Cancer patient with months to live wins court order for last-chance drug on NHS

A cancer patient yesterday won a legal battle against the NHS to be given a drug that doctors say could prolong his life by up to three years. Colin Ross, 55, of Horsham, West Sussex, has multiple myeloma, a cancer of the blood cells, and was not expected to survive to see Christmas unless he was given a drug described as his “last chance”. The High Court overruled the decision by West Sussex Primary Care Trust that treatment would not be cost-effective, and said that Mr Ross should receive Revlimid as an exceptional case.

Mr Ross had incurable cancer diagnosed in May 2004. In an interview with The Times last month he said that he was “sickened” that he was being denied the $60,000-a-year treatment even though the drug was available to patients living only a few miles away in East Sussex. But despite the exhortations of doctors treating Mr Ross at the Royal Marsden Hospital, the specialist cancer hospital in London, the trust had, since March, repeatedly refused to fund the drug, raising the issue of a so-called postcode lottery for NHS treatments.

However, Judge Simon Grenfell, sitting in London, condemned the trust’s decision yesterday as “one which no reasonable authority could have made on the application before it”. Revlimid is among the most expensive of new cancer treatments and is readily available to patients across Europe and in the United States and Scotland. But it has not yet been granted approval by the National Institute for Health and Clinical Excellence (NICE) and, because of the cost, is likely to be rejected. It is provided by only some trusts in England and then only in exceptional circumstances.

The case is likely to encourage other cancer patients who may have been denied expensive drugs on the NHS, but experts emphasise that the case does not set a legal precedent and that decisions will be taken case by case in other areas. The judge issued an emergency injunction to enable Mr Ross to begin treatment today, but the ruling was made on an interim basis pending a further appeal and not as the start of permanent treatment.

Mr Ross was too ill to attend court for the ruling but his long-term partner and carer, Wendy Forbes-Newbegin, 52, who has breast cancer, cried after the victory. She said after the judgment that the family’s treatment by the NHS had been “appalling”. “The mental anguish that we have been through has at times been unbearable, and wholly unacceptable in this day and age,” she said. “Colin’s diagnosis and recent prognosis have been so awful in the first place, but to have to endure all the months of waiting for this life-prolonging treatment has been nothing short of shameful in the first degree.”

Mr Ross, who has two children and four grandchildren, told The Times that he feared that delays incurred by his appeals to the trust and ensuing legal action may have reduced the effectiveness of the treatment. “Depending on what the judges say, I could start treatment with Revlimid, or the doctors will simply refer me to start receiving palliative care,” he said last month. “My bed in the hospice is already booked. I realise the drug is expensive for the NHS, but to think that I could have a few extra months or years to spend with my daughters and watch my grandchildren grow up – I’ve never wanted anything more.”

The former engineer in the oil and gas industry had suffered years of pain and disability from the disease, which made his bones brittle and prone to fracture. He had already been prescribed other drugs on the NHS for myeloma, Thalidomide and Velcade, but was forced to stop taking them because of painful side-effects. Before yesterday’s ruling he was taking a cocktail of painkillers and other drugs “just to keep my head above water”, and was advised that Revlimid was now the only option.

In March, Mr Ross’s clinicians asked West Sussex PCT to fund Revlimid for three to four courses at a cost of $10,000 a course and presented evidence to show that it could give Mr Ross up to three more years of life. He had been unable to purchase the drugs privately, he said. “Even if I could, the law states that I would have to become a private patient and forfeit the rest of my NHS care.”

Richard Clayton, QC, acting for Mr Ross, told the court during a two-day hearing: “This application for this drug is the end of the road for him. Either he gets the drug and is able to have life-prolonging treatment, or he doesn’t and treatment ceases, with inevitable consequences.” He added: “Were the claimant to live a mile and a half in either direction from where he does, he would have received the drug.” West Sussex PCT said that it was considering whether to appeal. [What total, complete and utter assholes!]

Source





Australia: Perverted doctor charged over mutilation of women

This should have been done many years ago -- when the complaints first began. Yet another regulatory failure

A FORMER New South Wales doctor has been charged in relation to alleged sexual assaults and genital mutilations of patients who were undergoing surgery. Graeme Reeves, 58, who was banned from practising obstetrics by the Medical Board in 1997, has been charged with 17 offences against 10 women, Detective Superintendent John Kerlatec said.

Mr Reeves was arrested in the Sydney suburb of Baulkham Hills this morning after extensive investigations into more than 113 allegations of patient misconduct between 2001 and 2003 at Baulkham Hills and at Bega on the state's south coast. The Daily Telegraph was on the scene when Mr Reeves was brought in to a local police station at about 6.45am (AEST) in the back of an unmarked police car.

"It's been a lengthy investigation due to the fact there have been numerous people we've had to speak to including in excess of 100 (alleged) victims and witnesses, medical professionals, plus also examine numerous medical records," Supt Kerlatec said earlier on Macquarie Radio. "We also had to engage our own medical expert to give us advice on the difference between malpractice and what we consider to be criminal action. "This is the first investigation of this size and nature conducted by the NSW Police force and officers are treating the matter very seriously," the Daily Telegraph quoted him as saying.

