Directives to trim waiting lists using pay-for-performance targets have created a host of unintended consequences for the British National Health Service (NHS).          

Targets create incentives to manipulate patient records and official statistics, corrupting data used to measure system performance. Spot checks of NHS hospitals show that they extensively manipulated the data that were supposed to be used to compile waiting lists. Techniques included deliberately booking operations on days patients were known to be on vacation (thus creating an excuse to suspend them from waiting lists in their absence [link], excluding patients from lists if they had waited "too long" and arbitrarily reclassifying patients so that they were shifted to lists that were not monitored [link]. Continue reading »

A National Health Service (NHS) survey of 500 senior hospital doctors found that 41 percent had private insurance in 2006. The fraction rose to 55 percent in 2007 [link].

According to the British Medical Association spokesman, private medical coverage does not demonstrate a lack of commitment to the NHS. Instead, British doctors want speedy treatment so they can get back to their NHS patients as soon as possible. Continue reading »

One British newspaper went so far as to rebrand the National Health Service (NHS) the “National Filth Service” [link]. Two thirds to three quarters of NHS hospitals reportedly have pest problems that include plagues of rats, maggot infestations, flies, wasp nests, flying ants, bed bugs, fleas, and cockroaches in wards, kitchens, sterile areas, and operating rooms [link]. In the past, the NHS has also “put patient lives at risk” [link] with poor clinical waste management that breaches UK health and safety regulation, fire regulations, and hazardous waste regulations [link]. Continue reading »