Child Protection Level - Essay Example

Child Protection Level Nature/summary This case is about the insufficient training facilities to the staff and the subsequent improper child protection level in Plymouth Hospitals. Only 18 training places are there for the 60 staff members. Baby P case has revealed the inefficiency of British health care system in dealing with child healthcare (BBC, 2009a) Peter Connelly - was on Haringey Council's child protection register throughout eight months of abuse in which he suffered more than 50 injuries. His family had been seen 60 times by agencies including social workers from the council, which previously found itself at the centre of a national outcry over the murder of Victoria Climbié by her great-aunt and her boyfriend (Ahmed, 2009) Majority of the present healthcare professionals in Britain have level one and two training, but they lack level three training. The absence of level three training prevent the healthcare professionals from either indentifying the child abuse or reporting it to the appropriate bodies and put procedures into place to stop it. Cause Lack of training and training facilities and the negligence seem to be the major reason for the mishaps in British healthcare system. Even though most of the healthcare professionals have level 1 & 2 training, at least some of the healthcare professionals have not completed the much needed level 3 training for giving proper care to the children. In the baby P case, the social workers failed to identify or report the child abuse even though they visited the family of baby P around 60 times. Moreover, they failed to identify the criminal history of the family also. In other words, these social workers have not given much emphasised to their profession; they did everything mechanically. Most of the healthcare professionals in Britain may not have passion for this profession. They are engaged in working in the healthcare industry just for finding a livelihood rather than any social commitments. Solutions The most important solution for improving the standards of child healthcare system in Britain is to make the level 3 training compulsory for all the healthcare professionals and the social workers. Most of the hospital groups in Britain at present urge only the specialised staff to go for the level three training. Plymouth Hospitals have already admitted that most of their staffs are trained in level one and two whereas only a few got the level three training. They have cited insufficient training capacity as the major reason for the above problem (Plymouth Hospitals, 2009). South London and Maudsley NHS Foundation Trust has reported that their staff have received their refresher training at level one and level two but there are some who have not received their level three training. As of 31st December 2008 the Trust reported 4653 staff being eligible for Level 1 and 2771 staff being eligible for Level 2. In other words, only 62% of eligible staff is up to date on level one training even though the target was 80% whereas 69% got level two training even though the target was 80%. Then report has not mentioned anything about the level three training (South London and Maudsley NHS Foundation Trust Safeguarding Children Arrangements Declaration, 2009, p.2). It is evident from the above statistics that, not even level 1 training has been given adequately for the whole staff. 18 training places for 60 members of the staff are not adequate as 3 to 4 persons will be forced to take practical training from one place at a time. It is difficult to have a training place for each staff; but it is possible to increase the number of training places from 18 to 30 so that the ratio between the numbers of training place to the number of staff would be a much healthier 1:2 instead of 1:3 or 1:4. As per The Care Quality Commission (CQC), level three members of staff should be able to identity, neglect or abuse and also they should be able to inform the appropriate bodies about the child abuse and put procedures into place to stop it. Commitment to the profession is diminishing in the current world and healthcare profession is also not an exception. Healthcare professionals are dealing with the most precious thing in the world; the life of a person. Only committed professionals will be able to identify the importance of their profession and in order to raise the commitments of the healthcare professionals, awareness classes or refresher courses must be provided to them periodically. At present, the failures of healthcare professionals or social workers to identify or report the cases like baby P, is perceived as an ethically wrong thing. These social workers will escape from any legal proceedings. On the other hand, if the authorities can bring or incorporate legal aspects to the caring of the children, these social workers will take their profession more seriously. The healthcare professionals or the social workers should be given proper training for improving their numerical abilities and analytical skills to evaluate the child abuse cases more effectively. They must be able to judge the exact problems caused to the children after analysing family history and the feedbacks received from the parents. Communication is an important aspect in identifying the problems in the family and these professionals need more training for improving their communication skills. Child psychology must be elaborated in the training sessions of the healthcare professionals and the social workers. It is difficult to anticipate that the bay P has not displayed any signs of abuse it suffered from the family. The social workers either failed to recognize it or they knowingly hide it. Sometimes, the culprit might have cited other reasons for the visible injuries of baby P which the social workers might have swallowed. In any case, they failed miserably in their profession and deserve proper punishments. In short, healthcare professionals and social workers in Britain need more training especially in the level three. These professionals should be given more training for improving their skills in communicating with the child and the parents and they should be able to evaluate situations more meaningfully and should increase their commitments to their profession. Watchdog finds 'dirty' ambulances Nature/summary In an unannounced inspection conducted by the Care Quality Commission (CQC), in seven of the 100 East of England Ambulance Service's (EEAS) stations, they found dirty vehicles and grimy seats. CQC also reported that the trust has violated the regulations related to the healthcare-associated infection. Moreover the ambulance staffs were unaware of the basic measures to be taken to prevent or control the infection. They were even unaware of the need for uniform washing and decontamination of equipments used in the ambulance vehicles. Dust, dirt and debris were seen in parts of the ambulances including the seats inside the vehicle inspected by the CQC (BBC, 2009b) Cause Ambulance service is an emergency service and in an effort to give medical cares to the patients as quickly as possible; the users of ambulance service may not bother give proper attention to the cleanliness inside the vehicle. Most of the ambulance users might be in the critical conditions when they seek the assistance of the ambulance services which prevent them from giving more attention to the service quality. Thus mostly, the ambulance staff and their activities will gone unnoticed which encourage them to take their profession in a passive manner. Moreover, most of the ambulance users may not register any complaints about the services they received from the ambulance staffs. Another reason for the improper behaviour of ambulance staff is because of their unawareness or negligence towards the importance of the service they provide to the users. Ambulance staffs mostly have lower educational qualifications and low salaries compared to other healthcare professionals which are other reasons for the problems described in the given case. Solutions The educational level of the ambulance staff should be raised. The healthcare authorities should remember that a patient seeks ambulance service would be in a critical condition and his/her self immunization power would be less compared to other normal people. Any germs inside the ambulance can complicate the condition of the patient. So in order to avoid such mishaps, the healthcare authorities must appoint well qualified staffs only for the ambulance services. Even a momentary lapse of concentration or a silly negligence from the part of ambulance staff can result in the loss of life for a patient. Qualified, committed and dedicated personnel can reduce the ambulance mishaps up to certain extent. Most of the ambulance staffs are unaware of their personal hygiene in saving the life of a patient. So they will not take much care for washing their clothes or changing their clothes frequently. It is difficult to recognize whether an ambulance staff is using washed cloth or not. Under such circumstances, it is better to provide washed and decontaminated clothes to the ambulance staff daily from the hospital itself. The authorities should make sure that the ambulance staffs have taken their washed uniforms from the hospitals everyday and they are using it when they are at work. The ambulance crews should be specially trained as high dependency teams which are available for patients with specific clinical needs during transport (Careers in the ambulance service, n. d) For example, in some cases the patients might be anxious about their health condition and it is necessary to give some comforting advices to the patients while the transporting them to the hospital. The ambulance crews must be capable of providing such timely advices or counselling to the patients. Ambulance staff with extended training can save the lives of patients with cardiac arrest (Wright et al, 1990). Cardiac arrest is a severe health problem in many countries and UK is also not an exception. The success of treatment for such patients depends on how quickly the patient was able to achieve medical attention. In some cases, it is necessary to provide artificial breathing aids or massages to regain the lost breathing process even inside the ambulance. The ambulance staff should be properly equipped and trained for acting properly in such situations. “Ambulance staff provide the first point of access to healthcare for a wide variety of patient conditions, ranging from life-threatening emergencies to chronic illness and social care” (Ambulance staff, 2009). In many cases, the timely interference of the ambulance staff can save many lives. Ambulance staff should be dedicated professionals. The selection of the ambulance staff should be done after a careful evaluation of their attitudes towards the profession. The authorities should ensure that the persons seeking jobs in this field have strong character, willpower, and a sound philosophy in their life apart from the necessary social servicing attitude. All parts of the ambulance; inside and outside should be cleaned after every patient use. This include; Stretchers, Spinal boards/head, blocks, Carry chair, Other manual handling equipments, All medical equipments (cardiac monitor, defibrillator, resuscitation equipment, forceps etc), Mattresses, Pillows, Linen, Wheelchairs, Passenger seat etc (Cleaning standards ambulance trusts: vehicles, n. d.p.1) “The government's failure to tackle ambulance cleanliness was a major flaw in its infection control policy, according to the largest public services union, Unison” (Dirty ambulances linked to superbugs' spread, 2005). Most of the governmental policies and regulations in the healthcare industry are liberal which helped the culprits to escape from easily escaping from any punishments. Moreover, governments are reluctant in spending more on the healthcare industry and in the name of globalization and privatization; they try to stay away from such critical sectors by giving full responsibilities to the private people. Governments should remember that their basic duties include the protection of their citizen’s health also. A healthy generation is an asset for a country whereas unhealthy generation always causes problems. So, more governmental intervention is needed in the healthcare department generally and in the ambulance services, specifically. In short, improper management or administration of ambulance services, lack of training, lack of education, lack of attitude and commitments towards profession, liberal rules of punishments for mistakes etc are some of the major reasons for the poor performances of the ambulance staff in Britain. Surge in admissions to hospitals Nature/summary Health managers are of the view that the NHS in north Wales will face immense rush because of shortages of beds and delays in admissions. The north Wales regions is affected by many diseases like chest and respiratory problems, heart conditions, flu, norovirus, diarrhoea and vomiting due to cold weather. The surge in hospitals is not going to decrease as these patients are taking more time for recovery and at the same time more people were brought to the hospitals due to health problems. It is difficult for the hospital managers to find beds for new patients because of the excessive inflow compared to the outflow of patients (BBC, 2009c) The highly-infectious diarrhoea and vomiting illness, norovirus seems to be the mostly affected disease. Hospital managers asked visitors and relatives to avoid visiting the relatives and friends in order to avoid spreading of the disease. Because of the inconvenience and lack of facilities in hospitals, the hospital authorities are thinking in terms of treating the patients at home itself rather than bringing them to the hospitals (BBC, 2009c) Cause The above case is one of the better examples for the lack of facilities and capabilities of hospitals in dealing with emergency cases. Most of the hospitals in UK don’t have facilities to accommodate patients beyond certain limit. In emergency situations as mentioned in the given case, these limits were often crossed and the patients were unable to get proper care from the hospitals. Hospital managers or the organizations are often arranging facilities in hospitals based on the average inflow of patients taking a yearly statistics. They often neglect the emergency requirements. Solution Hospital service is an essential public service and the right for getting proper care from the hospitals is a basic right for citizens. Government and the hospital managers are spending billions of money in non productive sectors from the tax payer’s pocket. Thomson et al (2004), has mentioned that the majority of UK health care is provided by the publicly funded NHS, which is resourced from general taxation (Thomson et al, 2004, p.53). Most of the taxes collected from the public are spent for strengthening the defence sector and the budget allocations for other critical sectors like healthcare are often neglected by the authorities. The authorities should reduce the defence budget and spend more money in the healthcare sector to improve the infrastructure facilities there. Natural calamities and manmade disasters can strike any place anytime and the hospital services should be well prepared to meet any possible challenges. It is difficult to provide health care which meets the needs of patients within tight budget constraints. Cold climatic conditions and associated diseases are not an unexpected thing in UK. Every year this is happening and north Wales hospital authority’s incapability in providing proper healthcare to all the patients definitely shows the loopholes in the British healthcare system. The healthcare authorities not only failed to take preventive actions, but they failed to give proper medical care also. The above fact clearly indicates that the solutions for the healthcare problems in Britain must be addressed from the grass root level. Most of the governmental policies and reforms address the issue only at the surface level which may not long last. Drastic changes is necessary in the healthcare system in order to make it capable of meeting the expected or unexpected challenges The organizational setup in the healthcare sector needs a complete revision. Thomson et al (2004), also mentioned about the 1989 white paper published by the UK government in which the government emphasized the need for quality healthcare in Great Britain (Thomson et al, 2004, p.52). But these findings and recommendations are often lying on paper alone. UK health sector needs practical solutions rather than recommendations. The absence of centralized management is another problem in the healthcare sector in UK. The medical system is Britain enjoys high degree of autonomy (Klein, n. d. p.55). High degree of autonomy and absence of centralized management has created a mess in the British healthcare sector. In the absence of centralized management, most of the departments function independently which is not good for the wellbeing of the system and the patients. Governmental interventions in healthcare matters are limited which encourage the health professionals to relax a lot while at their work. Klein (n. d) has also pointed out that the NHS faces a central difficulty in offering any incentives to maximize efficiency or the services provided to consumers (Klein, n. d.p.48) Thomson et al (2004) has proposed further development of a single over-arching regulatory body, The Commission for Health Care Audit and Inspection, for the better functioning of the healthcare system in UK (Thomson et al, 2004, p.56). At present so many regulatory bodies are functioning in the UK healthcare system which helps them to escape from criticisms by giving silly excuses by blaming each other. A single regulatory body can function more effectively than multiple regulatory bodies. Private participation in healthcare industry is limited in Britain. It is not possible