Friday, July 01, 2011

Doctors ask: did Great Ormond Street boss cover up hospital's role in Baby P affair?

Hospital management ignored strenuous warnings about deficiencies in care that led to the death of a toddler (below)

Senior doctors at Great Ormond Street Hospital have called for an independent investigation into their chief executive, following claims she helped cover up its role in the Baby P affair.

The consultants have written to The Lancet saying it is now "impossible" to raise questions over the conduct of Jane Collins internally.

They imply the matter has not been "properly or impartially investigated" within the hospital, and warn that this makes the famous children's hospital appear to be "an organisation that buries its mistakes".

Their letter comes three weeks after Lynne Featherstone, the Equalities Minister and MP for Haringey in north London, said Dr Collins "deliberately withheld" important information regarding the children's clinic where Baby P was seen two days before his death.

Ms Featherstone told the BBC that it appeared Dr Collins "attempted to cover up the fact that the situation" at the clinic, St Ann's Hospital, had been deemed "clinically risky" in an independent report.

Clinical staff at St Ann's, including the consultant paediatrician was saw Baby P and missed that he had a broken back, were employed and managed by Great Ormond Street at the time of his death in August 2007.

While Great Ormond Street passed on the full report to police, only a summary went to the author of the serious case review looking into the death of the child, whose name was Peter Connelly.

Calling for an "independent investigation", the doctors wrote: "We want the matter properly and impartially investigated, not because error is inexcusable, but because we do not wish GOSH to be seen as an organisation that buries its mistakes."

A spokesman for Great Ormond Street Hospital claimed the consultants were motivated by other concerns.

He said: "There are a minority of consultants who are unhappy at some of the changes that the trust is introducing to improve patient care.

"We are sorry that they have chosen to express their views through the media, when there are plenty of avenues through which to raise concerns within the trust. The vast majority of staff are clearly comfortable to use these."

100,000 terminally ill Britons 'do not get proper palliative care'

Almost 100,000 terminally ill people do not get proper care, according to a Government review which concluded that a new funding system would save millions of pounds and better serve individuals. A national payment structure would cut variation around the country in what the state pays for and what it does not, and support far more people to be cared for in their own homes, it said.

Experts behind the report say the move could reduce deaths in hospital by up to 60,000 a year by 2021, translating into savings of £180 million annually.

At the moment, the amount primary care trusts (PCTs) in England spend on end-of-life care varies widely, from £186 per patient in one area to £6,213 in another.

Access to services, including round-the-clock nursing care, also depends on where people live.

Far more people die in hospital than wish to, and experts estimate that more than 90,000 people are not having their palliative care needs met.

The Palliative Care Funding Review, ordered by Andrew Lansley, the Health Secretary, last summer, proposes a "fair and transparent" funding system where the money is linked to the individual patient.

Under the scheme, people would receive an initial assessment of their needs, which would then be combined with other factors such as their age and capabilities.

This "needs classification system" would have 25 separate classes (13 for adults and 12 for children), each with its own pot of funding.

The funding would take account of things such as personal care needs, including help with washing and eating, the provision of 24/7 nursing care to support people at home and a co-ordinator to help patients work out their state entitlements as well as access to local charitable services.

At present, some end-of-life care providers are paid regardless of how much work they do, offering poor value for money across the service, the review said.

Meanwhile, 97% of hospices do not receive all the funding they need for the NHS services they provide, and some patients are victims of "rationing" towards the end of the NHS financial year.

These latest proposals would guarantee funding regardless of where patients live and whether they are in a care home, hospital or in their own home.

Thomas Hughes-Hallett, chair of the review and chief executive of Marie Curie Cancer Care, said: "No other country in the world has introduced such a system for both adults and children, so the step is both a bold and necessary one."

Professor Sir Alan Craft, adviser to the review, said: "The Government must act on the recommendations contained in the review because evidence shows us that incentivising the provision of palliative care leads to better outcomes for patients, supports choice and is the most cost effective way of using NHS resources.

"We need to remove the barriers within the current system to enable this to happen."

Between 56% and 65% of adults would like to die at home but only 20% do so, with 55% dying in hospital.

The ageing population and the increased complexity of needs towards the end of life mean 90,000 more people than at present could be dying in institutions by 2030, the review said.

Ciaran Devane, chief executive of Macmillan Cancer Support, said people wanted a choice over where to die.

"Twenty-four hour community nursing services are crucial to the delivery of choice and to the realisation of these ambitious recommendations. "It will be up to the Government to ensure that these services are standard across the country. "We need to see a massive improvement on the 56% of PCTs who currently provide 24-hour community nursing."

Simon Chapman, director of policy and parliamentary affairs at the National Council for Palliative Care, said: "It is vital that the Government acts on the review's recommendations and creates a fair funding mechanism that will ensure people get high quality end of life care where and when they need it.

"We only get one chance to get it right for dying people, which is why it must be a priority to ensure everyone who needs it can access palliative care round the clock."

Susan Munroe, Marie Curie Cancer Care's director of nursing and patient services, said: "Far too many people at the end of their lives are still not getting the care and support they need nor do they know what they are entitled to.

"We welcome the recommendations of the review as the next big step. "We now want to see these recommendations implemented by the Government as a matter of urgency."

You can't join NHS post-natal depression support group, you're too sad: What mother was told by mental health nurse

A young mother suffering from post-natal depression was told she would 'bring down' other mothers if she joined an NHS support group. Rachael Dobson was told that she was too unhappy to be allowed to join other mothers in the same situation in a bid to regain full health.

The 22-year-old was shocked when a health visitor refused to refer her to the group while a mental health nurse also refused to help her, saying she should 'work through' her problems on her own.

Mrs Dobson, who suffered severe post-natal depression following the birth of her son Andreas, is now setting up her own charity to help other sufferers.

She said: 'The health visitor told me there was a support group where women suffering from post-natal depression would meet up but she said to me: 'You're two pegs above them and you'll bring them all down.' 'It was like being told I was too unhappy to go to the group but that was the whole point of the group. 'It would hardly be full of women joking around - all these women were suffering post-natal depression. 'I genuinely felt like I had been slapped round the face.

'Post-natal depression is very misunderstood but it had a devastating effect on me. 'Some days I couldn't physically get up and my husband would have to take the day off and drag me out of bed. 'I've always been very active and sociable but post-natal depression knocked me sideways.'

Mrs Dobson was struck down with post-natal depression just minutes after giving birth to her son Andreas on February 8 last year. She said: 'The birth wasn't exactly plain sailing. I had an emergency caesarean and I felt as if I was being attacked. 'When Andreas was delivered I was put in a side room on my own and looking over into the cot I was not met with love or joy, just nothing.'

Her fragile state got rapidly worse when she and husband Stuart, 26, took Andreas back to their home in Shrewsbury, Shropshire. She said: 'For the first few weeks I would cry when my husband walked through the door and would launch into rageful fits of anger.

'I wouldn't do anything with my son and when he cried at night I would bury my head in the pillow and Stuart would get up to help him. 'One morning I was overwhelmed with tremendous anger and I wanted him [Andreas] gone. 'I was then met with a sadness and horror because I couldn't believe I felt like this towards a baby.

'I rang my health visitor and collapsed into tears on the phone. She came round and I poured everything out. 'After that I was contacted by a community practice nurse from the mental health team but she just told me I had to 'work through it' on my own.'

Rachael and Stuart, who both work for Severn Trent Water, moved to a new house in Shrewsbury under the care of a different health visitor.

Social Services got involved and Rachael was banned from being on her own with Andreas for four months until her condition improved and she was deemed safe. She has now set up her own support group called the Pandas Foundation for other mums suffering post-natal depression.

She said: 'I feel like I was left on my own by the health visitor. 'I was lucky that I had my family to fall back on for help and I feel like I'm coming out the other end of the post-natal depression now which is why I want to help others. 'I want to create a support network and one-to-one sessions for women and men who are suffering like I did. 'Post-natal depression is a terrible thing to happen to anyone and it almost sent me over the edge.

'I feel let down by the health visitor who refused to help me and almost led me to lose my family.'

Hospitals leaking patient data to 'no win no fee' firms, claims MEP

Confidential patient data is being leaked from hospitals to 'no win no fee' accident claims firms, an MEP claimed on Tuesday night. Paul Nuttall, the UK Independence Party MP for the North West, has called for an inquiry into the alleged practice, saying if true it was "an outrage".

He made the claim after being contacted by members of the public upset at being "harassed" by such firms after receiving treatment at hospitals in Liverpool and The Wirral. Both hospital trusts have denied the claims.

Mr Nuttall said: "I have been approached by constituents who are angry that have been bombarded with text messages to their mobile phones after hospital treatment. "The only way the claims firms can have got the information that they had been a patient and also got their mobile phone numbers is from the hospital itself," he said.

"I don't know if that is being done with the connivance of the hospital trusts concerned - Wirral and the Royal Liverpool Hospital - or whether some staff are doing this off their own bat.

"But I want to know and this must be stopped. I know that hospital trusts everywhere are having to make budget cuts but if they are selling this highly private information to boost their coffers it is an outrage and must contravene the Data Protection Act." He went on: "People are being harassed by these claim firms, who apparently sell or pass on the information to other similar firms when they get no response."

