Wednesday, July 08, 2009

Diary of despair of old lady who died in 'zoo' NHS hospital after 'catalogue of blunders by staff'

A horrifying journal of the neglect a great-grandmother suffered in hospital has been published by her family. Betty Dunn, 79, was admitted with a routine stomach problem but died six weeks later after a string of medical errors. During this time her relatives compiled the diary detailing her ordeal in a ward they grimly nicknamed the 'zoo'. The dossier tells how Mrs Dunn was:

* Given medication containing penicillin - despite warnings that she was allergic to it;

* Forced to sleep on a bare mattress;

* Made to wait 40 minutes for a bedpan;

* Treated by staff who could barely speak English;

* Made to eat a food substitute against medical advice.

At one stage, the mother- of-four's children became so desperate that they called the police for help but were told nothing could be done. In a final insult, the news that Mrs Dunn was dying was broken to her daughters in a busy corridor in front of other visitors.

The wartime Land Girl was being treated on a mixed-sex ward divided into bays at Tameside Hospital, in Ashton-under-Lyne, near Manchester. Labour had pledged to scrap this type of patient accommodation.

'The ward where mum was treated was like a zoo, and we called it that afterwards,' said her daughter, Liz Degnen, 49, today. "It was manic and chaotic with people running around like headless chickens. 'It doesn't matter if you're 79, 29, or 109, the way the hospital treated her was disgraceful. Every aspect of her care was just terrible. The staff did their best but there were not enough of them to cope. It's a scandal that hospitals can operate like this in this day and age.'

Mrs Dunn, a former dinner lady from Gamesley, near Glossop in Derbyshire, was admitted to Tameside on January 4 with complications from a stomach bug. 'On the night she was admitted for treatment mum was waving and blowing kisses and saying "See you, love",' said Mrs Degnen, a teaching assistant. 'Yet when we left for a few hours we came back to find her slumped across a bedside trolley. Her eyes were at the back of her head, rolling about.'

Her children responded by keeping a round-the- clock vigil and documenting the care she was given. They noted that one nurse even refused to change a faulty drip because she was about to go off duty. A few days later came the mix-up over the penicillin. 'At this point we were in tears,' one of the sisters wrote in the diary.

'Mum had yet again missed another dose, this was the final straw.' Mrs Degnen said yesterday: 'We didn't feel like they were listening to us. They were making blunder after blunder in our face. 'We could see there were other patients not being cared for. We tried to communicate with the staff but some of them couldn't even speak English'

Mrs Dunn's condition appeared to stabilise but on January 21 her family were told she had contracted C. diff. They had nursed her themselves without being offered protective gloves or aprons to guard against such infections. She recovered sufficiently however to be transferred to a local hospital only to deteriorate again and be moved back to Tameside. Five days later she died from complications caused by the hospital bug.

The hospital insists doctors were right to prescribe antibiotics containing penicillin as it was felt that the benefits would outweigh any minor side-effects. A spokesman said: 'We acknowledged and apologised for the shortcomings in Mrs Dunn's care. We would reiterate the apology here.' Staff have been sent for retraining or are having their performance monitored.

In 2006, a coroner condemned the hospital after four elderly patients died in agony following what he called 'despicable and absolutely chaotic' treatment.


British man died of heart attack while cowardly paramedic stood outside and conducted a "risk assessment"

An open door frightened him!

A grandfather died of a heart attack while an emergency paramedic stood outside his home for 16 minutes, making a risk assessment. The family of Roy Adams, 60, claimed yesterday that he might have survived if the paramedic had entered immediately. London Ambulance Service said that it had begun an investigation into the circumstances of the delay.

Mr Adams, a chauffeur for the Metropolitan Police, dialled 999 complaining of breathing problems and chest pains just after midnight on June 29. He was told by the operator to leave his front door open so an ambulance crew could get to him quickly.

However, a paramedic who arrived six minutes later and saw the door open feared that the property was being burgled. He stayed on the doorstep carrying out a “risk assessment exercise” before calling police for support. When he entered the property, 16 minutes after arriving, he found Mr Adams in the front room of his home in Morden, South London. Mr Adams was not breathing and was dead when he reached hospital.

