Tuesday, August 25, 2009

Authoritarian State medicine in Britain

You have no choice!! Our bureaucratic rules are supreme!! Mother dies a year after being denied her daughter's kidney

A mother who was denied a kidney transplant from her dying daughter because of rules banning donor requests has died. Rachel Leake, 41, had been in hospital for three months with septicemia. Her 21-year-old daughter Laura Ashworth had wanted to give her a kidney, but died in April last year before starting the process of becoming a 'living donor'. Doctors then insisted her organs go to strangers at the top of the waiting list.

Mrs Leake spoke out to condemn the rules and the Government announced a change to the law in March, allowing donors to choose who gets their organs after they die if there is no critical need for them nationally.

Mrs Leake first underwent a kidney-transplant in 2003, but the organ failed. Her daughter regularly spoke to friends and family about donating one of hers, but Mrs Leake refused to take her up on the offer because of her young age. Miss Ashworth then collapsed in her mother's arms after suffering an asthma attack and died because her brain was starved of oxygen.

When a friend of the family asked if a kidney could be used to help Mrs Leake she was told: 'There's a law which prevents directed donorship'. Miss Ashworth was carrying a donor card and her kidneys were given to men in Sheffield and London and her liver to a 15-year-old girl.

Mrs Leake hoped instead to get a kidney from her sister Carole Saunders, 52, but her continuing health problems meant the operation wasn't able to go ahead. Her health deteriorated further and she died at Bradford Royal Infirmary.

Mrs Leake, who was a diabetic, had been admitted for treatment because of an infection in her feet due to poor circulation. Relatives said the circulation problem would have been eased if she had received her daughter's kidney last year. But it is not known if or to what extent her death was related to her need for a transplant.

Mrs Saunders said: 'She had no fight left in her, to be honest, when she lost her daughter. We are all devastated, absolutely devastated. 'Rachel was a lovely, lovely person, a beautiful woman and a friend to so many people. She had a big heart. She was very caring and even though she had a lot of problems herself and suffered an awful lot of pain she still had time to listen to other people.' When her daughter died Mrs Leake took over the job of caring for her granddaughter Macie, despite her own poor health.

She lobbied her local MP and said: 'I am angry, really angry. I am not finding comfort at the moment in the fact that she helped three people. 'All I wanted to do was carry out her wishes. She would have been so upset that she was able to help other people and not her own mum. 'Everyone has gone mad and everyone is disgusted. The thing that hurts the most is how Laura would feel. She would be devastated that she was not able to help me.'


British Heart patients missing out on life-saving care after surgery

Two thirds of heart-attack survivors are not getting promised follow-up advice and treatment that could help them to live longer, a charity’s report says today

A national audit commissioned by the British Heart Foundation found that only 34 per cent of 83,500 heart attack victims took part in a cardiac rehabilitation programme after coming out of hospital.

The Government pledged to offer it to 85 per cent of heart patients by 2002 but seven years on, the audit for England, Wales and Northern Ireland, found that overall only 38 per cent of heart patients attended cardiac rehabilitation. The figure was only 30 per cent of those who underwent an angioplasty and 68 per cent for those who had heart bypass surgery.

A shortage of cardiac nurses and other therapists means that those who do receive the care get only one third of the recommended hours of physiotherapy. Women were found to be significantly underrepresented in the programme, accounting for only 28 per cent of those who received follow-up treatment.

Every year about 270,000 people in Britain suffer a heart attack. Coronary disease remains the country’s biggest killer.

Previous studies have shown that rehabilitation — typically a 6 to 12-week programme involving nurses, physiotherapists, dieticians, psychologists and occupational therapists — gives heart-attack patients a 26 per cent greater chance of surviving after five years.

The £600-per-patient treatment has also been shown to improve quality of life, decrease anxiety and reduce future hospital admissions. Mike Knapton, associate medical director at the foundation, said that the NHS was falling short of the goals outlined in the National Service Framework for treating heart disease in 2000. There has been no significant increase in the proportion of patients referred to the services, despite the 85 per cent target set by the framework.

“Recovery from a heart attack isn’t over when a patient leaves hospital and heart patients should be receiving the ongoing support they need,” Dr Knapton added. “Referral to cardiac rehabilitation should be a routine part of treating heart patients.”

The report’s author, Professor Bob Lewin, from the University of York, said that many people were simply not aware that rehabilitation services exist. He added that a third of patients who were offered the service turned it down, but said this was worrying.

“Why wouldn’t you be interested in a service that could prolong and improve your life? It is important that all of the staff within the NHS understand the benefits of cardiac rehabilitation and communicate how important it is to their patients.”

The Department of Health said that cardiac rehabilitation services were a matter for local trusts, adding: “We have made substantial progress in treatment ... and have already met our target to reduce deaths from cardiovascular disease by 40 per cent in people under 75 by 2010.”