However, both the Royal Liverpool and Broadgreen University Hospitals NHS Trust and the Wirral University Teaching Hospital NHS Foundation Trust have denied any wrongdoing.

A spokesman for the Royal Liverpool said the allegations were "completely false". She said: "We have not had any incidents where members of staff have sold patient information to claims firms. If we are made aware that any members of staff are not abiding by the Data Protection Act then they will be disciplined appropriately.

"If Mr Nuttall has been approached by patients who have concerns, then we urge those patients to contact us so that we can investigate this further."

A spokesman for Wirral hospitals said it could "categorically deny that is has supplied confidential patient information to accident claim firms".

Data on users - such as phone numbers of those who have been involved in accidents - are sold to claims firms by so-called "claims farmers". The collection and selling of such information is a grey legal area, but the subject must have given their explicit consent for their details to be passed on.

Rules on foreign doctors 'put patient safety at risk'

British patients are at risk from foreign doctors who are unfit to practise because EU laws put freedom of movement ahead of the safety of patients, leading clinicians have claimed.

Dr Hamish Meldrum, chair of the British Medical Association (BMA) council, said that European employment law and other countries' refusal to share information from their medical registers meant British medical regulators were sometimes powerless to guarantee foreign doctors' capability.

It raises the prospect that a doctor banned from practising in one country could be registered in Britain without the General Medical Council being aware of their prior record for incompetence.

EU laws mean the General Medical Council (GMC) can not test the clinical capability or language skills of European-qualified doctors as they can with those from other parts of the world.

Unlike the GMC, many European countries refuse to reveal information about malpractice hearings.

At a BMA meeting in Cardiff yesterday, Dr Meldrum said: "If a doctor was struck off and the GMC knew about it then I think the likelihood of them being able to practice is probably quite low, but the problem is whether the GMC always knows about it and also knows the reasons as to why it happened.

"We are aware of several cases where doctors have been removed from the medical register in this country because of fitness to practice problems, but are still practicing elsewhere in the EU. I am afraid EU law seems to put freedom of movement rather higher than protection of patients."

Daniel Ubani, a German-qualified cosmetic surgeon, was working as a locum out-of-hours GP in Cambridgeshire when he accidentally killed 70-year-old David Gray with a tenfold overdose of painkillers in 2008.

The GMC had been unable to verify whether Ubani had ever worked as a GP in Germany because his license automatically gave him the right to work in Britian. He can still practise in Germany.

Dr Meldrum added: "We saw with the Ubani case how he was found guilty in the UK and yet he is still practicing in Germany and that doesn't seem to be satisfactory."

Dr John Fitton, a GP from Kettering, Northamptonshire, said: "It should be unacceptable that a doctor who is found to be incompetent or untrustworthy in one jurisdiction of the country might equally be able to find employers in another."

The European Commission has launched a green paper consulting member nations on the prospect an international alert system when a doctor is found unfit to practise.

Niall Dickson, GMC Chief Executive, said: "This is about patient safety. When we take action against a doctor we actively tell other regulators.

"We want other regulators across Europe to do the same and have urged the European Commission to put a duty on them to do this. We believe all regulators must share this vital information in order to keep patients safe."

Britain's age timebomb: Cost of 1.4m extra pensioners means NHS cannot stay free, says think tank

Britain faces a bleak future of higher taxes and a rising deficit if ministers continue to increase spending on state pensions and the NHS, a hard-hitting report warns today.

The country is facing a demographic timebomb with the number of over-65s set to increase by 1.4million over the next five years. The report by think tank Reform warns that this ageing population threatens to overwhelm the Coalition's attempts to bring down the UK's biggest ever peace-time deficit.

The report calculates that the ageing population will impose an additional burden on the taxpayer of £32billion for pensions and nearly £40billion for healthcare by 2041, without allowing for inflation. This is set to force up both taxes and state borrowing during the next Parliament, 'swamping' Chancellor George Osborne's plans for deficit reduction.

The authors accuse ministers of 'burying their heads in the sand' about the scale of the impending crisis and call on individuals to take responsibility for their own futures. They go on to urge the Government to face down the unions by holding firm on reforms to public sector pensions.

The report also proposes a number of radical and controversial measures to prevent Britain from collapsing into a spiral of debt, including charging for the NHS.

They also include scrapping popular 'gimmicks' such as the Winter Fuel Allowance and free bus passes – and forcing people to save for their retirement.

The pro-market think tank also calls for the Coalition to reverse its decision to link the state pension with earnings and drop plans for a single tier pension – which has been estimated to cost an additional £11billion per year.

It says: 'Decisions such as indexing the state pension to wage growth not price growth should be reversed. 'Shifting forward the increase in the retirement age has not made this change affordable. It will only save money until 2021 after which the age will be back on its earlier trajectory.'

The report, called Old and Broke, says that between 2011 and 2016, the number of people aged 65 and over will increase by 1.4million while the working age population below 50 will decrease. There are currently 10.1million people aged 65 or over in the UK.

Population ageing will continue so that the ratio of workers to pensioners will fall from 3.9 in 2011, to 3.2 in 2021, and then to 2.5 in 2041.

The report adds: 'Change has to take place. Government programmes are largely funded on a pay as you go basis. 'With the ageing of the population ... younger people will face the prospect of paying more for less while the elderly population enjoys a heavily subsidised lifestyle and unearned windfall gains.'

The report continues: 'Research has shown that the UK has the largest pensions gap in Europe. Too many people “play chicken with the State” and assume that taxpayers will always be there to bail them out in periods of need.'

Pointing out that people in the UK make one of the smallest contributions to healthcare in Europe, the report calls for more charging in the NHS. It says: 'The service cannot remain free at the point of care. As well as increasing revenue for the services, charging will moderate demand and engage patients more in how they consume health services and how they manage their own health.'

The report's lead author, Dr Patrick Nolan, added: 'Starting long-term reform will give people time to make alternative plans for their future.'

British GP bonuses 'lead to poor patient care' as financial incentives boost some treatments... but caused a decline in others

Bonus payments for GPs mean some patients are missing out on improved care, say researchers.

The financial incentives have led to better measuring of high blood pressure and cholesterol levels, a study shows. But in other areas of patient care which are not in the scheme improvements were ‘significantly below’ what was expected. These included measurements involving people suffering from arthritis, dementia and back pain.

Pay-for-performance targets were introduced in 2004 as part of a new contract for GPs to reward them for taking better care of patients. The scheme had an annual price tag of £1.8billion at the time and is now worth around £1billion. Around a quarter of GPs’ average income – currently £105,000 a year – is linked to achieving the targets.

But the study says there may be ‘unintended consequences’ to the scheme, which is known as the Quality and Outcomes Framework. The study, published last night in the British Medical Journal, looked at data from 500 UK general practices and trends in quality of care for 42 activities.

Of these, 23 measurements or treatments attracted a bonus payment including measuring blood pressure and smoking habits. A further 19 activities did not lead to extra money, including measurement of thyroid function or blood sugar levels in certain categories of patients.

For all activities, there was a general improvement in quality before incentives were introduced.

When bonuses were attached to some measurements, there was a significant increase in quality during the first year after the scheme came in. This levelled off after three years to a 4 per cent rise above what would have been expected without incentives.

For measurements that did not attract extra money, quality was ‘significantly worse’ after three years, with a 5 per cent drop compared with the improvement that would have been expected without incentives.

Dr Tim Doran, who led the research team, said financial incentives resulted in a quicker rate of improvement in some activities. But it was questionable whether this lasted, and whether patients whose conditions did not attract bonuses were being neglected.

Dr Doran, a clinical research fellow at Manchester University, said: ‘It’s not possible to incentivise everything. It does improve quality in the short to medium term but it has a small detrimental effect on activities that do not attract financial targets. ‘In the medium term these may have been slightly neglected.’

Dr Doran said there were limitations to ‘bonus’ schemes because they set priorities for care that might result in other areas such as depression receiving less attention, partly because it was harder to measure improvements. Earlier this year research found that targets set to improve high blood pressure and cut heart attacks and strokes ‘had no impact’.

Researchers, led by Dr Brian Serumaga, a Harvard Medical School fellow working at Nottingham University, investigated 470,000 patients with high blood pressure. They found ‘little evidence’ of effectiveness of pay for performance targets.

The Government has pledged to reform the way GPs are paid for targets in the face of criticism.

The British Medical Association says the Quality and Outcomes Framework was designed to ensure that patients received uniform high-quality care no matter where they lived in the country, and, by doing that, to improve public health over the long term.

A Department of Health spokesman said: ‘The Quality and Outcomes Framework and other incentives for GPs are insufficiently focused on outcomes, including patient experience. ‘We therefore intend to reform the payment system so that GPs are rewarded appropriately for improving patient outcomes.’


Wednesday, March 24, 2010

Blog suspended

Now that the battle against socialized medicine in America is largely over, I have decided to suspend publication of this blog. I will of course still be posting on the issue when matters of particular interest arise but I will do so on DISSECTING LEFTISM from now on -- as you will see in most weeks.

My AUSTRALIAN POLITICS blog will also continue to cover the disasters of socialized medicine in Australia.