His daughter, Sarah Adams, 23, said: “It makes me feel sick to think that the paramedic waited outside for 16 minutes. They thought he was having a heart attack but didn’t go in. He was told to leave the door open, so I can’t understand how it was a surprise for the medic. The delay might have made all the difference. “I don’t understand what health and safety worries meant this man couldn’t help my dad. He was dying.”

Ms Adams said that the family was planning to sue the ambulance service. “No one has apologised to us for what has happened,” she said. “I would at least expect a letter or something like that — but I still want to take them to court.”

A spokesman for London Ambulance Service said that two “single responders” had been sent to the address in cars, an ambulance crew and a duty officer. “The first member of our staff to arrive carried out a full on-scene risk assessment and requested police assistance due to safety concerns,” the spokesman said. “He then took the decision to enter the property alone, while maintaining telephone contact with our control room. “We are looking into the incident and are in the process of contacting Mr Adams’s family to discuss things further.”

Concerns have been raised about the increasing use of solo paramedics as two-person crews were split up before the introduction of new government targets in April last year. Under the new targets, three quarters of the most serious emergencies have to be met within eight minutes of a 999 call being answered.

Ben Bradshaw, then a junior health minister, denied in December 2007 that “single responders” would put patients at risk. He said they could help to free resources and that emergency calls would be responded to more quickly.

Miss Adams added: “Why would you stand outside carrying out this risk assessment when you know an old man is inside with a serious medical emergency? My dad had been instructed to put the doors on the latch by the operator. Vital minutes were wasted. He might well have survived if the medic had gone in and treated him as soon as he arrived.”

The ambulance service spokesman described the risk assessment as a “mental checklist” which included considering the safety of the scene, types of risk and whether extra help or equipment was required. “We have a duty of care to treat patients but we also have to look after our staff,” he said. “In this case the medic conducted the assessment, had safety concerns and decided to call for back-up.”


Australian Feds trying to reduce government support for IVF

As the father of an IVF son, I wholeheartedy endorse the views below. I took no notice of the money cost of my heroic wife going through 10 IVF treatment cycles in a private clinic and have no clue what that cost was, but not everyone can afford to take that attitude

WHY are we paying the $5000 baby bonus to anyone who can get themselves knocked up, but taking money away from those who really want a baby, but can't conceive naturally? That's right. The Federal Government is planning to restrict Medicare funding for IVF, which could put the fertility treatment out of the reach of ordinary Aussies.

Most IVF users are devoted couples who deserve what the rest of us take for granted - a baby. I have watched many of my friends struggle - sometimes for years - to become parents. I have shared with them the highs, the lows, the pain, and the joy of IVF and other fertility treatments. Most have got there eventually - sometimes naturally after years of invasive medical treatments.

Others have had cycle after cycle of IVF and conceived only when they were on the verge of giving up - a miracle of medicine that has turned a couple into a family, and made them feel whole. Just one kid is enough to allow them to enter the magical world of parenthood - the trips to the park, the school days, the Friday night family dinners, cheering at sports matches, the school soccials, the children and the grandchildren.

It's a reminder that although my kids get me down at times, I know I am very lucky to have them. With three kids in 5 1/2 years, our fertility is a family joke. But our kids are a blessing for which I am grateful every day, and I want others to have the same chance. Surely having a baby is a basic right worth fighting for?

Why, then, would we ever think of restricting access to IVF just to those who can afford it? I hope this message gets across loud and clear in this week's Senate hearings on the issue. Let's not forget what the Federal Government change is estimated to do - triple the price of IVF, and thus put it out of reach of most middle-income Aussies. According to IVF rights campaigner Sandra Dill, from Access Australia, out-of-pocket expenses per cycle could be $3000 - up from $1000 at the moment. When you consider most people need two or three cycles to become pregnant, it's just not affordable.

I don't think fertility treatment is something that should just be the preserve of the rich, and not the rest. We'd end up like the US where the rich pay hundreds of thousands to buy a baby, rent a womb or choose the sex of their offspring, and the rest can barely afford to see a GP, let alone a fertility expert.

Federal Health Minister Nicola Roxon - herself a mother - says the Government is trying to crack down on doctors overcharging patients. But why not focus on the doctors rather than penalise the patients? We mustn't forget that IVF isn't just another medical procedure curing ingrown toenails or broken arms. And so we must fight for the right of 11,000 babies to be born every year to parents who desperately want to have kids, but can't for medical reasons.

After all, IVF is now mainstream - 3 per cent of all births are by assisted reproduction these days. Forget the Wacko Jackos and rent-a-womb Hollywood superstars. The "right to IVF" debate should instead be about the couple next door, and their right to have the baby they've always wanted.


The forbidding arithmetic of healthcare reform

THE FUZZY math behind the Massachusetts universal healthcare law is starting to add up - just as Washington studies the law as a possible model for the nation.

Because of a recession-related drop in state revenues and a surge in enrollment by the recently unemployed, the truth is emerging at an inconvenient time. Massachusetts doesn’t have enough money to pay for the coverage envisioned by the law. In June, state officials announced they are cutting $100 million from Commonwealth Care, which subsidizes premiums for needy residents. The poorest residents, along with the newest - legal immigrants - will take the hit.

This outcome is not surprising, but it is instructive as President Obama pushes for a national healthcare plan. On the day that Republican Governor Mitt Romney, for once, made Bay State Democrats happy, by signing the sweeping new healthcare bill into law, the Globe headline said it all: “Joy, worries on healthcare. As Romney signs bill, doubts arise about revenues.’’

In Massachusetts, the numbers never added up, as everyone involved in crafting the new law understood. But for a variety of reasons, ranging from Romney’s presidential aspirations to Senator Edward M. Kennedy’s longstanding commitment to healthcare reform, everyone smiled for the cameras and hoped for the best out of this noble experiment.

Today, the current governor, Deval Patrick, a Democrat, is skeptical about the end product. Asked during a televised town hall meeting in March if he believes national healthcare legislation should be patterned after the Massachusetts plan, he said, “I don’t know. I had real misgivings about it as a candidate. . . . I’m proud of it, but I don’t know if it’s a model for the nation.’’

The foundation of the Massachusetts law is the so-called individual mandate. That means everyone must have health insurance. From that perspective, the Massachusetts experiment is a success. The percentage of residents without insurance was down to 2.6 after two years. But, the law never provided an absolute way to pay for the expanded coverage, and it never addressed how to reduce costs. “They decoupled the access issue from the cost issue,’’ said Philip Johnston, chairman of the Blue Cross Blue Shield of Massachusetts Foundation, which played a key role in expanding healthcare coverage here. “The lesson is, there needs to be a dedicated revenue source to support health reform.’’

An even bigger lesson is that to make health reform happen, all the players must be invested from the start - and must stay invested. “Getting it done is politics. That means dealing with all the elements that are necessary for near-universal access and cost management, but not overreaching in any one area, so that major stakeholders turn from supporting the effort to opposing it,’’ said John Sasso, who represented Partners Healthcare, the largest healthcare provider in Massachusetts, and Blue Cross Blue Shield, the state’s largest insurer, during the reform process. The stakeholders are still at the table, trying to make the numbers work better, he points out.

It’s true that Massachusetts built a dream house of a healthcare plan, without knowing the exact cost or how to pay for it. But that doesn’t mean it should be dramatically downsized, as state Treasurer Timothy P. Cahill proposes as he positions himself for a gubernatorial run.

A recent report by the Massachusetts Taxpayers Foundation, a business-funded group that advocated for the healthcare law, found that state spending increased by about $88 million annually since it was implemented. Is that too much to absorb, within the context of a $28 billion state budget?

As Patrick also said about the state’s healthcare law at that town hall meeting, “The great story about Massachusetts is instead of waiting for the perfect solution . . . or doing nothing . . . we tried something.’’

Washington can’t be as adventurous. Costing out a national healthcare plan, and figuring out how to fund it, is the current fault line for Obama. The president insists he can overhaul the healthcare system without adding to the deficit. He should take this final lesson out of Massachusetts: Be honest about cost in the good times and make sure you can cover it in the bad.


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