Australia: Huge Queensland ambulance foulup (1) -- one of three such reported in one day

Girl, 8, died after life-saving defibrillator removed from ambulance. Since the Leftist Queensland State government took over the ambulance service some years ago and made it "free" for all, serious problems have never stopped coming, despite various "reforms" and "overhauls". Some of the problems stem from a typically Leftist love of centralization, with local call centres being abolished and operators in the newly centralized locations being made responsible for distant cities that they know nothing about. That is the exact opposite of what is actually needed. Another example of how disastrous government involvement in medical services can be. There are similar reports from other Australian States -- particularly Victoria

An eight year-old Gold Coast girl in cardiac arrest died after life-saving equipment was removed from the ambulance sent to treat her. Documents obtained by The Courier Mail under Right to Information laws show that the ambulance arrived without a defibrillator – a device used to restore the heart beat – because it had been taken out at the station for training purposes.

A report into the incident, which occurred on December 2, 2007, said the address was less than 3km from the station and an advanced care and student paramedic reached the scene within three minutes. "On arrival the officers identified that they had left the portable resuscitation kit and defibrillator at the station after it had been removed for the purposes of undertaking training," the report said.

"The officers reported that during CPR, copious amounts of vomit was 'flowing from the airway during cardiac compressions'. "Normally the airway would have been suctioned using the suction device in the portable resuscitation kit, however this was not available."

Two more crews were sent and arrived four and seven minutes later, but the girl's pulse was already "unrecordable" and "skin cold". "The patient was transported to hospital and was pronounced deceased a short time after," the report stated. "The officer who removed the equipment was under the impression that they would be the last crew out.

"The officer-in-charge confirmed that it was normal practice (to) remove equipment for training from the spare unit . . . when a spare vehicle was not available equipment would be removed from an operational vehicle."

The investigation concluded that it was "beyond the scope of this investigation to determine if the absence of the oxygen resuscitation kit and defibrillator contributed to the inability to successfully resuscitate the child". However, the absence was "unlikely to have had a significant bearing on the outcome of the patient".

Emergency Services Minister Neil Roberts said the defibrillator should have been there, but evidence suggested the girl would have died anyway. "The Coroner actually investigated that matter as well and there were no adverse findings to the QAS," he said. However, neither his office, nor the Coroner would provide a copy of the report.

Australasian College for Emergency Medicine Queensland chairman David Rosengren said defibrillators were the key to preventing death in this instance, but cardiac arrests were generally a life-ending event. "Everybody knows somebody who's had a cardiac arrest and been resuscitated and survived but they are clearly in the minority," he said.


Australia: Huge Queensland ambulance foulup (2) -- one of three such reported in one day

LORRAINE Silman watched her husband die while a misdirected ambulance took 45 minutes to find their Mackay home. Bob Silman, 63, a wedding photographer and sugar mill groundskeeper, was stricken with a heart attack on November 2 last year and could not be revived. A dispatcher in another city ignored Mrs Silman's directions and sent paramedics to an address that didn't exist.

"The ambulance officer can't be blamed. The system failed us," Mrs Silman said. "If they'd got there in the time frame they should have, he would have stood a chance." Mrs Silman kept her husband alive at their Pleystowe home for 15 minutes using CPR while the ambulance was lost.

Mr Silman left behind his wife of 40 years, three children and three grandchildren. He didn't live to see a fourth grandchild born. Neighbours knew him as the generous man who gave away the vegies he loved to grow and entertained their children in a Santa suit at Christmas

Daughter Alison Silman said it was "an absolute joke" that ambulances didn't have GPS devices and couldn't find homes in well-established areas close to urban areas. "In this day and age, they should be able to know where to respond," Ms Silman said. "This is happening too often. It's not good enough. People's lives are on the line."

The ambulance centre had never corrected a typographical error showing the Silmans lived at No. 2 Griffiths St, when no such address existed. The family lived at No. 20. The family called twice to have the address corrected. Mrs Silman said the ambulance was also told by the family not to cross a landmark bridge and did not send a vehicle from the closest station. "They kept asking me if I was in Miriam Vale. That's nowhere near here," Mrs Silman said. "My husband was dying in front of me. I told the woman I had to get off the phone." Although the station was only 13 minutes away, it took 40-45 minutes, she said. "When they got there, he'd passed away," she said.

Stress after her husband's death took such a toll on Mrs Silman she needed to be hospitalised two weeks later. Her daughter said the family drove her to the hospital rather than risk another ambulance miscue. "I wouldn't trust them," Alison said. "I just lost my dad. I wasn't going to lose my mother too."

The family said they were frustrated to learn a cadet officer in Rockhampton took their emergency call and a mentor supervisor didn't listen to the call.