And EYE ON BRITAIN has regular posts on the reality of socialized medicine there. For a long time now, not a day has gone by without a fresh horror story from Britain's "NHS" leading the posts on that blog.

Barack Obama signs health care bill amid warnings of Pyrrhic victory

President Barack Obama will sign into law the historic reform of the American health care system that has eluded his predecessors for a century on Tuesday. The 219 to 212 vote in the House of Representatives, in which 34 Democrats sided with a united Republican opposition, was a significant victory for Mr Obama. But critics warned it would be a Pyrrhic one that could lead to electoral disaster for his party in November's midterm elections. Mr Obama's poll ratings have fallen steadily to just under 50 per cent over the 14 months in which he has pushed relentlessly for health care reform.

The legislation, due to be signed by Mr Obama in a South Lawn ceremony, will expand health insurance coverage to 32 million currently uninsured Americans at a cost of $938 billion (£622 billion) over 10 years.

It will mandate that almost every American carry health insurance-a provision that opponents are set to challenge in the courts. The legislation expands Medicaid, the state health programme for the poor, while those earning more than $200,000 (£133,000) will face higher taxes.

A package of changes to an earlier bill passed by the Senate was still to be considered by the body but Democrats were confident that they had the votes to secure easy passage and Republicans conceded that their only options were future repeal and fighting provisions in the courts.

Robert Gibbs, the White House press secretary, responded jubilantly to the Capitol Hill vote late on Sunday with an email that played on Mr Obama's hope-laden campaign slogan: "Yes we can became yes we did."

Mr Obama himself proclaimed: "We pushed back on the undue influence of special interests. We didn't give in to mistrust or to cynicism or to fear. Instead, we proved that we are still a people capable of doing big things. This isn't radical reform but it is major reform.

Nancy Pelosi, Speaker of the House and the architect of the successful plan to pass the bill, described it as a "great act of patriotism" that honoured the vows of our Founders for us to be a land of opportunity, all the way back to before we were a country, in the Declaration of Independence talking about life, liberty and the pursuit of happiness".

However, critics warned that voters would have their revenge. Senator John McCain denounced the “euphoria” and “inside-the-Beltway champagne toasting” and predicted that Democrats would be punished by voters in the mid-term congressional elections. “We are going to have a very spirited campaign coming up between now and November. And there will be a very heavy price to pay for it,” he said.

Republicans said the bill would burden the nation with unaffordable levels of debt at a time of economic crisis, leave individual states with expensive new obligations and give an inefficient and overweening government an unacceptably enlarged role in the health care system.

The deal in the House of Representatives was sealed on Sunday afternoon when a handful of anti-abortion Democrats led by Representative Bart Stupak of Michigan agreed to vote yes in return for a White House executive order stating that federal funds would not be used to pay for abortions.

There was a feverish atmosphere on Capitol Hill, where large numbers of conservative protesters gathered to chant "Kill the bill" and wave signs that said "Don't Tread on Me" and "Doctors Not Dictators". John Boehner, Republican leader in the House of Representatives, said: "The American people are angry. This body moves forward against their will. Shame on us."

Representative Paul Ryan of Wisconsin, a rising star in the Republican party, denounced the bill as "a fiscal Frankenstein" while his colleague Virginia Foxx described it as "one of the most offensive pieces of social engineering legislation in the history of the United States".

Rush Limbaugh, the Right-wing radio host, spoke for many American conservatives when he railed: "We're not a representative republic. The will of the people was spat upon."

The legislation will still leave 23 million uninsured in 2019, a third of those illegal immigrants. According to the non-partisan Congressional Budget Office, the cost of the bill will be offset by savings in Medicare, the state health system for the elderly, and by new taxes and fees, including a tax on some employer schemes and on wealthy Americans.


A Point of No Return?

by Thomas Sowell

With the passage of the legislation allowing the federal government to take control of the medical care system of the United States, a major turning point has been reached in the dismantling of the values and institutions of America. Even the massive transfer of crucial decisions from millions of doctors and patients to Washington bureaucrats and advisory panels-- as momentous as that is-- does not measure the full impact of this largely unread and certainly unscrutinized legislation.

If the current legislation does not entail the transmission of all our individual medical records to Washington, it will take only an administrative regulation or, at most, an Executive Order of the President, to do that. With politicians now having not only access to our most confidential records, and having the power of granting or withholding medical care needed to sustain ourselves or our loved ones, how many people will be bold enough to criticize our public servants, who will in fact have become our public masters?

Despite whatever "firewalls" or "lockboxes" there may be to shield our medical records from prying political eyes, nothing is as inevitable as leaks in Washington. Does anyone still remember the hundreds of confidential FBI files that were "accidentally" delivered to the White House during Bill Clinton's administration? Even before that, J. Edgar Hoover's extensive confidential FBI files on numerous Washington power holders made him someone who could not be fired by any President of the United States, much less by any Attorney General, who was nominally his boss.

The corrupt manner in which this massive legislation was rammed through Congress, without any of the committee hearings or extended debates that most landmark legislation has had, has provided a roadmap for pushing through more such sweeping legislation in utter defiance of what the public wants.

Too many critics of the Obama administration have assumed that its arrogant disregard of the voting public will spell political suicide for Congressional Democrats and for the President himself. But that is far from certain. True, President Obama's approval numbers in the polls have fallen below 50 percent, and that of Congress is down around 10 percent. But nobody votes for Congress as a whole, and the President will not be on the ballot until 2012.

They say that, in politics, overnight is a lifetime. Just last month, it was said that the election of Scott Brown to the Senate from Massachusetts doomed the health care bill. Now some of the same people are saying that passing the health care bill will doom the administration and the Democrats' control of Congress. As an old song said, "It ain't necessarily so."

The voters will have had no experience with the actual, concrete effect of the government takeover of medical care at the time of either the 2010 Congressional elections or the 2012 Presidential elections. All they will have will be conflicting rhetoric-- and you can depend on the mainstream media to go along with the rhetoric of those who passed this medical care bill.

The ruthless and corrupt way this bill was forced through Congress on a party-line vote, and in defiance of public opinion, provides a road map for how other "historic" changes can be imposed by Obama, Pelosi and Reid.

What will it matter if Obama's current approval rating is below 50 percent among the current voting public, if he can ram through new legislation to create millions of new voters by granting citizenship to illegal immigrants? That can be enough to make him a two-term President, who can appoint enough Supreme Court justices to rubber-stamp further extensions of his power.

When all these newly minted citizens are rounded up on election night by ethnic organization activists and labor union supporters of the administration, that may be enough to salvage the Democrats' control of Congress as well.

The last opportunity that current American citizens may have to determine who will control Congress may well be the election in November of this year. Off-year elections don't usually bring out as many voters as Presidential election years. But the 2010 election may be the last chance to halt the dismantling of America. It can be the point of no return.



House Democrats last night passed President Obama's federal takeover of the U.S. health-care system, and the ticker tape media parade is already underway. So this hour of liberal political victory is a good time to adapt the "Pottery Barn" rule that Colin Powell once invoked on Iraq: You break it, you own it.

This week's votes don't end our health-care debates. By making medical care a subsidiary of Washington, they guarantee such debates will never end. And by ramming the vote through Congress on a narrow partisan majority, and against so much popular opposition, Democrats have taken responsibility for what comes next—to insurance premiums, government spending, doctor shortages and the quality of care. They are now the rulers of American medicine.

Mr. Obama and the Democrats have sold this takeover by promising that multiple benefits will follow: huge new subsidies for the middle class; lower insurance premiums for consumers, especially those in the individual market; vast reductions in the federal budget deficit and in overall health-care spending; a more competitive U.S. economy as business health-care costs decline; no reductions in Medicare benefits; and above all, in Mr. Obama's words, that "if you like your health-care plan, you keep your health-care plan."

We think all of this except the subsidies will turn out to be illusory, as most of the American public seems intuitively to understand. As recently as Friday, Caterpillar Inc. announced that ObamaCare will increase its health-care costs by $100 million in the first year alone, due to a stray provision about the tax treatment of retiree benefits. This will not be the only such unhappy surprise.

While the subsidies don't start until 2014, many of the new taxes and insurance mandates will take effect within six months. The first result will be turmoil in the insurance industry, as small insurers in particular find it impossible to make money under the new rules. A wave of consolidation is likely, and so are higher premiums as insurers absorb the cost of new benefits and the mandate to take all comers.

Liberals will try to blame insurers once again, but the public shouldn't be fooled. WellPoint, Aetna and the rest are from now on going to be public utilities, essentially creatures of Congress and the Health and Human Services Department. When prices rise and quality and choice suffer, the fault will lie with ObamaCare.

While liberal Democrats are fulfilling their dream of a cradle-to-grave entitlement, their swing-district colleagues will pay the electoral price. Those on the fence fell in line out of party loyalty or in response to some bribe, and to show the party could govern. But even then Speaker Nancy Pelosi could only get 85% of her caucus and had to make promises that are sure to prove ephemeral.

Most prominently, she won over Michigan's Bart Stupak and other anti-abortion Democrats with an executive order from Mr. Obama that will supposedly prevent public funds from subsidizing abortions. The wording of the order seems to do nothing more than the language of the Senate bill that Mr. Stupak had previously said he couldn't support, and of course such an order can be revoked whenever it is politically convenient to do so.