Police from Strike Force Tarella raided a storage unit allegedly belonging to Mr Reeves last week at Gladesville in Sydney's northwest, where officers allegedly located a raft of medical documents. Mr Reeves is expected to face court today, but police said the probe was continuing. "Today's arrest marks the first phase in this lengthy and complex investigation and inquiries are ongoing," Supt Kerlatec said.

He praised the courage of the former patients of Mr Reeves who had come forward with their allegations. "We were extremely encouraged throughout this whole matter by the strength displayed by these women," he said. "It's been a very traumatic experience for them and it's taken a great deal of courage for them to come forward."

Mr Reeves' appointment by the Southern Area Health Service in 2002 has been examined by Peter Garling SC as part of his wider investigation into the NSW public hospital system. He found that when Mr Reeves applied in 2002 there were "deficiencies" in the system that meant authorities failed to detect he had been banned from practising obstetrics. "I find that Dr Reeves' intentional and calculated dishonesty was the main reason he was recruited to a position he was legally unable to fill," Mr Garling wrote in his report.

Source







Australian public medicine at work

On a day the State Government promised to fast-track compensation for as many of 100 of Graeme Reeves' alleged victims one woman tells her story in the hope of creating a more accountable health system

MY DAUGHTER Sarah was delivered by Graeme Reeves at Hornsby Hospital in 1995 - her heart rate was falling, she was in foetal distress and he didn't care. The nurses kept coming back to me saying he wouldn't come in, he wanted them to fax through a copy of the foetal heart monitoring strip because he didn't believe them. I had visited him earlier that day and had an ultrasound and everything was OK, I went into labour that night and the nurses rang him at home and he said 'You couldn't be in labour, you're only 34 weeks'. He got me mixed up with another woman, I was 38.5 weeks.

By the time he arrived and delivered her, Sarah was dead. She was revived, it took some time before she took her first breath and I never really saw him again after that. Sarah has cerebral palsy. It is quadriplegic spasticity which means it affects all four limbs. She's blind, she has an intellectual disability and epilepsy, she is in a wheelchair, she has no communication and is reliant on me for everything. The midwives gave me my paperwork when I left the hospital and said 'you might need this one day'. It was that comment that kept in my head. At the time I was sleep deprived and Sarah was fighting to survive but they knew. That is the sad part. I know nurses complained, a lot of nurses complained but what happens to nurses who complain? They get crucified.

I don't work any more, Sarah is 24/7 care, I have equipment costs, medication costs, I have to lift her in and out of our car because I can't afford to have a wheelchair conversion done, which is about $25,000. We're in hospital at least once every year for several weeks a year. She has had six hip operations, she had more than 100 per cent scoliosis of the spine.

But as much as our family has suffered, it is Sarah who paid the ultimate price, it is her life. She has been deprived of the life she should have had and, while we're doing everything to give her the best life possible, it is nothing compared to what she should have had. She would have been one of these kids that is always running. Sarah is beautiful and we love her to death but the Government was supposed to be protecting us from people like Graeme Reeves. There is no system to provide that protection. Sarah loves life, she is a fighter, she loves music and people. Going out in the car, going for coffee and shopping are some of her favourite things, she is such a girl.

I wrote to the Health Care Complaints Commission in 1997. They wrote back to me that the public interest had been served, Graeme Reeves was no longer practising as an obstetrician and his gynaecological business was under supervision. I was happy no one else could be injured by this man but I still protested to have my individual case investigated. I did the right thing, I put in a complaint with the HCCC. That was the system and the system didn't work, it doesn't protect anyone. When it came out in the media in February, that's when I learnt they hadn't done what they had said, he had been practicing that whole time and no one had been supervising him. I felt sick.

We took action against Hornsby Hospital and Graeme Reeves and that's when we found out Reeves was theoretically uninsured and bankrupt. I had a statement of claim against Hornsby Hospital. It was at a time when the full history of Dr Reeves wasn't known and we had to withdraw from our action in 2003. I had to sign a consent judgment to release us with no costs, which means I could not make another claim. With all this new information and the fact there were 35 complaints received at Hornsby Hospital between 1986 and 1997, I wanted to apply to make another claim with the Government's insurance company. They have rejected us.

My lawyer wrote to Hornsby Hospital lawyers in July asking for their consent for the judgment in favour of the hospital from 2003 to be set aside. It was the only way I could make another claim and it was met with outright refusal.

Former health minister Reba Meagher said in February: "I want to assure the community the NSW Health system will take responsibility for any failings of public hospitals relating to Dr Reeves' practice." The Government has not fulfilled its duty to protect Sarah and cover her needs. It is not interested in my daughter. I am happy charges have been brought against Graeme Reeves for allegedly assaulting women but it should never have got to this point.

Source