BRITISH TB SUFFERER DIES BECAUSE OF DELAYED TEST

Six months to get a test for TB? A normal NHS wait, no doubt. An American doctor would almost certainly have ordered all possibly relevant diagnostic tests and examinations immediately -- and got the results in short order. In Australia where I live, most diagnostic tests are done on the day that they are ordered and the results take only a few days to arrive. This case is made worse in that an important part of an early test report was ignored. The test interpreter did his/her job but the doctors were apparently to cocksure to heed the warning. The penalties for malpractice are usually negligible in Britain so why should they take care?

A grandfather died two days after doctors admitted they had spent six months treating him for the wrong disease, it emerged yesterday. Tony Bannister, 73, endured gruelling radiotherapy treatment for bone cancer before experts told him he was actually suffering from tuberculosis. Following the discovery, the former managing director was immediately put on a course of antibiotics and admitted to hospital - but two days later, he suffered a massive heart attacked and died. An investigation has been launched into the father-of-three's diagnosis and treatment after his widow insisted doctors were responsible for his death.

Marian Bannister, 68, said from the couple's home in Chichester: "It was too little, too late. "If they hadn't settled for an easy cancer diagnosis then they would have been able to treat Tony and he wouldn't have died." Mr Bannister, who worked for an electroplating company, became ill in August 2005, when he lost weight and began to suffer from flu-like symptoms. By September of that year, he was suffering from such severe back pain that he was given morphine to help him cope with the pain. Mrs Bannister, 68, said: "I told the doctor they had to do something. It was awful to see him in such pain. "The GP sent him for a bone scan and when it came back it showed terrible damage to three vertebrae and a disc. "A radiographer had written on the results of the scan 'Damage to the disc, suggested possibly infection'. "This should have been picked up on. "Cancer isn't an infection - but TB is."

Following the bone scan at St Richard's Hospital, Chichester, Mr Bannister was diagnosed with bone cancer and referred to St Mary's Hospital, Portsmouth, where he received months of treatment. However, medics told to the family the bone cancer was secondary and they were still searching for the primary cause of the cancer. "The radiotherapy was awful," said Mrs Bannister. "I told the oncologist 'You have almost killed him. What have you done?'" It was not until April 2006, when Mr Bannister was referred back to St Richard's for a bronchoscopy - an investigation into his airways - that the truth was discovered. Instead of revealing the source of the cancer, the examination revealed that Mr Bannister had tuberculosis.

He was put on a course of antibiotics and admitted to hospital, but passed away two days later after suffering a heart attack. A post mortem examination called for by the family later confirmed the cause of death was TB. Mr Bannister's distraught family then complained to the hospital, which is investigating the chain of events that led to his death.

His family have no idea how he contracted the infectious disease, which was almost eradicated in the Seventies after a prolonged vaccination programme but is now on the rise again. Tuberculosis is caused by the the bacteria Mycobacterium tuberculosis, and is spread by other sufferers. It can be cured with a prolonged course of antibiotics if caught early - but if left untreated it will kill more than half its victims. Mr Bannister's daughter Rachel, 43, from Brighton, said: "My dad was white, middle class and lived in Chichester. "He wasn't the type of person who gets TB - he was the sort of person who gets cancer."

A spokesman for the West Sussex Primary Care Trust said: "I can confirm that this patient's case is currently subject to investigation and therefore we are unable to comment any further."

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Dr Gerry shows why cash can't cure NHS

Considering what he's done in the last decade, you wouldn't trust Sir Gerry Robinson to run a bath, let alone the National Health Service. He's demonstrated that charm can take you a long way, but is a poor material for building lasting businesses. Television viewers may remember him as the man who tried to Show Them Who's Boss by going into dozy companies and making those in charge look like idiots. Entertaining telly, perhaps, but of limited value for those running an enterprise..... Before that... oh, but anyway, you might have expected his treatment of the NHS to be charmingly facile and practically useless.

Yet those who have invested three hours this week watching Dr Robinson's diagnosis on the telly couldn't describe his efforts as a waste of his time or ours. Probing beneath the "caring" image which seems to protect every health-service employee from criticism like a carapace, he exposed the determined resistance to even the smallest changes, and proved once again that the committee is the finest mechanism yet devised to prevent progress.

Inside the health service there is a profound disbelief in the market, or indeed in the ability of those at the workface to make sensible decisions if they are given the chance. This goes right to the top of the Department of Health, as was demonstrated by last week's leak of its submission for the Comprehensive Spending Review. The projection of a surplus of consultants and a shortage of nurses was so laughable that a spokesman was reduced to claiming that the document was merely an early draft.

As Karol Sikora, professor of cancer medicine, said: "It's difficult to imagine how this is done, but I suspect there is a bank of computers and people writing on the backs of envelopes. That's central planning." Nowhere is this Stalinist mentality clearer than in the looming disaster of the world's most expensive nonmilitary IT project, to put every NHS patient onto a national database. The costs are out of control, the medical profession hates it, and it will make everyone's medical records available to any half-competent hacker.

If we hadn't already strongly suspected it, the fact that health service managers don't actually manage in any way that would be recognised outside the public sector would have made for shocking television. By dint of great effort (and the mind-concentrating presence of the camera) Gerry actually helped make Rotherham General a slightly less inefficient place. As a demonstration of why throwing cash at the health service won't cure it, the Robinson report was worth half a dozen conventional inquiries. So not another unkind word about him, please, or at least not this week.

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Wait grows for elective surgery as Australian public hospitals struggle

Patients are waiting longer for elective surgery, despite a significant increase in government spending on public hospitals. A federal Government report found 4.8 per cent of patients waited more than a year for elective surgery in 2004-05, up from 3.9 per cent in 2003-04. Ninety per cent of patients were treated within 217 days, up from 193 days in 2003-04.

Australian Healthcare Association executive director Prue Power said hospitals were struggling to find qualified staff. "Demand is increasing due to the ageing population and technological advances. New medical technologies and new drugs allow us to keep people alive much longer," Ms Power said. "What we need to do to keep up with the demand is actually keep people out of hospitals by concentrating on health promotion and prevention of disease."

According to the Productivity Commission's Report on Government Services 2007, released today, the number of public hospital beds across the nation increased from 53,300 to 55,100. Total spending on public hospitals rose by 4.9per cent to $21.8billion. "The problem we've always had, with the federal and state governments both running the system, remains," Ms Power said. "There are still people waiting in public hospitals longer than necessary to be discharged to aged-care facilities, and we still have a shortage of staff."

The report shows the number of nurses has remained steady at about 4.6per 1000 people. However, a report released by the Council of Deans of Nursing and Midwifery found a shortage of 3200 nurses nationally. The council estimates that increased demand on the health system will lead to critical shortages in some states by 2010. It predicts a shortage of almost 1500 nurses in Queensland, and about 900 in Victoria. Council chairman John Daly said most states would need more nurses in the next three years. College of Nursing executive director Judy Lumby said more nurses were in the workforce, but many were part-time. Attempts to increase the workforce were hampered by state and federal governments operating at cross-purposes, she said. "Thousands of nurses have left the public hospital system to work as practice nurses with GPs," she said. "The project to promote practice nurses came from the federal Government, which is responsible for helping GPs. However, those nurses left the public hospital system, which is run by the state governments."

The Productivity Commission report reveals that efforts to introduce a national system for reporting medical errors in hospitals have stalled. NSW, Victoria and South Australia were the only states to provide figures on the number of "sentinel events" such as medication errors and procedures performed on the wrong patient or body part. In 2004-05, there were 97 sentinel events in those states.

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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