We have never understood why pro-lifers consider abortion funding more morally significant than the rationing of care for cancer patients or at the end of life that will inevitably result from this bill. But in any case Democratic pro-lifers sold themselves for a song, as they usually do.

Then there are the self-styled "deficit hawks" like Jim Cooper of Tennessee. These alleged scourges of government debt faced the most important fiscal vote of their careers and chose to endorse a new multitrillion-dollar entitlement. They did so knowing that the White House has already promised to restore some $250 billion in reimbursement cuts for doctors that were included in yesterday's bill to make the deficit numbers look good. Watch for these Democrats to pivot immediately and again demand "tough choices" on spending—and especially tax increases—but this vote has squandered whatever credibility they had left.

Mrs. Pelosi did at least abandon, albeit under pressure, the "deem and pass" strategy that would have passed the legislation without a vote on the actual Senate language. We and many others criticized that ruse early last week, and the House decision to drop it exposes the likes of Norman Ornstein of the American Enterprise Institute and other analysts who are always willing to defend the indefensible when Democrats are doing it.

All of this means the Senate's Christmas Eve bill is ready for Mr. Obama's signature, though only because rank-and-file House Members also passed a bill of amendments that will now go back to the Senate under "reconciliation" rules that require only 50 votes. Those amendments almost certainly contravene the plain rules of reconciliation, and the goal for Senate Republicans should be to defeat this second "fix-it" bill. It's notable that Democrats didn't show yesterday for a meeting with the Senate parliamentarian to consider GOP challenges, no doubt because they fear some of them might be upheld.

Though it's hard to believe, the original Senate bill is marginally less harmful than the "fixed" version, not least because the middle-class insurance subsidies are less costly and it would avert the giant new payroll tax. That's the White House increase in the Medicare portion of the payroll tax to 3.8% that Democrats cooked up at the last minute and would apply to the investment income of taxpayers making more than $200,000.

If the reconciliation bill goes down, Big Labor and its Democratic clients would be forced to swallow a larger excise tax on high-cost insurance plans, and it would also forestall the private student-loan takeover that Democrats included as a sweetener. In other words, they'd be forced to eat the sausage they themselves made as they have abused Congressional procedure to push ObamaCare into law.

We also can't mark this day without noting that it couldn't have happened without the complicity of America's biggest health-care lobbies, including Big Pharma, the American Medical Association, the American Hospital Association, the Federation of American Hospitals, the Business Roundtable and such individual companies as Wal-Mart. They hope to get more customers, or to reduce their own costs, but in the end they have merely made themselves more vulnerable to the gilded clutches of the political class.

While the passage of ObamaCare marks a liberal triumph, its impact will play out over many years. We fought this bill so vigorously because we have studied government health care in other countries, and the results include much higher taxes, slower economic growth and worse medical care. As for the politics, the first verdict arrives in November


Health care reform: We’re being fooled again

The medical system does need reforming — radical reforming. It’s more expensive than it ought to be, and powerful interests prosper at the expense of the rest of us. The status quo has little about it to be admired, and we shouldn’t tolerate it.

Thus, the American people should be fed up with Barack Obama, Nancy Pelosi, and Harry Reid for insulting our intelligence with their so-called heath-care reform. It is nothing of the sort. What they call progressive reform is little more than reinforcement of the exploitative system we suffer today.

Whether intentionally or not, Obama & Co. have misdiagnosed the problem with the current system and therefore have issued a toxic prescription as an alleged cure. They essentially say that the problem is too free a market in medical care and insurance; thus for them the solution is a less-free market, that is, more government direction of our health-care-related activities.

Yet if the diagnosis is wrong — which it is — the prescription will also be wrong.

Note that the attention of nearly all the “reformers” is on the insurance industry. What ostensibly started out as “health-care reform” quickly became health-insurance regulation. A common theme of all of the leading proposals is that insurance companies have too few restrictions on them. So under Obamacare, government will issue more commands: preexisting conditions must be covered; policy renewal must be guaranteed; premiums may not reflect the health status or sex of policyholders; the difference between premiums charged young and old must be within government specs; lifetime caps on benefits are prohibited, et cetera.

In return for these new federal rules, insurance companies are to have a guaranteed market through a mandate that will require every person to have insurance. So what looks like onerous new regulations on the insurance companies turns out to be a bargain they are happy to accept. Instead of having to innovatively and competitively attract young healthy people to buy their products, the companies will count on the government to compel them to do so. Playing the populist role, Obama & Co. bash the insurance companies, but in fact the “reform” compels everyone to do business with them.

What about this would the insurance companies dislike? Health insurance is not the most profitable business you can be in; the profit margin is 3-4 cents on the dollar. So a guaranteed clientele is an attractive prospect. The people who will be forced to buy policies are the healthy, who will pay premiums and make few claims. The only thing the companies don’t like is that that penalty for not complying with the mandate is too small. Many young people may choose to pay the penalty rather than buy the insurance because it will be cheaper. But that presents a problem: when the uninsured get sick and apply for coverage, they won’t be turned down because that would be against the law. So look for harsher penalties in the future to prevent this gaming of the system. The insurance companies win again.

What’s missed is that the “reformers” leave untouched every aspect of the uncompetitive medical and insurance cartels that exists entirely by virtue of government privilege. Most of this privilege is extended by state governments through monopolistic licensing, but Congress could repeal the prohibition on interstate insurance sales and the tax favoritism for employer-provided medical coverage. The ruling party has refused to consider those sensible moves.

The upshot is that this reform is a fraud. It leaves in place the government-created cartels and throws a few crumbs to people who are struggling — but mostly by bolstering the insurance monopoly.

Two myths must be shattered. First, the choice is not between this phony reform and the status quo. The “reform” merely puts makeup on the status quo. The free market is the real alternative.

Second, the free market couldn’t have created the medical mess because there has been no free market in medicine. For generations government has colluded with the medical profession and the insurance industry to force-feed us the system we have today.

The Who was wrong: We are being fooled again.


Our future under Obamacare

The bill will cost more than advertised. It won't be long before Congress is shocked — shocked! — to discover that health-care reform is going to cost a lot more than expected. It's not just the budgetary gimmicks that Democrats have been employing to hide the bill's true cost. It's also that government programs — and government health-care programs in particular — almost always end up exceeding their cost estimates.

For example, when Medicare was instituted in 1965, it was estimated that the cost of Medicare Part A would be $9 billion by 1990. In actuality, it was seven times higher — $67 billion. Similarly, in 1987, Medicaid's special hospitals subsidy was projected to cost $100 million annually by 1992, just five years later; it actually cost $11 billion, more than 100 times as much. And in 1988, when Medicare's home-care benefit was established, the projected cost for 1993 was $4 billion, but the actual cost in 1993 was $10 billion.

Insurance premiums will keep rising. The president has tried to convince people that health-care reform will cut their insurance costs. They are in for a surprise. According to the Congressional Budget Office, insurance premiums will double in the next few years. The bill will do nothing to diminish that increase. In fact, for the millions of Americans who get their insurance through the individual market, rather than from an employer, this bill will raise premiums by 10–13 percent more than if we do nothing. Young and healthy people can expect their premiums to go up even more.

The quality of care will be worse. Doctors' reimbursements for providing care will be squeezed, making it harder to find a doctor. A new survey in the New England Journal of Medicine reports that 46 percent of doctors may give up their practice in the wake of this bill. While that is probably exaggerated, many doctors will likely decide to reduce their patient loads or retire. At the same time, increased demand will create additional problems.

In Massachusetts, after the passage of Romneycare, the wait to see a primary-care physician increased from 33 to 52 days. Research and development will also be cut back, meaning there will be fewer new drugs and other medical breakthroughs. And the government will increasingly intervene in medical decision making, micromanaging medical decisions and deciding what treatments are most effective or, frighteningly, most cost-effective.

The Left will keep pushing for more. Speaker Nancy Pelosi's inner censor was clearly on the fritz this week when she said, "Once we kick through this door, there'll be more legislation to follow." Faced with rising costs and higher premiums, not to mention millions still uninsured, Democrats will blame the "evil" insurance companies and demand further reform. They will argue that we tried "moderate" reform and failed. Pelosi could no longer keep a lid on what the hard Left has been restraining itself from saying all along: It sees this legislation as the perfect first step in the long march to universal single-payer health care.

Republicans won't really try to repeal it. Republicans will run this fall on a promise to repeal this deeply unpopular bill, and will likely reap the political advantages of that promise. But in reality there is little chance of their following through. Even if Republicans were to take both houses of Congress, they would still face a presidential veto and a Democratic filibuster.

But more important, once an entitlement is in place, it becomes virtually impossible to take away. The fact that Republicans have been criticizing Obamacare for cutting Medicare shows that they are not really willing to take the heat for cutting people's benefits once they have them — no matter how unaffordable those benefits are. Paul Ryan put forth a serious plan for entitlement reform — and attracted just six co-sponsors at last count. Enough said.

As Scrooge asked in A Christmas Carol, "Are these the shadows of the things that will be, or are they shadows of things that may be?