Mrs Silman has difficulty dealing with the experience and still doesn't sleep well. "It's hard to get through the trauma of that day. I don't think I'll ever get over it. I don't wish any other family to have to go through it," she said. She was frustrated ambulance staff were not more knowledgeable about places they were responsible for.

The Member for Mirani, Ted Malone, the shadow minister for emergency services, raised concerns about the Silman death in Parliament in December.


Australia: Huge Queensland ambulance foulup (3) -- one of three such reported in one day

Paramedic quits after being sent to the wrong city. Once again it's the management, not the men on the frontline who are at fault

PARAMEDICS were ready to break into a Mackay home to treat a suspected heart attack victim when they learned the emergency was actually in Brisbane. Eric Fleissig who later quit the Queensland Ambulance Service in disgust at its management and working conditions, said he was met by a startled and confused person when he attended a Code 1 emergency call. He said he went to an address provided by ambulance dispatchers where the resident told him he knew nothing about an emergency.

The paramedics queried the communication centre, which then realised that the street name was correct but the emergency was in the Brisbane suburb of Ashgrove and not the Mackay suburb of Andergrove. "It happens all the time," Mr Fleissig said. Paramedics say the QAS hasn't done enough to make sure the best maps and direction-finding equipment are available, or to train communications staff who know their areas.

QAS Commissioner David Melville said dispatch systems were not perfect but Queenslanders were given the best possible service regardless of where they lived. "I'd like to think we will get it perfect, but I can't give you a 100 per cent guarantee on it," he said. "We try to give the best possible service no matter where people are." [But HOW HARD do you try? Not very, given the frequency of stupid and dangerous foulups. As well as the three reported today, there was another one reported just a couple of days ago]


What Soviet Medicine Teaches Us

In 1918, the Soviet Union became the first country to promise universal "cradle-to-grave" healthcare coverage, to be accomplished through the complete socialization of medicine. The "right to health" became a "constitutional right" of Soviet citizens. The proclaimed advantages of this system were that it would "reduce costs" and eliminate the "waste" that stemmed from "unnecessary duplication and parallelism" — i.e., competition. These goals were similar to the ones declared by Mr. Obama and Ms. Pelosi — attractive and humane goals of universal coverage and low costs. What's not to like?

The system had many decades to work, but widespread apathy and low quality of work paralyzed the healthcare system. In the depths of the socialist experiment, healthcare institutions in Russia were at least a hundred years behind the average US level. Moreover, the filth, odors, cats roaming the halls, drunken medical personnel, and absence of soap and cleaning supplies added to an overall impression of hopelessness and frustration that paralyzed the system. According to official Russian estimates, 78 percent of all AIDS victims in Russia contracted the virus through dirty needles or HIV-tainted blood in the state-run hospitals.

Irresponsibility, expressed by the popular Russian saying "They pretend they are paying us and we pretend we are working," resulted in appalling quality of service, widespread corruption, and extensive loss of life. My friend, a famous neurosurgeon in today's Russia, received a monthly salary of 150 rubles — one third of the average bus driver's salary.

In order to receive minimal attention by doctors and nursing personnel, patients had to pay bribes. I even witnessed a case of a "nonpaying" patient who died trying to reach a lavatory at the end of the long corridor after brain surgery. Anesthesia was usually "not available" for abortions or minor ear, nose, throat, and skin surgeries. This was used as a means of extortion by unscrupulous medical bureaucrats.

To improve the statistics concerning the numbers of people dying within the system, patients were routinely shoved out the door before taking their last breath.

Being a People's Deputy in the Moscow region from 1987 to 1989, I received many complaints about criminal negligence, bribes taken by medical apparatchiks, drunken ambulance crews, and food poisoning in hospitals and child-care facilities. I recall the case of a fourteen-year-old girl from my district who died of acute nephritis in a Moscow hospital. She died because a doctor decided that it was better to save "precious" X-ray film (imported by the Soviets for hard currency) instead of double-checking his diagnosis. These X-rays would have disproven his diagnosis of neuropathic pain.

Instead, the doctor treated the teenager with a heat compress, which killed her almost instantly. There was no legal remedy for the girl's parents and grandparents. By definition, a single-payer system cannot allow any such remedy. The girl's grandparents could not cope with this loss and they both died within six months. The doctor received no official reprimand.

Not surprisingly, government bureaucrats and Communist Party officials, as early as 1921 (three years after Lenin's socialization of medicine), realized that the egalitarian system of healthcare was good only for their personal interest as providers, managers, and rationers — but not as private users of the system.

So, as in all countries with socialized medicine, a two-tier system was created: one for the "gray masses" and the other, with a completely different level of service, for the bureaucrats and their intellectual servants. In the USSR, it was often the case that while workers and peasants were dying in the state hospitals, the medicine and equipment that could save their lives was sitting unused in the nomenklatura system.

