Les Britanniques chérissent leur système médical, ils en sont fiers et le montrent. Mais même s’ils en vantent les mérites, le NHS est de plus en plus contesté. Entre 2005 et 2009, un hôpital de Londres a profondément abusé du système pour en tirer profit, ce qui a coûté la vie à plusieurs patients. Comment une institution si prestigieuse a-t-elle pu permettre une erreur de cette envergure ? Quelles en sont, aujourd’hui, les conséquences ?
The French and the British healthcare systems are fundamentally different. The French one is composed of both public and private actors: medical care, performed by professionals, and health insurance. The French Sécurité Sociale provides economic and social protection for everyone who suffers from disease and requires a doctor, medicine or even a surgery. The British system is entirely public and is called the National Health Service. It provides free health care to every citizen. In particular, it produces the most important part of health care that individuals need, including dental care and surgical operations.
The Stafford Hospital is an NHS hospital located in London. Between 2005 and 2009, too many deaths occurred in that hospital. In February 2013, Mr Francis, a lawyer, published a 3000-page report which highlighted that insufficient care was to blame for the deaths and showed that around 1200 patients had died because of it. Moreover, as he explained, some professionals do help patients to sleep away. They do so because they think it is in the interest of the patient as he/she would be relieved from unbearable pain. Stafford Hospital is a case that deserved to be studied. First the hospital needed to save money. And as it is a famous hospital, it treats a huge number of patients and constantly needs more beds. Therefore, because of both economic issues and a constant need of space, the hospital’s staff mistreated the patients and is said to have let some die. Mr Francis published different testimonies in his inquiry, all of which are impressive. Some patients ended up drinking water from flower vases after they had asked many times for a glass of water in vain. Some slept in their faeces for many days. Others, who were not able to eat by themselves were left unfed. Sometimes, as the bedroom was so dirty, patients had to clean it themselves. The staff voluntarily put the button –the one which can be pressed by patients to ask for help- away from their patients. As doctors say, there is no “scientific way of diagnosing imminent death”…
The scandal shows the unacceptable failures of the British National Health Service that Britons are so proud of. Indeed they even have made the NHS one of the main symbols of Great Britain at the opening ceremony of the 2012 Olympic Games. But today, the NHS is questioned: how could the Stafford scandal happen and last so long before it was unveiled? What is the real quality of the NHS care?
The National Health Service is the biggest public health care service in the world but the quality of this institution was severely questioned especially in the Francis report. It underlines that the system may have forgotten the security of the patients for the interest of a corporation. In fact, the report describes hospital directors as so obsessed to break even to have the “NHS foundation trust” label that they completely forget about the quality of the care. It points out the importance of untrained and unregistered health care assistants. Because of these cost-saving measures the managers have replaced the qualified nurses by unqualified health care assistants. Mr Francis believes a stricter control of the staff and its regulation is required. He also requests the adoption of a “duty of candour” by doctors and nurses in order to admit when they have made a mistake and as a consequence to be sued if they don’t respect it.
After the publication of the report, Cameron apologized to the whole government and to the country. He promised an investigation to better understand how this scandal could have occurred and to take measures to address this undeniable NHS failure. Finally, he said he championed the creation of a general inspector and strengthening hospital inspection.
Obviously the system can’t secure perfect control all the time. It can not prevent some people from abusing it. There is talk of turning the system into a private one. Yet to privatize everything would not necessarily be a solution. Indeed health care in the USA is private but costs Americans much more and covers five in six Americans only. Private insurance companies aim at being profitable and sometimes refuse to cover expensive treatments. Until Obama’s reform, insurance companies could refuse to cover patients with a “pre-existing condition”. So is the NHS really the worst of all systems? In spite of Stafford, there is reason to believe it isn’t.
Anaïs SEGONDS & Nathalie TA