A View from Britain

A British friend who has been following the health-care debate writes in:

In Britain the introduction of the NHS was passionately supported by both parties. Tory opposition to the legislation accepted the principle of medical care free at the point of consumption and concentrated instead on secondary questions. It could hardly have done otherwise since Churchill's wartime coalition government had developed its own plans for a single-payer system of universal health insurance—along with other statist social welfare measures.

At the time of its passage the cost-benefit structure of the new British system was radically opposite to that of Obamacare. Its benefits—mainly the extension of free medical care from the poor to the middle class—came at once; its costs were delayed for a decade and a half as almost all budgetary health allocations went to current spending and almost none to capital investment. Not until 1962 did a British government embark on a hospital building program; until then—and for many years afterwards—the national health service lived off the fixed capital invested by private Victorian philanthropy. (Even a few years ago you could tell this from the appearance of the buildings.) The advance of medical science today makes a repeat of this performance quite impossible. So the money to meet the increasing demand for medical services will have to come from somewhere other than the capital budget. Where?

Rationing is implicit in both Obamacare and the NHS. But the customers of both systems are very different. Most modern Americans get good health care. They have learned to expect it. They will complain if they don't get it. And they have their present care as a method of comparison to any new system. Brits in 1948 had just survived a terrible war. Rationing was part of their everyday lives. They were a deferential people to begin with in a much more hierarchical society. Brits of today would be much much harder to convince—if they had not got used to getting free but inadequate health care.

And the ratio of winners to losers in both cases is very different. As the previous paragraph suggests, there were no real losers in the Britain of 1948. Only a tiny handful of very rich people had any experience of great medical care—and they were rich enough to pay higher taxes AND private insurance premiums. Everyone else got roughly the same medical care; but now the middle class got it for nothing as most of the poor had done before. Nobody lost—not for another fifteen years when the quality of medical care began to decline noticeably. And by then they were hooked. By contrast almost every insured Ameerican is a potential loser under Obamacare. And some of those considered to be winners—i.e., the currently non-insured—will feel like losers if they are forced to insure and then remain inconveniently healthy.

So, for all sorts of reasons, opponents of this bill should not feel deterred from hope of repeal by the British experience. At the very least they have a window of opportunity to reverse the legislation of about eight to ten years. It's doable if you think it's doable—not if not.

Finally the wise words of . . . John Maynard Keynes: "The unexpected always happens; the inevitable never."


Tuesday, March 23, 2010

Landmark health care plan passes

House Democrats rallied late Sunday night to pass President Obama's landmark health care overhaul plan and send to the president's desk the politically risky initiative, which Republicans vow to wield against the Democrats in November's mid-term elections. A companion package of repairs to the bill now heads to a Senate fight. But regardless of the outcome there, Mr. Obama's yearlong struggle for his signature initiative is just a stroke of his pen away from becoming law.

The Senate's health care bill squeaked through the House in a 219-212 vote, with 34 Democrats joining all 178 Republicans in opposition after a last-minute White House executive order convinced a small group of pro-life Democrats that the bill wouldn't fund abortions. The companion "fixes" bill passed 220 to 211, with 33 Democrats joining all 178 Republicans in opposition.

Democrats hailed the vote as one of the most significant change in American social policy since the creation of Medicare in 1965 or Social Security in 1935. "This is an American proposal that honors the traditions of our country," House Speaker Nancy Pelosi said, adding that access to health care is in the same league as the Declaration of Independence's claims about the inalienable rights to "life, liberty and the pursuit of happiness."

The 10-year, $940 billion overhaul plan aims to reshape the nation's health system by imposing new reforms on the insurance industry and guaranteeing insurance coverage to nearly all Americans with hopes of reducing health care costs and the federal deficit. "This is what change looks like," Mr. Obama said at the White House shortly after the vote, which he watched in the Roosevelt Room with Vice President Joseph R. Biden Jr.

Outside the Capitol, a few hundred protesters shouted "Kill the bill." Walking from a House office building to the Capitol on Sunday afternoon, Mrs. Pelosi linked arms with Rep. John Lewis, a Georgia Democrat who walked in the civil rights marches in Selma, Ala., in the 1960s and who said he was called a racial epithet by health care protesters on Saturday. Republicans called it an isolated incident and maintained their opposition to the health reform plan.

They argue that cuts to Medicare would undoubtedly hurt seniors' coverage, that insurance premiums for all Americans would spike, and that Democrats won't be able to make good on Mr. Obama's often-repeated promise that "if you like your plan, you can keep it." "The decisions we make will affect every man, woman and child in this nation for generations to come," Minority Leader John A. Boehner said. "This bill is not what the American people need." Mr. Boehner and Sen. Jim DeMint, South Carolina Republican, separately promised to introduce legislation to try to repeal the plan.

Mr. Obama, in his pitch to Democrats on Capitol Hill in recent weeks, said that much of his presidency is on the line with passage of his overhaul plan. It marks the most significant legislative accomplish of his presidency. But it would be a victory with a large asterisk. The Senate promised House members that it will be able to pass a companion bill to "repair" controversial provisions in the bill, such as a tax on high-cost insurance plans and state-specific deals that critics say were meant to buy votes. Mr. Obama could sign the Senate bill into law immediately. But doing so without the Senate repair bill would likely anger House members.

The debate over how to reform the $2.5 trillion health care industry has taken on a deeply partisan tone for more than a year. Many of the moderate Democrats who won Republican-leaning districts on Mr. Obama's coattails in 2008 acknowledged that their support may cost them their jobs this November as the overhaul hasn't polled well.

Democrats say that support will shift once Americans see the plan's benefits -- the poor will get tax credits to help them meet the requirement to buy insurance coverage; their insurance company won't be able to impose lifetime or annual caps on coverage or deny coverage because of pre-existing conditions; young adults can stay on their parents' plan until age 26; and Medicare's gap in drug coverage will be filled. It's paid for through cuts to Medicare funding, which Democrats say will only cut waste and fraud, and a new Medicare tax on unearned income, such as investment profits, of couples making over $250,000 and individuals making over $200,000.

Abortion threatened to hold up the vote until almost the last minute. A group of about 10 pro-life Democrats said they wouldn't vote for the Senate plan unless they had a guarantee that it wouldn't allow for federal funding of abortions. They were concerned the bill would allow federal tax subsidies to fund insurance policies that cover the procedure and that funding for community health centers would not come with a prohibition on covering abortions. But their objections were met with an executive order Mr. Obama issued on Sunday affirming that the bill wouldn't do so.

Catholic groups have been divided over whether the Senate bill would authorize the federal funding of abortions, with the U.S. Conference of Catholic Bishops staunchly opposed to the Senate plan; but others, such as a group of hundreds of nuns, endorsed the plan last week. Catholic Advocate, a 501(c)(3) lobbying group, said Sunday that passing the Senate bill would account for one of the greatest expansions of abortion since the landmark Roe v. Wade Supreme Court ruling and promised to contest House members who supported it.

But the executive order was thought to be enough to push Democrats over the 216 mark required for passage. The companion reconciliation bill would remove the Senate's tax on high-cost insurance plans, federal funding for Nebraska's Medicaid costs and other problems House members had with the Senate plan. The Senate is expected to start work on the bill on Tuesday.

Over the weekend, Democrats decided against using a controversial procedure, called "deem and pass," that would have allowed both bills to pass with one vote. Republicans had called it a parliamentary trick. The vote required House members to take a bit of a leap of faith that the Senate was going to be able to deliver on the companion bill. They now have no leverage left since the Senate bill can go to Mr. Obama's desk and become law despite their grave misgivings about it. Senate Democratic leaders are expected to easily come up with the 51 votes they need. "There's a strong desire to do what's in that bill," Sen. Debbie Stabenow, Michigan Democrat, told reporters last week.

But it's a potentially difficult climb for the Senate as reconciliation rules allow Republicans to introduce an unlimited number of amendments and require each provision of the bill to affect the budget or be struck by the Senate's nonpartisan parliamentarian. If the bill is changed at all, in the form of amendments or budget strikes, it will have to go back to the House for another vote, throwing another wrench into the process.

Republicans have promised a fight, warning they plan to put up every procedural obstacle they can. They've already eyed parts of the bill that they contend are not related to the budget and can be brought up as a violation of the so-called "Byrd" rule.

Mrs. Pelosi said Friday that she doesn't foresee any Byrd-rule violations surviving. "We tried to have a 'Byrd' scrub," she said, but "the parliamentarian would not necessarily give us definitive answers on anything."

Republicans said Sunday they like their chances on an objection that the bill affects Social Security, which would be a violation of budget rules. If the parliamentarian agrees and the presiding officer of the Senate upholds the decision, Democrats would need 60 votes to override the decision. All 41 Republicans recently signed a letter saying they will object to overriding the parliamentarian. "We've informed our colleagues in the House that we believe the bill they're now considering violates the clear language of Section 310g of the Congressional Budget Act, and the entire reconciliation bill is subject to a point of order and rejection in the Senate should it pass the House," said Don Stewart, spokesman for Senate Republican leader Mitch McConnell of Kentucky.


Democrats' death by suicide

The government takeover of health care will go down in history as the worst piece of legislation to emerge from a Congress held in general disdain by the American people. The only bipartisanship on the health bill was in the opposition.