At the end of the socialist experiment, the official infant-mortality rate in Russia was more than 2.5 times as high as in the United States and more than five times that of Japan. The rate of 24.5 deaths per 1,000 live births was questioned recently by several deputies to the Russian Parliament, who claim that it is seven times higher than in the United States. This would make the Russian death rate 55 compared to the US rate of 8.1 per 1,000 live births.

Having said that, I should make it clear that the United States has one of the highest rates of the industrialized world only because it counts all dead infants, including premature babies, which is where most of the fatalities occur.

Most countries do not count premature-infant deaths. Some don't count any deaths that occur in the first 72 hours. Some countries don't even count any deaths from the first two weeks of life. In Cuba, which boasts a very low infant-mortality rate, infants are only registered when they are several months old, thereby leaving out of the official statistics all infant deaths that take place within the first several months of life.

In the rural regions of Karakalpakia, Sakha, Chechnya, Kalmykia, and Ingushetia, the infant mortality rate is close to 100 per 1,000 births, putting these regions in the same category as Angola, Chad, and Bangladesh. Tens of thousands of infants fall victim to influenza every year, and the proportion of children dying from pneumonia and tuberculosis is on the increase. Rickets, caused by a lack of vitamin D, and unknown in the rest of the modern world, is killing many young people.

Uterine damage is widespread, thanks to the 7.3 abortions the average Russian woman undergoes during childbearing years. Keeping in mind that many women avoid abortions altogether, the 7.3 average means that many women have a dozen or more abortions in their lifetime.

Even today, according to the State Statistics Committee, the average life expectancy for Russian men is less than 59 years — 58 years and 11 months — while that for Russian women is 72 years. The combined figure is 65 years and three months.[1] By comparison, the average life span for men in the United States is 73 years and for women 79 years. In the United States, life expectancy at birth for the total population has reached an all-time American high of 77.5 years, up from 49.2 years just a century ago. The Russian life expectancy at birth is 12 years lower.[2]

After seventy years of socialism, 57 percent of all Russian hospitals did not have running hot water, and 36 percent of hospitals located in rural areas of Russia did not have water or sewage at all. Isn't it amazing that socialist government, while developing space exploration and sophisticated weapons, would completely ignore the basic human needs of its citizens?

More here

Sen. Lieberman: Postpone Universal Healthcare

One of the Senate's most powerful Democrats said Sunday that President Obama should take an "incremental" approach to fixing health care and argued that the country should postpone adding nearly 50 million new patients to the government system until after the recession is over.

"We morally, every one of us, would like to cover every American with health insurance," Sen. Joseph Lieberman of Connecticut, told CNN's John King on the "State of the Union" program.

"But that's where you spend most of the $1 trillion plus, a little less that is estimated, the estimate said this healthcare plan will cost," he said.

"I'm afraid we've got to think about putting a lot of that off until the economy's out of recession," he added.

"There's no reason we have to do it all now, but we do have to get started. And I think the place to start is health delivery reform and insurance market reforms."

John King asked Lieberman if it was "time for the president to hit the reset button? Forget sweeping healthcare reform this year, do three or four incremental things that are less costly?"

Lieberman responded: "In a word, yes. I don't think -- I give the president tremendous credit for taking on the healthcare problem. And it really is a problem that we've got to deal with. But he took it on at a very difficult time that was not of his making.

"In other words, we're in a recession. People are very worried about their jobs, about the economic future. They've watched us add to the debt of this country. We're projected to run a $1.8 trillion deficit this year, September 30th, more than $1 trillion next year. You mentioned the 10-year numbers. People are nervous, I think the protests coming out at the public meetings around the country this month are as much to do with that larger environment as they are with questions about healthcare reform. I think great changes in our country often have come in steps. The civil rights movement occurred — changes occurred in steps. Let's focus now on how to reduce costs. That's been a central theme of the president.

"Let's talk about how to change the way health care is delivered. Let's talk about protecting people from not getting insurance because of pre-existing illness. Let's take off the caps on the amount of insurance coverage you can get over the years. Let's pay for preventive services for health from the first dollar. Here's the tough one. We morally, every one of us, would like to cover every American with health insurance. But that's where you spend most of the $1 trillion plus, a little less that is estimated, the estimate said this healthcare plan will cost."

Lieberman also said he oppose any attempt his colleagues to use a Senate maneuver called "reconciliation," in which only 51 votes — rather than 60 — would be needed to overcome opposition to a health care bill.

"I think it's a real mistake to try to jam through the total health insurance reform, healthcare reform plan that the public is either opposed to or of very, very passionate mixed minds about," he said. "It's just not good for the system, frankly, it won't be good for the Obama presidency."


No comments: