This question, now routinely asked, is a daft one. It implies that you have a choice which hospital to go to. Which, in case of dire need, is hardly likely to be the case.
And anyway, I don’t want to have to choose – whether it’s between hospitals, schools, electricity suppliers or brands of toothpaste. I just want the best possible service or product as near and handy as it reasonably can be.
The mania for “choice”, as if it was always a good thing to have, is a cancer eating away at our society.
Nevertheless, nine out of 10 patients at Addenbrooke’s Hospital in Cambridge say they would recommend it to family and friends. Which would sound like a good advertisement if applied to toothpaste or cat food, and is well above average for hospitals.
Whether you’re there for a broken finger or major life-saving surgery, you’ll get better care and less risk at Addenbrooke’s than almost anywhere else. Its survival rates, notably for cancer patients, is among the highest in the country.
The Care Quality Commission found: “Staff were hard-working, passionate and caring … prepared to go the extra mile for patients.”
So why did that same CQC report deem Addenbrooke’s to be “inadequate”. Why was it placed last week under those grim-sounding “special measures” and taken over by an “improvement director”?
Here’s a clue: “Inspectors found a significant shortage of staff in a number of areas, including critical care services.”
And here’s another one about those passionate, caring doctors and nurses. They were, the report says: “Having to swim upstream against the pressures they faced.”
But it’s not just Addenbrooke’s – which, incidentally, was rated “outstanding” the last time the inspectors called. Talk to anyone working in the NHS and you’ll hear about the same pressures, the same staff shortages.
Staff at Addenbrooke’s, the inspectors say, are moved from ward to ward to cover gaps. Often they don’t have the necessary skills.
The same goes for agency workers brought in to cover shortages, who are less familiar with patients or routines than permanent staff on lower pay.
Not good. Now find me a hospital where things are any different.
Last January Addenbrooke’s declared a “major incident” when it struggled to cope with demand for its services. The Norfolk and Norwich was one of 19 other hospitals in the same boat.
One major factor was the number of beds being occupied by mostly elderly folk who should have gone home but couldn’t because of a lack of social care. At Addenbrooke’s that was 200 of its 1,000 beds.
It’s a serious problem throughout the country. My mother is a recent victim of it.
Prof Sir Mike Richards, the CQC’s chief inspector of hospitals, says: “It’s not just the local authority’s problem, it’s the hospital’s problem.” He adds: “It’s about the management of the hospital.”
Well, yes and no, Sir Mike. It’s about the management of the whole NHS. Which is the Government’s responsibility. And so, as it happens, are the cuts in local authority budgets that have caused the dire shortage of social care.
Addenbrooke’s is not alone. It is the 24th NHS trust to be put under special measures in just over 18 months, and the 33rd to be left without a chief executive.
This is not just about failings at Addenbrooke’s – it’s a national scandal.
Despite David Cameron’s famous promises, the NHS is facing the worst funding crisis in its history. That much-touted £8billion is still five years away, and would be too little if delivered now.
An ageing population and the growing cost of medical care (see below) mean the current 0.8 per cent annual rise in the NHS budget is in real terms a hefty cut.
Addenbrooke’s is haemorrhaging £1.2m a week. Faced with a choice between running up debt or offering poorer care, health professionals choose debt.
Then in go the attack dogs of the CQC to lay the blame at their door. Softening up a formerly (and still mostly) outstanding public service for takeover by some profit-driven private business.
So why is health care getting more expensive?
Part of it is all the clever things they can do now, keeping people alive – often at high cost – by techniques that were science fiction not so long ago.
Part of it is the cost involved in the research and development of new treatments and new drugs.
And part of it is the thing that drives capitalism. Greed. As brilliantly exemplified by Martin Shkreli, the man who outraged America last week by doing what Americans generally seem to love – finding a way to get rich quick.
The 32-year-old hedge fund manager bought the rights to Daraprim, a drug that treats parasitic infections and is used by some Aids and cancer patients. He promptly raised the price from $13.50 (£8.85) to $750 (£491), a 5,555 per cent hike that took the cost of a year’s supply to $336,000 (£220,000).
He’s since climbed part-way down, under public pressure. But he’s only a symptom of the disease, not the cause.
In fact, he may have done a public service by revealing the rottenness of a system in which companies charge whatever they get away with for things that keep people alive.