A Trusted English Doctor who was convicted yesterday of Killing Fifteen of his Female Patients with Herion, and is suspected in the Deaths of more than One Hundred others, is probaly Britains most Prolific Serial Killer.

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-- Zguy (its@bubble.con), February 02, 2000

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-- Zguy (its@bubble.con), February 02, 2000.

Listened to an NPR story on this yesterday. Britain's National Health Service really screwed up on this one.

Our hyper-litigious and market-driven health system would have had this monster in the slammer after only one, maybe two victims, simply because everyone is so paranoid about malpractice suits and HMO screw-ups. The National Health bureaucracy in the UK, on the other hand, had scores of chances to stop him and dropped the ball completely. A real tragedy...

-- DeeEmBee (macbeth1@pacbell.net), February 02, 2000.

DeeEmBee- Yes there is an extraordinary amount of bureaucracy in the NHS. But then again, you have to look at the amount of people they serve and how restricted they are by budgetary constraints. The health service provides free healthcare to UK citizens AND citizens of the European Union under reciprocal deals. Their funding comes from deductions to workers paychecks, but is a proportianatly small amount. They do a good job with the resources provided, and their doctors and nurses are not paid anywhere near what is paid to medical personnel here. They are very dedicated to put up with what they do. This doctor is a freak of nature, and a lone bad apple. Nothing more.

-- Gia (laureltree7@hotmail.com), February 02, 2000.

Gia -

I have some experience with NHS services and the personnel were indeed dedicated and hard-working.

That hard work and those good intentions do not change the fact that the "responsible authorities" had many opportunities to catch this monster and save many lives, and they did not do so. He went about his business within the system for at least 4 years, killing vulnerable seniors, racking up a mortality rate far outside statistical norms, and no one really caught on until he started forging signatures. Heck, if he'd just stuck to his primary methods, he'd probably still be killing people.

The system failed in a fundamental and massive way. All that dedication and hard work counted for nothing when it came down to ensuring that patients were being treated safely.

-- DeeEmBee (macbeth1@pacbell.net), February 03, 2000.

DeeEmBee- You do make a very good point. What is of particular concern here is that accountability will come into play, and something will be learned. I guess the point I was trying to make is that socialized medicine was not the evil, the extent of human intervention was.

-- Gia (laureltree7@hotmail.com), February 03, 2000.

Like the vast majority of such bureaucratic institutions, the NHS has always had poor accountability and oversight mechanisms. Heck, there's a very funny (and scary) British play called "The National Health" which was written back in the late 60's - early '70s.

Unless an organization has a sense that there will be rewards and consequences for its actions on a day-to-day basis, it will not establish good internal processes for ensuring success. That's why bureaucracies tend to be so non-responsive to the public and so unaccountable internally. It takes time and energy to maintain vigilance, and good intentions are no substitute for the sense that the organization's overall health and profitability (and one's paycheck) are dependent on one's actions with each and every case.

The NHS will now establish better oversight processes, of course, but absent any fundamental change, these will begin to slip. That's a natural tendency in organizations, and there are no small, near-term rewards or consequences to keep this slippage from recurring with the NHS. It takes a major failure and tragedy like this to bring about change, but absent some serious reworking, it is unlikely to "stay fixed".

-- DeeEmBee (macbeth1@pacbell.net), February 03, 2000.