reader.
In 2009/10, there were 16.8 million hospital admissions in the UK. The new survey suggests that circa 660,000 people were brought back to hospital last year within 28 days of leaving. That makes the running rate 3% – hardly an epidemic. Most private hospitals would, I suggest, be happy with a 97% in and out rate.
There is (you won’t be surprised) a specialist quango called the HES (Hospital Episode Statistics) to record all this sort of stuff. While some of this can be written off as pinstripes and bighair protecting themselves, the HES site notes that ‘ the entire patient pathway should be taken into consideration. Take a readmission to hospital with an infection following a hip replacement, for example. Was the infection as a direct consequence of the original procedure/interventions, or was it to do with the level of aftercare, or the patient’s own actions?’
All perfectly sensible, I would’ve thought. More to the point, the HES doesn’t even consider ‘rushed treatment’ as a significant factor. But the Torygraph does. Why?
On the surface, one excellent point being made by Robert Winnett, of course, is that the emergency readmission syndrome is on the increase. His piece records: ‘The figures show that 620,054 patients had to be readmitted in 2009-10 – compared to just 348,996 a decade before, a 78% increase’.
But here, the Telegraph is being unpardonably naughty: between 2000 and 2009, there was a 38% increase in admissions per se – which more than halves the real rate of increase.
Not only naughty, but also dim. One of the biggest rises in patient type over that period was demographic in nature – lots more old people. As the NHS stats clearly show, the number involving 60 to 74-year-olds also rose rapidly – by nearly 50%…and 66% for those over 75.
And this is the clincher: 7.8m of all 16.8m admissions were elderly people. Now you don’t have to be a brain surgeon to work out that complications are far more likely to occur among old than young people. Indeed, NHS Information Centre chief executive Tim Straughan says,“This [analysis] gives an insight into the changing demands placed on England’s hospitals, which are getting busier every year. It is clear that the effects of England’s aging population are being felt in secondary care”.
Not only is the Winnett piece thus shown to be largely tosh, it also misses the point it should have made: that aged care is going to have a bigger and bigger impact on our society. But it seems to me that the article had an aim in mind long before a word was written.
Let us consider the political background to this. The Coalition in general and Andrew Lansley in particular are in a serious pickle over the NHS. The policy is, you might say, in need of a brain transplant - and has been from the off. There are two key things to note about the article over and above those mentioned above:
1. The main subhead says that ‘the Daily telegraph can disclose’ the information we’re given. Then in very small type under the main shot, it says ‘The Department of Health has released’ the information. Neither the Guardian nor the Independent, however, seem to know anything about it. To any old head, this means but one thing: the Daily Telegraph has been given the data by friendly hands.
2. Mr Lansley himself seems to have been remarkably available for comment. And his comments in the Winnett column do rather give the game away.
“Having to be readmitted and treated all over again is hugely distressing. These figures show how Labour’s obsession with waiting time targets meant that patients were treated like parts on a production line to be hurried through the system rather than like people who need to be properly cared for,” asserts the Health Secretary.
But all that statement shows is the degree to which Lansley is either unaware of, or skating over, the real reasons – demography and incompetence – why the NHS readmissions rate is escalating: he is a Minister in a corner, distracting attention away from a potentially disastrous future towards a rewritten past.
This ‘scandal’ (an increasingly worn-out word at the Maily Tabloidgraph) is a scandal only in the sense that, yet again, we are served up something here described as ‘news’ that is merely propaganda. This is increasingly apparent in Britain’s predictably biased news media: it is most risibly obvious in the Guardian, frequently apparent at the BBC, and always blindingly obvious at the Daily Mail. And it is the reason why online readers read sites like The Slog.
Only ten days ago, I produced a withering attack on the Guardian and its Feedmeister Lord Mandelson. This site has never and will never have any bias in favour of any political Party, for the simple reason that it wants shot of all of them, and exists to deconstruct bollocks.
But the worst bollocks of all is disguised, planted bollocks – the ultimate hidden agenda. That’s what Robert Winnett has consented to write in this piece, and that’s why I will view all his work from now on with suspicion.
Readers have a right to the news they paid to read, and news media have a duty to supply that news without fear or favour. Until we get away from a situation where major titles are under the thumb of Left wing Trusts or ultra-Rightist expat egomaniacs, discerning news consumers will need to be constantly on their guard. I do not see any reason why they should have to work that hard purely to see through dissembling journalism.
Related: Give mutuality a chance in the NHS
The inverse correlation between Guardian copy and reality (scroll to relevant piece)