Usually autopsies are reserved for after the patient has died, but in this case it is useful to get ahead of the matter. The malformed health legislation is not the only reason Democrats are facing political extinction in November, but it is one of the most dramatic. The legislative process in this country has never been so unseemly. Arm twisting, backroom deals, special privileges and potentially criminal "government jobs for votes" agreements became a normal way of doing business. House Speaker Nancy Pelosi fixated on the mantra that the Democrats' health plan is "historic," but so was the Black Plague.

President Obama went to Capitol Hill on Saturday to give a final pep talk to Democrats, where he absurdly called his socialist health care measure "one of the biggest deficit reduction measures in history." This contradicts the chief actuary at the Centers for Medicare and Medicaid Services, who says his staff currently has no idea what the impact of the plan is "due to the complexity of the legislation." Democrats have been hoodwinked into believing they won't pay a political price for their actions, but they will soon discover they miscalculated.

The new system will suffer a tsunami of bad publicity when states sue the federal government over unfunded mandates, when the IRS begins enforcing the aspects of the bill that voters never knew existed, when small businesses start firing employees because they cannot afford the higher costs of the new system, when new and unforeseen costs blow out the already record federal budget deficit, and when seniors begin to feel the impact of Medicare cuts. All of this is what Mr. Obama euphemistically calls "bending the curve" but which seniors will find out is better termed "denial of care." Whether the formal "death panels" will convene before the November elections is still to be determined.

Many members of Congress probably don't know exactly what is in the bill. The 2,300 pages of "fixes" to the Senate bill presented last week were only a draft, and no member can be certain what has been slipped in. A frantic Democratic Party memo sent out Thursday instructed members -- twice, in italics -- not to "get into a discussion of details of the [Congressional Budget Office] scores and the textual narrative" with the bill's opponents. But the devil was in those details. Mrs. Pelosi's offhand statement that members would learn what was in the bill after it was passed should have been a warning.

The majority party was even having problems over the weekend determining if they could vote to amend a law before it was signed by the president. It is a sad day for America when senior members of Congress either dont understand the Constitution or no longer think it applies.

Democrats in Congress refuse to believe the contempt with which the American people hold them. Gallup shows congressional approval ratings in the teens and headed downward. Gallup also found that "more Americans believe the new legislation will make things worse rather than better for the U.S. as a whole, as well as for them personally."

Democrats are in much worse shape than in 1994 when they lost power, and the opposition is far more energized. Once voters have a chance to tell the most irresponsible government in American history that enough is enough, the Democrats' brief reign will expire, and be deemed death by suicide.


Burned girl 'turned away' from British hospital

A five-year-old girl with severe burns was turned away from hospital and her parents forced to drive 25 miles before doctors would treat her. Madison Healy was turned away from Coventry's University Hospital after her clothes caught fire in a freak accident at home. Her mother Alana Regan, 27, took her to A&E, expecting her daughter's injuries to be treated swiftly.

Instead, she says a doctor merely "poked at her leg" before telling her and her partner John Austin, 33, they would have to drive Madison to a specialist burns unit 25 miles away themselves. The Coventry couple, who had no money for petrol and did not know the way drove for an hour before doctors at Birmingham Children's Hospital were able to treat her. There it was discovered Madison had third degree burns requiring a skin graft plus years of treatment and physiotherapy in the future.

Now, Ms Regan has filed an official complaint against University Hospital, saying they let down her seriously injured child. Ms Regan said: "She is only a five-year-old girl and she should have been treated with more priority. "She suffered long term, life-changing injuries and they should have treated her with more compassion and urgency."

A spokesman for University Hospital said Madison had been seen by triage staff within four minutes of arriving at A&E and given painkillers. He added within 50 minutes she went on to be reviewed again by a doctor. "In line with our pediatric pathway relating to burns and scalds Madison was referred to Birmingham Children's Hospital who were advised to expect her arrival and provide ongoing specialist service.

"As the burn was categorised as a small burn covering less than one per cent of the total body surface it is considered safe and within guidelines to transfer by car with a written referral and full directions. "The Trust do apologise if the family felt distressed, however Madison did not require resuscitation or treatment during her transfer."


Monday, March 22, 2010


Four articles below from ONE DAY show what Americans can expect under Obamacare

The NHS bungles never stop

Man left infertile after wrong testicle disabled

A man was left infertile when he had part of the wrong testicle removed by surgeons. Doctors were supposed to cut away the patient's right epididymis - one of two narrow tubes connected to the testes which is used to store mature sperm. But the patient's left epididymis was removed by mistake at the West Suffolk Hospital in Bury St Edmunds. Surgeons had to operate on his again to take out his other epididymis after the blunder was discovered and the man was left infertile.

Officials at the NHS hospital have refused to identify the man or confirm if he was paid compensation.

A major investigation was launched into the error and the hospital has now introduced more stringent procedures to stop it happening again. Nigel Kee, the hospital's interim chief operating officer, said: "The safety of our patients is our number one priority. "As such, we take any incidents which compromise safety extremely seriously.

"A thorough investigation into this case was carried out by an independent consultant, who advised us to introduce an additional hospital-wide policy giving clearer instructions on marking and verifying sites prior to surgery. "We implemented this recommendation immediately."


British TV star's death was 'unnecessary and preventable': Her doctor launches attack on NHS

Jade Goody's death was preventable and a result of 'incompetence and neglect' by the NHS, a leading doctor and Harley Street consultant claimed today. One year after the 27-year-old died on March 22, Dr Ann Coxon said Goody's symptoms - which included heavy and irregular bleeding, pain and abnormal smear tests - were 'glaringly obvious'.

The former NHS doctor claimed the reality television star had a tangerine-sized tumour which medical experts failed to spot. 'There should have been alarm bells ringing,' she told The Sun. 'Jade's death was completely unnecessary and preventable. She died of neglect and incompetence.'

Despite strong evidence of cervical cancer, Jade did not suspect anything serious was wrong due to her medical history. 'She'd had abnormal smear tests since she was 16 so by the time she was 27 it didn't worry her much, because she didn't really know what it meant,' Coxon said. 'It had never been properly explained to her.

'After she was diagnosed she said to me, in that typically Jade way, "I'm not daft. If I'd known it was to do with cancer, I'd have been checked out every three months". She added: 'Jade realised she had been let down. She simply said, "Sometimes people make mistakes".'

The mother-of-two, who became a star as a contestant on Big Brother, refused to attend scheduled smear tests after being told she could not have any more children, Coxon alleged. This was nine months prior to her diagnosis.

Jade was given an ultrasound at the Princess Alexandra Hospital in Harlow, Essex, in August 2008. She then flew to India to appear in a reality television show after doctors had confirmed she could travel. However, results of a smear test - only performed because a nurse noticed she had skipped appointments - revealed cancerous cells. Goody received the news she had cervical cancer on camera and flew back to the UK where she was treated by Coxon.

The doctor said: 'An ultrasound should be able to pick up lesions just 1.2mm wide, and Jade had a tumour the size of a tangerine. It should have been blindingly obvious.'

Jade underwent an emergency hysterectomy, chemotherapy and radiation therapy - but it was too late to save the star. 'She probably had cancer for at least a year before her diagnosis. The abnormal smear tests were signs that she was high-risk,' said Coxon. 'She was only diagnosed because of one nurse bothering to do her job.'


Girl, 9, saved by optician after NHS doctors fail to spot plum-sized brain tumour SIX times

For money reasons, diagnostic scans are avoided

A nine-year-old girl whose brain tumour was missed by doctors six times was saved by opticians after her worried mother took her for an eye test. Shanice Bailey could have been left paralysed by a rare plum-sized 'schwannoma' tumour growing out of a nerve and pressing on her brain stem. She visited GPs six times between September 2009 and January this year complaining of headaches and sickness but was repeatedly diagnosed with asthma and sent away.

Only when Shanice developed a squint in her left eye did her mother Laura, 27, decide to take her for an eye test - where Specsavers optician Nadia Ahmed immediately spotted the growth. Ms Ahmen told Ms Bailey to take her daughter straight to Queen Elizabeth Hospital in King's Lynn, Norfolk, where a scan revealed the two inch tumour. Eleven days later surgeons removed the tumour in a nine-hour operation.

Despite spending a month in hospital with side-effects Shanice is now at home recovering with her family. Ms Bailey, from Wisbech, Cambs., said she would be forever grateful to the optician. ‘It's so lucky we went to Specsavers when we did, otherwise the effects could have been devastating. ‘I kept taking Shanice back to the doctor as her symptoms got worse and more frequent. ‘Originally they said her symptoms could mean anything but then they thought it was asthma because she was coughing when she was sick. ‘She has been so brave it was unbelievable - she hasn't cried once.

‘If they hadn't have found the tumour she could have died because it was blocking fluid at the top of her spine. ‘I don't necessarily blame the doctors but they should be given more training to check for problems in these areas. Just because it's rare doesn't mean they should ignore it.’

Laura took Shanice to the Clarkson Surgery in Wisbech over five months where she was seen three times by one GP and by a different doctor on every other occasion. On their last visit, the doctor referred Shanice for an appointment with a paediatrician on January 20 to work out why her mystery symptoms were persisting.

But she had the eye appointment on January 3 where optician Ms Ahmen used a magnifying light that picked up swelling on the optic nerves.

The schwannoma tumour is usually only found in elderly women but the benign growth was coming out of Shanice's hyoglossal nerve and blocking fluid at the top of her spine. A week after her surgery the youngster also suffered from a vasospasm, where blood gets into the brain, and needed a second operation to drain cerebrospinal fluid.

Shanice said she felt great after her ordeal. ‘I feel so much better now. I can do things I couldn't do before like my favourite street dancing classes,’ she said.

Trevor Lawson, a spokesman for Brain Tumour UK, said Shanice's type of tumour was extremely rare in such a young child. ‘To my knowledge in the last five years no children were reported to have suffered that from type of tumour, which was responsible for only six per cent of all adult cases,’ he said. ‘The challenge for doctors is that brain tumours can present with common symptoms and we regularly support people who were diagnosed after an eye test.’

Paul Eagling, manager of Specsavers in Wisbech, said he was ‘extremely pleased’ they had been able to spot the growth. ‘Benign tumours can leave people with long term problems and we believe every brain tumour case should be given the same level of attention as cancer. ‘People tend to only go to the opticians when they have problems with their eyesight but regular visits to the optician are vital for checking general eye health.’


Hundreds may have died in British ambulance blunder

An inquiry is being demanded into ambulance services after a Sunday Telegraph investigation uncovered a major flaw in the 999 [emergency number] system that may have left hundreds dead. Doctors, politicians and charities have called for the inquiry to examine how a mistake by ambulance chiefs led to delays in despatching paramedics.

The scandal is exposed by the death of a woman who was left for 38 minutes after an emergency call was received despite the fact that she was unconscious and breathing abnormally, having fallen 12ft. Call handlers following automated advice provided by a computer program categorised the case of Bonnie Mason, who died last May, as a lower priority than that of a drunk woman who had fallen on the pavement. By the time paramedics reached Mrs Mason, 58, she could not be saved.

An investigation by The Sunday Telegraph has uncovered a critical danger placed in the software used by most ambulance services. It meant that for a decade, 999 calls in which a patient lay unconscious and struggled to breathe after a fall of 6ft or more were “downgraded”, with call handlers told not to send the most urgent response. Some services told operatives to “override” the flaw, but The Sunday Telegraph has established that five out of 12 of England’s ambulance trusts told call handlers not to diverge from the automated advice.

Last night experts demanded an inquiry to establish how many patients had suffered because of the blunders. John Heyworth, of the College of Emergency Medicine, said the potential risks were devastating. He said: “Any system which isn’t prioritising accurately needs review because the consequences are so catastrophic.”

Peter Walsh, of the charity Action Against Medical Accidents last night expressed horror at the dangers. He said: “Who knows how many people this could have harmed and how many may have died? Given the volumes of 999 calls involving people who have fallen and are unconscious, there is a risk that thousands were affected. Who knows how many might have died – it could be hundreds, but even if it’s just one needless death, we need a full review.”

The problem occurred when a government committee which governs the use of computerised 999 software allocated a lower priority to falls of 6ft or more than had been recommended by the system’s makers. As a result, the automated system instructed call handlers to class such calls as category B even if the person was also unconscious or breathing abnormally – life-threatening conditions which should have had the most urgent response. The Department of Health said the risk had been eliminated from the latest version of the software, introduced last year.


Sunday, March 21, 2010

Paging Doctor Kildare

If Obamacare becomes law, about 30 percent of the primary care doctors in America will consider leaving the medical profession. That bit of brightness comes from a survey by The Medicus Firm, the results of which were posted by The New England Journal of Medicine. Medicus interviewed more than a thousand American physicians, and 55 percent of them believe the quality of medical care in America will decline if the Democrats pass the current health care reform proposals. Apparently, many of them want no part of it.

Although the media largely ignored the Medicus study, the story is huge. Perhaps as many as 30 million more Americans may have access to health insurance. The question is: Who will treat them? The Bureau of Labor Statistics projects a 22 percent increase in practicing physicians over the next decade. But that will not be enough to treat the universal health care crush, especially if a bunch of doctors now on the job pack it in.

There are essentially two reasons why Obamacare nauseates some doctors. First, control. Medical people simply do not want federal pinheads telling them how to treat their patients. The medical profession attracts intelligent, assertive people who are motivated to help others. This is not a docile crowd.

Second, money. Right now, many doctors are already seeing too many patients in order to pay the bills and provide a decent living for their families. Obamacare does nothing to bring down the outrageous expense of medical malpractice insurance, and it is likely to cut Medicaid and Medicare reimbursements. Doctors can do the math. Their expenses remain high; their incomes decline. Again, these are smart people who could make good money doing something else.

In Canada and Great Britain, where socialized medicine is practiced, it is difficult to actually see a doctor in some places. Instead, nurses, physician assistants and other medical personnel fill the need. That is what could happen in the United States if the feds begin calling the health care shots.

Not since the Iraq war has America been so divided on an issue. Yes, ideology is playing a part. Conservatives despise government intrusion in the marketplace, but liberals love it. Right now, however, most polls show that the majority has turned on Obamacare. The latest Wall Street Journal poll, for example, found 48 percent opposing and just 36 percent supporting.

Here's my question: What would Marcus Welby, M.D., and Dr. Kildare say? These guys usually had the answers, back when wise doctors were the subjects of TV programs and health care seemed to be a glamorous profession. Would Ben Casey support Obamacare? We know the "M*A*S*H" guys would. Dr. Jekyll might like it, but Mr. Hyde? I don't know. What I do know is that many Americans are sick of the whole health care thing. And no prescription on earth will change that.


16,500 more IRS agents needed to enforce Obamacare

New tax mandates and penalties included in Obamacare will cause the greatest expansion of the Internal Revenue Service since World War II, according to a release from Rep. Kevin Brady, R-Texas.

A new analysis by the Joint Economic Committee and the House Ways & Means Committee minority staff estimates up to 16,500 new IRS personnel will be needed to collect, examine and audit new tax information mandated on families and small businesses in the ‘reconciliation’ bill being taken up by the U.S. House of Representatives this weekend. ...

Scores of new federal mandates and fifteen different tax increases totaling $400 billion are imposed under the Democratic House bill. In addition to more complicated tax returns, families and small businesses will be forced to reveal further tax information to the IRS, provide proof of ‘government approved’ health care and submit detailed sales information to comply with new excise taxes.

Americans for Tax Reform has a good breakdown of the bill by the numbers. Isn't it reassuring that at a time of recession, government will do what's necessary to ensure its growth?


The corruption never stops

Health-vote ally Nelson to get new VA hospital for Nebraska

The Obama administration has delivered another budget plum to Democratic Sen. Ben Nelson and the state of Nebraska, adding more than a half-billion dollars for a new veterans hospital in Omaha.

The move reverses a decision by Mr. Obama's own Veterans Administration of a year ago, which called for repairing an existing hospital.

The Veterans Administration made the budget switch during internal deliberations in 2009 at a time when the White House was wooing the moderate Democrat to vote for President Obama's health care overhaul bill.

Mr. Nelson was among the last of the Senate Democrats to sign on to the health bill, deciding to vote "yes" after securing special Medicaid payments for Nebraska in a deal known as the "Cornhusker Kickback." Health care reform opponents have widely panned that deal.

At the time that deal was being made, Mr. Nelson was getting another boost from the VA as it formulated its next budget.

Jake Thompson, a spokesman for Mr. Nelson, rejected the idea the new hospital was awarded in exchange for the senator's health care vote.

"It was never discussed," Mr. Thompson said. "He wasn't discussing the Omaha VA hospital in any relation to health care. The answer is no."

The spokesman added that Mr. Nelson "has been advocating [a new hospital] with this administration, with the previous secretary of the VA and the current secretary of the VA. But in relation to health care, it wasn't discussed at all. I think the VA's own study was the principal reason it was moved up" on the construction priority list.

But Rep. Steve Buyer of Indiana, ranking Republican on the Veterans' Affairs Committee, said, "This one doesn't smell right or feel right."

Mr. Buyer said testimony by VA officials to the Senate last August showed managers recommended renovation and some expansion of the existing Omaha site -- not an entirely new hospital at a much higher cost.

More here

Study Shows ‘ObamaCare’ Could Cost 700K Jobs

As many as 698,000 jobs could be lost if the health care reform plan (a.k.a., “ObamaCare”) being pushed hard by liberal Democrats is passed by Congress and signed into law by President Barack Obama, according to a study released today that was the subject of a blogger conference call this morning.

The executive summary for the study, conducted by the Beacon Hill Institute in conjunction with Americans for Tax Reform, boils down the findings in a nutshell:

Nancy Pelosi, the Speaker of the House of Representatives, has urged passage of the massive health reform plan moving through Congress as a way to create up to 400,000 jobs. Speaker Pelosi bases her claim on a report by the Center for American Progress (CAP) in which the Center estimates that the Patient Protection and Affordable Care Act (PPACA) would create 250,000 to 400,000 jobs per year over 10 years.

This estimate by CAP amounts to a hurried effort to add academic heft to the claim that national health care reform offers a collateral benefit in the form of an economic “stimulus.” It turns out, however, that its methodology, stripped of unsupportable claims about savings in health care costs, shows just the opposite of what CAP intended. PPACA is a job killer, not a job creator.



Three new reports from just ONE DAY about Britain's NHS below

Life-saving cancer scans delayed in NHS funding crisis

Vital scans for patients who may have cancer are being postponed by up to six weeks as the NHS grapples with a major funding crisis. GPs have also been ordered not send elderly people for osteoporosis scans, to refer children with tonsillitis to specialists - or even allow men to have vasectomies. In addition, wards are threatened with closure and thousands of key staff have been told to work shorter hours or take unpaid 'career breaks'.

Charities and patient groups said the delays could have disastrous consequences if early signs for potentially fatal conditions go undetected. The drastic cutbacks illustrate a funding nightmare threatening to overwhelm the NHS within months, as trusts battle to save millions of pounds in the wake of the credit crunch.

Last night the Royal College of Physicians warned ministers and NHS managers against 'slash and burn' cuts. In a strongly-worded pre-budget briefing to MPs, they said: 'Following a decade of growth, the NHS is being asked to deliver considerable efficiencies. 'There is a risk that without careful management, a supportive rather than confrontational culture and a high degree of medical engagement, any effort to reduce productivity could easily subside into a process where services and posts are indiscriminately slashed and burnt. 'Over-hasty decisions now to cut back on the medical workforce, biomedical research, and audit programmes could have implications for generations.'

Ministers say the NHS needs to save 20billion pounds over the next five years. Although both Labour and the Tories have pledged not to cut NHS funding, rising demand and an ageing population means the money will not go as far as in the past, necessitating cuts.

Dozens of hospitals are already considering closures of A&E departments and maternity wards, while others are asking staff to consider voluntary redundancy and early retirement. The respected King's Fund think tank says it may be necessary to freeze NHS pay until 2014.

One NHS trust under pressure is North East Essex primary care trust, which last month asked its GPs not to refer patients for MRI scans - used to diagnose possible tumours and kidney disease - and other tests until April 1.

Sarah Woolnough of Cancer Research UK said delays in MRI scans could run the risk of early signs of cancer being missed. She said: 'Speedy access to diagnostic tests and quick referral can help to diagnose cancer as early as possible which can ultimately lead to better treatment for patients and improved survival.'

Matt Bushell, director of commissioning at the trust, said: 'As part of the procedures to ensure budgets are balanced at the end of the current financial year, we have, just for the month of March, asked GPs to defer referrals for a very small number of non-urgent, therapeutic services: heel scans, vasectomies, ENT and nonurgent MRI scans. 'We have maintained priority for urgent MRI scans. These arrangements will remain in place only until April 1 2010.'

Other examples of cuts across the NHS include:

* GPs in Hertfordshire being told to get 'approval' before referring patients for hysterectomies, tooth extraction and removal of skin 'lumps and bumps';

* Planned closures of A&E wards at Whittington Hospital in North London, Queen Mary's in Sidcup, Chase Farm in Enfield and others;

* Almost 4,000 workers at Stepping Hill hospital in Stockport, and 2,000 at Scunthorpe general hospital, being asked to consider early retirement, voluntary job cuts or shorter hours.

Tory health spokesman Andrew Lansley said: 'This will be very worrying for patients. The NHS has had increased funding this year, so just where has the money gone?'

Matthew Elliott of the TaxPayers' Alliance said: 'It's infuriating that despite billions of pounds being poured into the NHS, patients are having treatment delayed thanks to a failure to plan properly.'


Blundering NHS surgeon in £10m lawsuit after 100 women patients take him to court

Bungling surgeon George Rowland was allowed to operate for almost FOUR YEARS after the first alarm was raised

More than 100 women suffered botched bladder surgery at the hands of a gynaecologist who continued to work for four years after the alarm was raised. Patients of George Rowland suffered chronic pain or worsening bladder symptoms after he operated on them. But it was only after doctors expressed concern about his behaviour that the scale of his mistakes was realised and he was told to stop carrying out procedures.

Yesterday, as a report criticised managers for not picking up on the problem sooner, it emerged that more than 100 of his patients are taking legal action - leaving the NHS facing a compensation payout of as much as £10million.

Ian Cohen, of Goodmans solicitors which is representing most of the women, said: 'There have been devastating, life-changing outcomes for many patients. We have a substantial number of women who should never have had that surgery, who have been left worse following the surgery. Some have been left in a bad state, with chronic pain. 'Some women have complete difficulty passing urine. 'The trust's board appears to have allowed an obsession with targets and anxiety about potential damage to its reputation - and that of the consultant - to bar earlier action to prevent patient harm.'

Mr Rowland, aged in his 50s, was a respected urogynaecologist performing hundreds of operations a year at Aintree Centre for Women's Health in Liverpool.

In 2004 concerns were raised that he was carrying out more surgery than colleagues, often 'bundling' different procedures into single operations, such as hysterectomies with surgery for incontinence. But it was not until colleagues began expressing concern in 2007 that an investigation was launched. Mr Rowland was not suspended until the following year.

Last year the General Medical Council barred him from performing urogynaecological procedures until further notice, and hundreds of his patients were recalled to the hospital for a further consultation. Some complained they had been left in chronic pain and that their incontinence had not improved. Lawyers representing others say the surgery was simply inappropriate for their conditions.

The highly regarded Liverpool Women's Hospital, which runs the Aintree centre, commissioned an independent report into the affair, and yesterday criticised bosses for not noticing the mistakes earlier. It pointed out that Mr Rowland was responsible for picking up such problems as the clinical governance lead - a clear conflict of interest, the women's lawyers say.

Its report found warning signs dating back to 2004 were not acted upon, criticised the 'cultural divide' between staff at the Aintree centre and the main hospital, and said more needed to be done to stop doctors from working in isolation from their departments. Jonathan Herod, clinical director of gynaecology, admitted Mr Rowland often worked alone. If the case was repeated, 'it would be picked up on straightaway', he added.

Trust chief executive Kathryn Thomson said: 'We decided it was important to look at governance practices more widely to ensure we learnt as much as possible.'


£250,000 victory for war vet who sold home to pay care bill that NHS should never have charged him

NHS bureaucrats don't care about people at all. Saving money is their no.1 priority

The family of a war veteran suffering from Alzheimer's has won more than £250,000 from the NHS for nursing home fees he should never have been charged. The payout, which is believed to be the biggest of its kind, was awarded to relatives of Leslie Terry, 86, whose home was sold to pay for his £3,500-a-month care. Despite being totally immobile - he has not been out of bed for four years - and in need of constant nursing, Mr Terry was denied funding under the NHS's ' Continuing Care' scheme.

The scheme is meant to fully fund patients with health needs resulting from conditions such as Alzheimer's and Parkinson's disease. It applies mainly to those who are in nursing homes, or long-term hospital or home care.

Mr Terry's nephew, Bryan Talbot, 71, from Banbury, Oxfordshire, who mounted a legal challenge to recover the backdated fees covering eight years, said: 'My uncle has been unable to get out of bed for four years, he is at risk of choking, has to be fed, and is unable to communicate verbally. 'I felt it was clear that his health needs meant he should be the responsibility of the Health Service. I am amazed that, despite him having annual assessments, the NHS did not inform me about possible available funding. It's important people take advice. 'We've had a rough ride to get to this point but I want other people to know you don't have to sell your home to get the care you need. He has received first class care from very professional staff at Gloucester House Nursing Home.'

The payout comes after three families last year won a total of £350,000 - with the family home sold in two cases - after being wrongly denied Continuing Care. So far, more than £9million has been recovered by solicitors representing 2,000 families who claim they have been wrongly charged nursing home fees. Under English law, the elderly must pay for residential care unless their needs are health-related, when the whole cost is met.

However, Department of Health criteria on who qualifies for health needs are subject to interpretation by individual NHS trusts. The Daily Mail's Dignity for the Elderly campaign has repeatedly highlighted the unfairness of the system, which means many families of Alzheimer's sufferers are being charged for long-term nursing care. Many are denied funding by Primary Care Trusts, which have to foot the bill, because the disease does not automatically make the patient eligible for NHS 'continuing care'.

Mr Terry, who joined the Army in 1942 and fought in India and Burma, retired from his job as a porter at Sevenoaks Hospital in Kent, in 1983 before succumbing to dementia in his 70s. He never married. Mr Terry also suffers from a severe skin disease, which needs monitoring.

Solicitor Lisa Morgan, of Welsh law firm Hugh James, who acted for him, said: 'Under current government policy, there should be a full assessment on health needs, which determines whether patients pay for their nursing care fees. 'That is not happening in many cases. With the cost of nursing homes averaging £675 per week, families are still being left with huge fees to pay. There is a clear disparity across the country and, despite national guidance, Primary Care Trusts still apply their own judgment.'

Michelle Mitchell, charity director for Age Concern and Help The Aged, said: 'The system for deciding where the line is drawn between free NHS Continuing Care, and paid for social care has been a mess for years. 'We are still very concerned older people may wrongly be forced to pay for their care when it should be free. We strongly encourage anyone who believes they are unfairly missing out to fight for their rights.'