for the government to offer adequate health facilities to the citizens through public medical institutions alone. The private sector concentrates only on some more profitable specialized areas. Klein (n. d) has mentioned that in total, private spending amounts to about 5 percent of total expenditure on health care (Klein, n. d.p.49). In other words around 95% of the healthcare services in UK are under public sector. The core of globalization and privatization policies demands more private participation by reducing governmental spending. The shortage of qualified healthcare staff is a major problem faced by even developed countries and UK is also not an exception. The government should encourage the youths to seek a profession in health sector and for that it is necessary to provide adequate facilities and working conditions in this field. Most of the hospital staffs are working overtime when emergency occurs because of the shortage of professionals. Such overtime work will definitely reduce the quality of the service and it should be implemented only as a temporary option rather than a permanent option. Community health services should be strengthened and the public should be given more awareness about the necessary precautions, possible first aids for preventing the spreading of diseases. In short, the healthcare problems in Britain cannot be solved by the government alone. The combined efforts of government, public/private organizations, healthcare professional and the public must be needed to solve the current problems existing in the British healthcare sector. References 1. Ambulance staff, (2009), retrieved on 08 January 2010 from http://www.nrls.npsa.nhs.uk/resources/search-by-audience/ambulance-staff/?entryid45=61467 2.  Ahmed Maria, (2009), Baby Peter case in Haringey, retrieved on 08 January 2010 from http://www.communitycare.co.uk/Articles/2009/08/11/109961/baby-peter-case-in-haringey.htm 3. BBC (2009a), Child Protection level Criticized, retrieved on 08 January 2010 from http://news.bbc.co.uk/2/hi/uk_news/england/devon/8153372.stm 4. BBC (2009b), Watchdog finds 'dirty' ambulances, retrieved on 08 January 2010 from http://news.bbc.co.uk/2/hi/uk_news/england/8287050.stm 5. BBC (2009c), Surge in admissions to hospitals, retrieved on 08 January 2010 from http://news.bbc.co.uk/2/hi/uk_news/wales/north_east/7841264.stm 6. Careers in the ambulance service, (n. d), retrieved on 08 January 2010 from http://www.nhscareers.nhs.uk/details/Default.aspx?Id=468 7. Cleaning standards ambulance trusts: vehicles, (n. d.), retrieved on 08 January 2010 from http://www.nrls.npsa.nhs.uk/resources/search-by-audience/ambulance-staff/?entryid45=61467 8. Dirty ambulances linked to superbugs' spread, (2005), retrieved on 08 January 2010 from http://www.guardian.co.uk/society/2005/sep/05/mrsa.uknews 9. Klein Rudolph, (n.d.), CONSERVATIVES SUPPORTA SOCIALIST HEALTHCARE SYSTEM retrieved on 08 January 2010 from http://content.healthaffairs.org/cgi/reprint/4/1/41.pdf 10. Plymouth Hospitals, (2009), Annual Health Check 2008/9,  retrieved on 08 January 2010 from http://www.plymouthhospitals.nhs.uk/patients%20and%20visitors/howdoourservicescompare/Pages/AnnualHealthCheck20089.aspx 11. South London and Maudsley NHS Foundation Trust Safeguarding Children Arrangements Declaration, (2009), retrieved on 08 January 2010 from http://www.slam.nhs.uk/news/docs/SLaM%20Safeguarding%20Children%20Declaration.pdf 12. THOMSON RICHARD, TABER SALLY, LALLY JOANNE AND KAZANDJIAN VAHÉ, (2004), UK Quality Indicator Project® (UK QIP) and the UK independent health care sector: a new development, International Journal for Quality in Health Care 2004; Volume 16, Supplement 1: pp. i51–i56, http://intqhc.oxfordjournals.org/cgi/reprint/16/suppl_1/i51.pdf 13. Wright D, Bannister J, Ryder M, and Mackintosh A F, (1990), Resuscitation of patients with cardiac arrest by ambulance staff with extended training in West Yorkshire, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1663751/ Third Case study: Full article Page last updated at 21:42 GMT, Tuesday, 20 January 2009 Surge in admissions to hospitals Health managers are warning that the NHS in north Wales is having to cope with exceptionally high numbers of emergency admissions. They say it is resulting in shortages of beds and delays in admissions. All the region's hospitals have been affected by the problem which is thought the cold weather has caused. Patients have been arriving with chest and respiratory problems, heart conditions, flu and norovirus, the bug that causes diarrhoea and vomiting. A spokesman for the North Wales NHS Trust said "All hospitals across north Wales have been affected by a surge in admissions. "This hasn't been caused by a single type of illness, rather it appears that the recent periods of colder weather have meant people have been more seriously affected by a range of illnesses. "The surge in demand appears to be lasting for much longer than is usually the case and is causing increasing pressure on hospitals." In particular, the spokesman said, it is making it much more difficult to find beds for new patients, which in turn causes results in delays in areas like A&E. Norovirus "Of course we will continue to admit patients who are seriously ill and need hospital care," the spokesman added. "However, in the first instance we would encourage people who are feeling unwell to make use of NHS Direct or their local GP out of hours service. "Here they will be able to get expert advice on their condition and find out whether they would be better off treating themselves at home, rather than facing a potentially long wait to be seen in hospital." Earlier this month Wrexham Maelor Hospital said 99 patients had been affected by an outbreak of norovirus, the highly-infectious diarrhoea and vomiting illness. Patients in 10 wards had displayed signs of the illness which first emerged before Christmas. Hospital managers then asked visitors and relatives to think twice before visiting relatives and friends. Read More