Sunday, August 12, 2007

Girl dies of brain tumour after NHS doctor tells her 'headaches are caused by stress'

When I requested an MRI in Australia a couple of years ago, I got it next day. They were apologetic that they could not do it same day. But I have private insurance -- like about 40% of Australians. It's only 10% in Britain

A woman who had complained to her GP of severe headaches for almost a year collapsed and died of an undiagnosed brain tumour. Jennifer Bell, 22, had been told she was suffering from stress but after months of illness had finally been referred to a neurologist. She then faced a 13-week wait before a 'relatively urgent' MRI scan could be carried out. Three days before the long-awaited appointment she collapsed at home and died later in hospital.

Her parents, Colin and Joyce Bell, want to know why Jennifer's MRI referral was logged only as 'relatively urgent'. Yesterday at an inquest in Norwich, Coroner William Armstrong agreed that an early scan would have led to much faster intervention.

Jennifer, of Thorpe End, Norwich, developed severe headaches, nausea, a stiff neck and diarrhoea in August 2005. Her health became so poor she gave up her job as a passenger service agent at Norwich airport. She visited her GP for the first time on November 4, 2005. Between then and April 10, 2006, she had five GP appointments. She also had six physiotherapy sessions. Her GP, Dr Helene Barclay, of Thorpe Medical Group, had recorded her symptoms as stressrelated.

But eight months on and still no better, Jennifer was referred to the Norfolk and Norwich University Hospital. There a neurologist discovered that her periods had stopped, a symptom not usually associated with headaches and decided she needed a scan. But on July 3 last year - only three days before her appointment, Miss Bell collapsed at home. She was taken to the N&N hospital and then transferred to Addenbrooke's Hospital, Cambridge, where she died.

At the inquest, Dr Barclay defended her decision to prescribe painkillers and physiotherapy for Miss Bell's stiff neck. "She did not show any sensory symptoms and I feel the routine referral to the N&N was appropriate," she said. Dr Jeffrey Cochius, consultant neurologist and clinical director at the N&N, said it was a credit to the neurologist who had referred Jennifer for the MRI as many would not have asked questions about her menstruation.

Coroner Mr Armstrong recorded a narrative verdict, saying: "I think there is no doubt that the tumour caused her death but it is also quite clear that early detection would have resulted in medical intervention of some kind. "The expression 'relatively urgent' is inherently ambiguous and the hospital might consider whether its use is helpful or appropriate. "Jennifer died as a consequence of a progressive undiagnosed brain tumour of a rare type and location urgent is a dangerous term because it is a contradiction."


A British dentistry expansion that instead became a contraction

In the best tradition of bureaucratized medicine

The government's scheme to expand NHS dentistry led to fewer patients being treated by fewer dentists in the first year of operation, official figures revealed yesterday. Ministers had expected local NHS commissioners to buy extra capacity to make it easier for people to register for regular dental treatment. Dentists were put on a new contract that was supposed to let them escape the "drill and fill" treadmill and provide time for preventive work.

But the Department of Health acknowledged that the reform did not bring quick benefits. It said 28.1 million people went to an NHS dentist in England in the year to March - 50,000 fewer than in the previous 12 months. And the number of NHS dentists fell from 21,111 to 21,038.

Health minister Ann Keen said the reform helped the NHS create services, citing examples in Cumbria, Lincolnshire and Cornwall. "Putting right nearly two decades of deterioration in NHS coverage is not the work of 12 months. It will take longer to develop services to a position where all primary care trusts are able to meet local requirements fully," she said.

But Liz Phelps from Citizens Advice said: "Even by the government's own estimate there are still two million people trying to get NHS dental treatment who can't find a dentist."

Peter Ward, chief executive of the British Dental Association, said: "This first year report on the new untested contract for dentists justifies our concerns and will do little to rebuild trust ... The government must start listening to the profession [What an optimist! Doesn't he realize that bureaucrats know best?] and patients if local commissioning is to provide the services that local communities deserve."


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