Saturday, October 13, 2007

Corrupt NHS hospital

The NHS has become a honeypot for bureaucrats -- particularly if they are incompetent. Sick people are bottom priority

The Health Secretary has instructed an NHS trust at the centre of a super-bug scandal to withhold a redundancy payment to its departing chief executive amid the possibility of a criminal investigation. Rose Gibb left her job as head of Maidstone and Tunbridge Wells NHS Trust last Friday, days before a damning report revealed that mismanagement of an outbreak of Clostridium difficile had contributed to more than 90 deaths at the trust. The investigation by the Healthcare Commission, published yesterday, found “significant failings” in infection control at every level of the organisation and was heavily critical of the management regime by Ms Gibb during the worst outbreaks ever recorded of C. difficile.

Alan Johnson made the request to postpone any severance payout amid rumours that Ms Gibb could expect to receive 500,000 pounds or more after serving in her post for four years. Annual accounts showed that she earned around 150,000 in salary, 5,000 in benefits and 12,500 in pension in 2006-07.

Mr Johnson said yesterday morning that the circumstances leading to the deaths had been a “scandal”, before announcing last night: “I have instructed the trust to withhold any severance payment to the former chief executive of Maidstone and Tunbridge Wells NHS Trust, pending legal advice.” The Department of Health said that it was consulting lawyers to confirm whether the Secretary of State had powers to prevent such a payment. “We believe this is an unprecedented case,” a spokeswoman said. “It’s usually up to the trust to decide payments to its staff.”

Meanwhile, the Health and Safety Executive (HSE) met Kent Police yesterday to discuss whether to bring criminal charges against the trust or Ms Gibb as an individual. Lawyers said yesterday that the trust or Ms Gibb could be charged under existing criminal or health and safety law, but recent changes to make organisations more accountable for deaths under the new offence of corporate manslaughter will not come into force until April next year. A spokeswoman for the HSE said: “We look for evidence admissible in court whether there has been any breach of law by the corporation. “If you can prove that, then you could also prosecute those in charge, such as the directors or chief executive. There you are looking for evidence that by deliberate action of those in charge, the breach occurred.” Deliberate action would mean that the chief executive or directors knew that people could die or an adverse outcome could occur from a breach of the Health and Safety at Work Act.

A spokesman for Kent Police added: “We are in the process of reviewing the contents of the report given to us by the Healthcare Commission. Until such stage we have digested the contents of the report, we cannot say we are going to fully investigate this. We have got to review it first. The purpose of the review is to see if any criminal acts have taken place.” He said that if any criminality was found, police would gather evidence and liaise with the Crown Prosecution Service.

Appalling hygiene standards at Kent & Sussex Hospital, Pembury Hospital and Maidstone Hospital resulted in C. difficile contributing to 345 deaths, of which it was directly linked to 90. More than 1,100 patients were infected at the hospitals over a two-year period, the Healthcare Commission found.

The trust has refused to disclose how much money Ms Gibb received after leaving, but it is understood that managers in a similar position have been awarded up to 900,000 pounds. A spokesman for the trust said yesterday: “As with any employee, the financial arrangements are confidential.” In a statement last week the trust chairman and Ms Gibb said that they had “agreed that this is the right moment for her to move on”. It said that she was leaving to “pursue new challenges”.

Geoff Martin of the campaign group Health Emergency said that the intervention by Mr Johnson had been “absolutely right and proper”. “A severance payment should never have been considered in the first place,” he said. “I have heard from Maidstone NHS staff this morning that [she] is rumoured to have received a massive payoff from the trust. “If it’s true, we have a right to know how much taxpayers’ money is involved and it would fuel the scandal even more if it turns out that senior managers have walked away from this carnage with their pockets stuffed with NHS cash.”


Australia: Public hospital gridlock kills

TWO patients with lung cancer went undiagnosed although early signs of the disease had been detected on X-rays but not reported to the referring doctors at Liverpool Hospital. The hospital has a huge backlog of scans that have not been interpreted by radiologists. It has emerged that emergency patients are being called back months after being examined.

As evidence of the state's health woes continues to mount, the embattled Health Minister, Reba Meagher, declared yesterday that she trusted the word of nurses over that of a senior doctor in the case of an elderly patient at Royal North Shore Hospital who was moved out of a ward and into a treatment room overnight. Tony Joseph, the hospital's head of emergency, who is also the NSW chairman of the Australasian College for Emergency Medicine, said that Ms Meagher should admit that hospital emergency departments were in chaos.

Meanwhile, the director of radiology at Liverpool Hospital, Glen Schlaphoff, confirmed that two patients examined at the hospital in the past two years had early signs of lung cancer that were detected on X-rays but not reported to the referring doctors. He said one of the patients, X-rayed last year, had died and the second, seen this year, was still living. In both cases, X-rays had revealed a cancerous lump in the lung. "The nodule was reported and a report issued, but the doctor team that requested the report never saw the report," Dr Schlaphoff said.

Investigations into both incidents had blamed the hospital's paper-based system for the failure to pass on such crucial information. He said he had campaigned for four years to have an electronic system of reporting radiology examinations. This would be installed by next year. A senior staff member, who did not want to be named, said that at best X-ray reports were completed within several days of examination, but "there are examples of reports that come to us with significant findings that come to us months after the person has passed through the emergency department. You are left in an awkward position of having to contact the person and calling them back to the hospital." While most doctors were trained in how to read an X-ray, "radiologists are able to detect more subtle findings". The Herald reported on Saturday that the hospital's official estimate of the backlog was 4500 images that had not been reported on by a radiologist.....


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